Classic Perineoplasty

This is the short version of a presentation from the ISCG Cosmetic Vaginal Surgery program. Most vaginoplasty (vaginal rejuvenation) procedures consist of two procedures to achieve the desired calibration -- tightening of the outer muscles (perineoplasty) & tightening of the inner canal (levator myorrhaphy/posterior colporrhaphy). This case was unique. She had been "tightened" by two previous surgeons, but still felt loose. The inner "Kegel" muscles were very tight, but the outer muscles were very loose. The solution was a classic perineoplasty -- a precise excision of loose perineal skin and outer vaginal epithelium combined with a controlled approximation of bulbocavernosus and transverse perineal muscles. The procedure presents no technical challenge for an experienced vaginal surgeon. The art, however, lies in choosing just the right amount of excision & tension -- too much or too little will yield a suboptimal result. For anesthesia, I selected a tumescent local field block -- a technique borrowed from liposuction. The beauty of this method is that it creates total anesthesia and a near bloodless surgical field. In addition, the anesthetic effect lasts up to 12 hours. The procedure took just under 30 minutes. The patient's pain score was zero out of 10 from the start of the procedure until bedtime without taking any pain killers. Recovery is quick, return to work is a few days, return to sex is six weeks. Marco A. Pelosi, III, MD, cosmetic gynecologist and cofounder of the International Society of Cosmetogynecology (ISCG). Cosmetic procedure info & more at http://www.iscgmedia.com. Portfolio and consultation inquiries at http://www.lvr-nj.com More at http://www.youtube.com/user/mpelosi3 andhttp://www.sexesthetics.com