Be kind to your vagina
Before sounding out to her mother, a 9-year-old Googled the excess skin folds in her genital area, which made her uncomfortable. Their pediatrician suggested that they consult Dr. Annebelle Aherrera, a pediatric-adolescent gynecologist and functional aesthetic gynecologist.
Since the child was in the prepuberty stage, Aherrera held off surgery until the patient started to menstruate. By then, the tough skin around her delicate area would have softened due to the increase in estrogen and hormones.
Then there were teenage patients who complained of painful urination despite normal findings in their urinalysis and discomfort in wearing jeans. They had large labia, the fleshy lips around the vaginal opening, which created a bulging crotch in swimwear and uneasiness in activities.
Aherrera was alarmed that her patients were getting younger. Since she began performing functional and aesthetic vulvovaginal surgery in 2007 at Makati Medical Center, most of her patients were adults, who sought to tighten the labia or vaginal muscles or enhance sexual gratification.
Perceived abnormalities
The procedure, vulvovaginal restoration, isn’t about getting an attractive “face down there,” she maintained. It aims to repair the form, function and appearance of the vulva, the structures that comprise the woman’s external genital area, and the vagina, the passage for reproduction and urination.
Many patients come for perceived abnormalities. Aesthetics is not the only reason for surgery. Aherrera said some patients complained of overstretched vaginal muscles from frequent sex and childbirth. This resulted in urinary incontinence and problems with penetrative sex that either caused pain due to dryness or less of sensation.
Unsightly labia—usually too big or saggy—has become common. Younger patients suffered from congenital abnormalities, while mature patients experienced loss of elasticity in and around the labia due to declining hormone levels. The more prominent labia invariably compresses other parts of the genitals and locks in more bacteria, enabling the germs to move up to the urethra and vagina. This explains frequent urinary tract infections, burning sensations during urination and discharges.
Labiaplasty, other surgical vulvovaginal restorative procedures and nonsurgical radiofrequency tools are based on the same principles in plastic surgery.
“The form and structure are maintained or enhanced. The function is achieved—you can urinate normally or have sex without vaginal looseness. The appearance of the labia majora and minora (outer and inner lips) must be symmetrical, not uneven,” explained Aherrera. The healing time for surgical procedures takes about four to six weeks. There is no downtime for nonsurgical procedures.
‘Flower arrangement’
Some cases entailed complementary procedures. An OFW from Dubai brought his wife who suffered from vaginal slackness after several childbirths. Aside from loss of pleasure in sex, other symptoms caused by a loose vagina are urine leakage after sneezing, coughing or running and loss of control in bowel function.
The patient required labiaplasty and vaginoplasty to restore the vulvovaginal structures. Surgeons refer to it as “landscaping” or “flower arrangement” or restoring the vaginal opening and support areas.
The couple was extremely grateful after the combination of surgical procedures: labiaplasty, vaginaplasty and perineoplasty (tightening the area between the anus and vagina).
Some conditions, as a result of the natural process of aging, do not require surgery. “I have helped many women over 60 who are happy with my solution for vaginal dryness. But it’s not only because I performed Thermiva (a temperature-controlled radiofrequency treatment that restores the collagen and elastin fibers in the vagina) on them. More important is the proper diagnoses of something as simple as lack of estrogen. Estrogen cream relieved them of the symptoms of vaginal dryness,” she said.
Proper hygiene
In all, Aherrera’s main advocacy is to promote women’s health. “Not many women will look at their face ‘down there,’ the vulvovaginal areas, she said. “It is the least talked about yet most neglected and vulnerable part of the woman’s body.”
Since vaginal health begins with proper hygiene, Aherrera recommended: “Spread the labia, the lips in and around the vagina. Massage the labia with fingers to improve circulation and to wash away any build-up of secretions in between the lips. Always use downward strokes when washing from the vagina to the anus to prevent the spread of bacteria from anus to the vagina. Moreover, one must ensure the use of a feminine wash with the correct vaginal pH regardless of age.”
She notes that legions of women are unaware of their genital health conditions and just bear with the symptoms.
“Women are suffering silently. They think there is no hope or alternative solution,” she said. “Stop pretending that everything is okay. Why suffer when there are options? I’m trying to make women aware that it’s time to come out and seek help.” —CONTRIBUTED INQ
