Intimate plastic surgery: correction of age-related changes with injectable drugs
Intimate aesthetic correction procedures are becoming increasingly in demand. Let's look at the capabilities of aesthetic medicine specialists.
For many years, Ukrainian women largely did not seek professional medical help and perceived physiological changes in the anogenital area as a proper and inevitable part of aging. This is due, on the one hand, to the lack of awareness among patients about the possibility of correcting problems in the intimate sphere, and on the other hand, to the fear of judgment when talking about this topic. But times are changing, intimate aesthetic correction procedures are becoming more and more in demand
The topic of the intimate female sphere has remained taboo for aesthetic medicine for a long time.
The relevance of this issue is due primarily to the physiological purpose of a woman as a mother (hormonal changes during pregnancy and lactation), mechanical effects on the genitals during childbirth, age-related changes in the female body caused by menopause and chronic stress associated with the dynamic pace of professional and social life
All these factors are integral components and natural stages of aging of the female body. As a result , intimate health disorders arise, which are manifested by vaginal dryness, unpleasant sensations during sexual intercourse (dyspareunia), urinary incontinence, impaired sensory and aesthetic appearance of the intimate area, and others. These changes lead to a decrease in pleasure from intimacy, refusal of sexual activity, self-doubt and the belief that the prime of femininity is far behind.
Of course, in the psychological aspect, this situation affects the quality of all spheres of women’s lives and, of course, is a relevant topic for the field of medical services.
Modern trends have drawn attention to the beauty and restoration of the functional state of the intimate area. Realized, self-sufficient and successful women are increasingly interested in methods of rejuvenation and improvement of the intimate area of their body and the opportunity to restore the quality of their intimate life.
In European countries, beauty and rejuvenation of the intimate area today have become a must-have in a woman’s comprehensive care program on the path to beauty, youth and health. Thus, a new topical direction has been formed - aesthetic gynecology.
Over the past year in Ukraine, this area of medical services, fortunately, has also begun to gain momentum. Thus, last year the Association of Aesthetic Gynecology and Andrology was created, the main activities of which are promoting the development and widespread introduction into medical practice of the latest technologies in the field of aesthetic gynecology and andrology, expanding contacts and exchanging experience with organizations in other countries, conducting cultural, educational, scientific programs aimed at popularizing and widely introducing new technologies in this industry into Ukrainian medical practice and promoting the improvement of the provision of specialized medical care to the population in the field of aesthetic gynecology and andrology. Of course, many practicing doctors already had certain developments and protocols for aesthetic correction of intimate areas, based on their own experience, but the creation of the above-mentioned association can be considered the starting point for the development of aesthetic gynecology in Ukraine.
OBJECTIVES AND METHODS OF AESTHETIC GYNECOLOGY
The main goal of aesthetic gynecology is to improve the appearance of the intimate area, restore its physiological parameters and improve the quality of sexual life in the aspect of a comprehensive concept of women's health . The main methods of aesthetic gynecology are intimate peeling, intimate biorevitalization, contour plastic surgery, PRP therapy, thread lifting, lipofilling and plastic surgery . Accordingly, leading manufacturers of products for aesthetic medicine have focused their efforts on creating effective and safe products for the intimate area in order to harmonize the female body and improve the quality of intimate life.
Sofiderm DERM PLUS is a biphasic filler based on hyaluronic acid of non-animal origin with a prolonged action, created specifically for intimate non-surgical plastic surgery for both men and women. Used to replenish the volume of soft tissue in the urogenital area, improve sexual satisfaction and correct sexual disorders. The drug is completely safe and does not cause allergies; over time, it dissolves and is completely eliminated from the body. Sofiderm DERM PLUS is designed to solve aesthetic problems in intimate areas. All TM Sofiderm fillers have European and Ukrainian state certification.
Basic intimate correction procedures
Taking into account the fact that aesthetic gynecology is a relatively new, promising method, doctors of various specialties are introducing intimate services into their practice. First of all, these are, of course, gynecologists, as well as plastic surgeons and dermatologists-cosmetologists. In my opinion, a clear distribution of spheres of influence is still to come and requires legal regulation. However, it is very important for a specialist who begins to practice aesthetic gynecology to understand the limits of competence in accordance with his specialization, knowledge and practical skills. Remember that it is important not only to have the appropriate skills to perform the procedure correctly, but also to be able to effectively treat possible complications.
