Cosmetic Gynecology Surgery is becoming more popular in Thailand now, and it is important that the doctor would make the patient understand the advantages and the disadvantages of the surgery. A doctor does not only desire the benefits of the business but also considers the safety of the patient. This is the objective of Dr. Vitasna Ketglang, Head of the Cosmetic Gynecology Center and the President of the Thai Cosmetic Gynecology Society, who upholds this good doctor’s principle.
The Beginning of Interest in Cosmetic Gynecology Surgery
- “When I was a medical student, I was more interested in improving my surgical skills. I thought that Obstetrics and Gynecology is the field that I like. It is a science that does not have much difference with General Surgery combined with Internal Medicine.
- After I graduated, I paid out my scholarship by working in a hospital in the province. That was my chance to train with a General surgeon who was the Director of the Hospital in the province. I practiced doing the Caesarean Section procedures and accumulated experience. Then I worked in a private hospital for 1 year.
- During that time, Yanhee International hospital was founded and was popular for Plastic Surgery and there was only one male doctor in the Obstetrics and Gynecology Department. The hospital needed one female doctor and Dr. Supot Sumritvanitcha gave me the chance to work with Yanhee International Hospital.
Focusing on Work and Care of details
- When I started to work with Yanhee International Hospital, I worked for both the Obstetrics and Gynecology, and Cosmetic Gynecology departments. This included doing Caesarean Section surgeries, Hysterectomy, Labiaplasty, Uterine Prolapse, and Vaginal Repair.
- Three years later, there was an increase in the number of patients. There were many cases presenting to the hospital, and the results may not be completely satisfactory. However I wanted to pay attention to each case and provide the best procedures for surgery so I decided to do only Cosmetic Gynecology and did not accept Caesarean Section procedure as I did not want to hurry and pressure myself. In some cases I may be called upon to perform surgeries that include prenatal care, cancer checking, ectopic Pregnancy surgery, and tumor removal.
- Ten years later, the number of cases in Cosmetic Gynecology has increased greatly. Mostly Cosmetic Gynecologic Surgery, including both Labiaplasty and Vaginal Surgery. One of my teachers once said that, “ If one doctor has 2 Anterior-Posterior Vaginal Repair cases a month, 24 cases per year, 240 cases for ten years, that would already mean a lot. But in 6 years, I had 900 Anterior-Posterior Vaginal Repair cases for pelvic relaxation and with other cases I had a combined almost 10,000 cases. I have worked 14-15 years until now. I would like to thank the patients who honor me and the hospital. I have not been born with fame. I got the chance to work and progress here until I have had the chance to open the Cosmetic Gynecology Center to provide a service earnestly to patients.”
Certified by Laser Vaginal Rejuvenation (LVR®) Institute of America
- “We all know that Cosmetic Gynecology surgery in Thailand is ongoing for a long time. In other foreign countries, the procedure grows and new technologies are introduced. The reputation of the hospital and the specialist is not enough.
- We should bring new technology and upgrade. We should also learn new techniques to help patients and perform surgery safely. Yanhee International Hospital sent me to learn with the Master of Vaginal Repair, Dr. David Matlock. United States of America (USA) has new and better technology. I acquired many techniques especially with Laser Vaginal Rejuvenation (LVR ®) technique.”
Challenges with What Women Want
- I would say that challenges in the past years are different from now. The last 10 years, I have to try to make the patient accept to undergo the surgery without being afraid of the side effects or complications. She has to understand that after the surgery, gauze isn’t applied on the wound so she will have bleeding, and she will have difficulty in walking and urination. I have to make the patient understand very carefully. But now, the challenge is how to improve my skills to prevent postoperative complications. In my many experiences I understand that I cannot control patients to avoid the pressure on the surgical area, coughing, or sneezing after the surgery. On the other hand, I have to suture carefully and improve my suturing skills.
Dr. Vitasna as Guru of Aesthetic Gynecology
- I have heard this statement before, but I do not think that I am a Guru. I cannot be a doctor without the many teachers who taught me and I still cannot say that I am a Guru. Thank you, I am honored. I especially thank my Guru Dr. Supot Sumritvanitcha who stays in the 14th floor, the Chief Executive Officer (CEO) of Yanhee International Hospital, who believes in me and has given me the chance to be where I am today.