The priority remains the division into invasive procedures that fall within the competence of gynecologists, urologists and plastic surgeons, as well as non-invasive ones, which is the prerogative of dermatologists-cosmetologists
In my practice, I use both invasive and non-invasive techniques, providing my patients with a comprehensive approach to correcting age-related changes in the intimate area.
Basic aesthetic gynecology procedures that dermatologists-cosmetologists can and should use in their practice are intimate peeling and intimate biorevitalization . This is absolutely logical, since it is the doctors of this specialty who are fluent in both theoretical knowledge and practical skills in applying such techniques.
These are safe, easy-to-perform and effective procedures that make it possible to create a comprehensive anti-age body care program for our patients, improve the quality of their intimate life and restore confidence in their own femininity.
INTIMATE PEELING
The main indications for intimate peeling are hyperpigmentation and decreased turgor and elasticity of the integumentary tissues of the anogenital area . The most common causes of hyperpigmentation include:
- hormonal imbalance ,
- mechanical friction of the inner thighs in overweight patients,
- x rhonic alteration of linen,
- age-related changes and individual skin characteristics.
Etiological factors that cause a decrease in turgor and elasticity of soft tissues include:
- age-related changes,
- hyperextension during childbirth,
- scars as a result of surgical procedures,
- impaired regeneration due to radiation or chemotherapy,
- radical fluctuations in body weight,
- atypical sexual habits and accessories,
- individual skin characteristics.
First of all, all drugs that you use in your practice must be registered in Ukraine as medical supplies . These must be safe and effective drugs, with clear and understandable protocols provided by the manufacturers. For me, an important issue is also the duration of the result, since for modern patients it is important to achieve the effect in one procedure.
Accordingly, it is logical to choose a peeling solution that can penetrate to a sufficient depth of the skin to realize a depigmenting effect and stimulate collagen and elastogenesis. At the same time, a prerequisite for such a product is the patient’s comfortable feeling during the procedure.
In the anogenital area, I use the Happy Intim line from Skintech Pharma Group (Spain). It offers several peeling products that meet all of the above criteria and always give good results. These hybrid peels in physicochemical parameters have the ability to penetrate the basal layer of the epidermis, but can reach the Grenz zone or papillary dermis - depending on the number of layers and frost characteristics.
To correct anogenital hyperpigmentation, I use a peel containing trichloroacetic acid (15% TCA) and phenol (3%). A small percentage of phenol in the peeling solution ensures an absolutely painless procedure, uniform penetration and, which is very important for this area, an antiseptic effect. Consequently, such a chemical composition of the peeling solution guarantees controlled alteration and at the same time ensures a comfortable feeling for the patient during the procedure.
To improve the quality characteristics of the skin of the anogenital area while reducing the turgor and elasticity of the integumentary tissue, I use another peeling, which contains trichloroacetic acid (15% TCA), antioxidants, glycolic and citric acids.
Treatment frequency
When using highly effective peelings, the course consists of 1-2 procedures with an interval of 1 month. In the future, you need to carry out maintenance procedures 1-2 times a year, depending on the indications.
To increase efficiency and prolong the results, manufacturers add products for post-peeling home care to their lines. I prescribe to my patients a cream that potentiates the whitening effect of peeling (kojic acid, arbutin, plant enzymes, vitamins), as well as a cream with a revitalizing and lifting effect (argan oil, vitamins E and C, plant enzymes, hyaluronic acid, CG-bFGF) .
INTIMATE BIOREVITALIZATION
Intimate biorevitalization is a technique for injecting preparations of non-reticulated hyaluronic acid into the dermis or submucosal layer to restore the hydrobalance of the skin of the anogenital area and the vaginal mucosa, improve the turgor of soft tissues, improve sensory perception and fullness of the labia majora.
Accordingly, indications for this procedure are disturbances in the hydrobalance of the skin, a decrease in its turgor, and deterioration in sensory perception. This procedure must be carried out regularly to rejuvenate and maintain the physiological parameters of the integumentary tissues of the intimate area.
Choice of drug
First of all, this is, of course, certification, the purpose and quality of the components of the biorevitalizant itself, the convenience of the syringe, and also, given the fairly large area of the anogenital area (with the inguinal folds and the inner surface of the thighs inclusive), a sufficient amount of the drug.
In my practice, I use a special biorevitalizant for the intimate area, HAPPY Intim Rebirth Gel. 5 ml of this drug contains: hyaluronic acid – 75 mg (15 mg/ml), as well as amino acids: arginine – 2 mg (0.5 mg/ml), glycine – 4 mg (0.8 mg/ml), isoleucine – 2 mg (0.5 mg/ml), leucine – 4 mg (0.8 mg/ml), lysine – 4 mg (0.8 mg/ml), proline – 4 mg (0.8 mg/ml) . A high concentration of non-reticulated hyaluronic acid and a rich amino acid composition provide not only an effective restoration of hydrobalance, but also a powerful stimulation of cell regenerative activity and a revitalizing effect.
PURPOSE OF PROCEDURES
First of all, it is necessary to remember that this is an extremely intimate and sensitive topic. Our patients usually know that we attend professional conferences and master classes, and often ask: “What's new in the world of beauty?” This is when it’s worth pointing out that you attended a seminar on a new area of aesthetic medicine – correction of the intimate area.
It is important to note that these are safe and effective methods that ensure the restoration of women's health, improve the quality of intimate life and prevent aging of the intimate area
There is no need to persistently question patients. If any of them have certain problems in this area, they will definitely contact you and come for a consultation. Some will contact you immediately after your notification about new skills and services, while others will need more time to gain courage.
Your main task is to easily convey information that new services have appeared in your arsenal
During the consultation, be guided by the principles of medical deontology , remember maximum tact and delicacy, control your emotions and use universal medical terminology, since the line between professionalism and vulgarity on this topic is quite thin. The same goes for the wording and choice of illustrations when distributing information about your new services on social networks.
At the consultation stage, it is necessary to listen to the patient’s complaints, carefully collect a gynecological history and conduct an examination to identify the above indications for intimate correction procedures. It is also important to determine contraindications , which include infection of the intimate area, skin maceration, hypersensitivity to drug components, pregnancy and lactation .
PREPARATION AND POST-CARE
No special preparation is required for intimate correction procedures. It is necessary to shave hair in the intimate area no later than the day before the procedure. We also schedule an appointment no later than 10 days before the start of menstruation, or better after it ends, in the first half of the menstrual cycle.
The rehabilitation period after intimate peeling, according to patients, is absolutely comfortable and does not affect the quality of everyday life. Delicate peeling begins on the 3-5th day, continues for 4-6 days and is noticeable only during washing, and there is no discomfort.
After intimate biorevitalization, papules remain, which resolve within 2–3 days. The patients also did not experience any discomfort.
To prolong the results obtained, you need to provide proper care not only for the intimate area, but also for the body as a whole. I usually recommend to my patients the use of cosmeceutical products from the already mentioned line for daily body care. This is a non-abrasive cleansing foam with an exfoliating effect pH 3.5 (lactic acid 1.7%, phytic acid 0.2%, glycolic acid 6%, retinyl palmitate) and regenerating cream (ascorbyl palmitate, enoxolone, urea, retinyl palmitate, phytic acid, α- lipoic acid, tocopherol acetate, idebenone). These cosmeceutical products provide daily rejuvenating and caring effects for the skin of the entire body.
Of course, working with the intimate area takes the relationship between doctor and patient to a new, more confidential level, creating a feeling of a special secret between the two of you. Nowadays, patients seeking facial enhancement procedures tend to migrate from doctor to doctor, but with such intimate issues, they are most likely to be given everything to you. Plus, by working with the intimate sphere of your patients' lives, you provide them with confidence in their femininity. And a confident woman can conquer any heights!
This article is part of the special project Injection anti-aging
You can read all the articles on this topic:
SPECIAL PROJECT. And injectable anti-aging
Literature:
Lyudmila Bespalko, Ph.D., plastic surgeon, member of VAPREH, assistant at the Department of Normal Physiology, Lviv National Medical University. D. Galitsky, international trainer of Skin Tech Pharma Group on aesthetic gynecology (Ukraine )