Method, Standpoint, Slogan which you follow
- Every time I am working, I always plan. If a patient comes for consultation, I think of what to do with the case. I also review every case even after surgery. I do the surgery with refinement, I pay attention to every detail, and I do it professionally, and consider every patient as family. Now I am 50 years old, my dream is to be stable and be a good doctor, not only focusing on business.
“As an experienced gynecologist with more than 30 years of practice, I felt really excited when I was introduced to this novel, extremely innovative laser technology for the treatment of Vaginal Relaxation Syndrome. After doing the procedure for one year I can say that IntimaLase ® is a great solution for vaginal tightening. Many of my patients highly praise the therapy for its minimal invasiveness and noticeable improvements in their sexual gratification. For me this is a simple, safe and efficacious procedure which enabled me to broaden the range of aesthetic gynecological therapies our clinic offers.”—By Ivan Fistonic, MD, PhD, Fistonic Gynecology Clinic, Zagreb, Croatia
Vaginal Relaxation Syndrome
- Vaginal relaxation syndrome is referred to as the increase in the internal diameter of the vaginal canal as a result of age, childbirth, hormonal factors, genetics, etc.
- This condition is generally linked with a reduction in sexual gratification for both the woman and her partner. This condition is also linked with other gynecological problems like stress urinary incontinence, anterior-posterior vaginal wall prolapse, etc.
Why You Need Treatment?
- Nobody desires to become old and lose the “ideal function” of the vaginal canal. The vagina best functions when it wraps around the penis firmly during intercourse. This increases sexual gratification for both the woman and her partner. However, because of certain conditions mentioned above, the vagina cannot perform the “ideal function” adequately and as a result sexual gratification decreases.
- A study conducted by Masters M.D. and Johnson M.D. confirmed that sexual gratification is directly associated with the tightness of the vaginal canal.
Incisionless Laser Vaginal Tightening
- This is a new innovation and has never before been used for Cosmetic Gynecology Surgery. The Cosmetic Gynecology Center of Yanhee International Hospital is the first hospital in Thailand which has opened its doors to the Laser Incisionless Vaginal tightening procedure. Incisionless vaginal tightening is a procedure where laser energy is being delivered to the vaginal canal and introitus area, and the treated vaginal tissues become tighter.
How Does Incisionless Laser Vaginal Tightening Work?
- Incisionless Laser Vaginal Tightening utilizes thermal energy produced by laser. After the laser has been applied to vaginal tissue, it causes the collagen in the tissues to alter its structure and shrink. The laser also stimulates the formation of new collagen. All these changes lead to a tighter, firmer vaginal canal.
- Vaginal tightening through Incisionless Laser Vaginal Tightening procedure requires 1-2 sessions in one course in between 2 to 4 weeks and it is effective for one year. Unlike undergoing the traditional procedure (by scalpel), this procedure does not hurt. There are no specific pre-operative preparations or post-op precautions required. You can resume normal activity as soon as possible. However, you have to refrain from sexual intercourse for 2-4 weeks after procedure.
Scientifically Proven Clinical Results
Before the procedure, the tightness of the vagina will be measured using a medical vaginal measuring instrument. After 4-6 weeks, it will be checked again and finally after 4 months.
- Clinical studies (by Dr. Ivan Fistonic at Fistonic Gynecology Clinic, Zagreb, Croatia) show a tightened vaginal canal, better sexual pleasure and considerable improvement in a patient’s quality of life. 97% of patients at the time of the clinical study experienced a high level of satisfaction with the results from the Incisionless Laser Vaginal Tightening procedure.
Benefits of Incisionless Vaginal Tightening VS Other Forms of Treatment
- Safe, fast and easy
- Performed with intravenous anesthesia
- Minimally invasive, no incisions required
- Usually treats symptoms of incontinence
- Noticeably better sexual pleasure and desire
- Boost quality of orgasms gained during intimacy
- Tightens the vagina and revitalizes natural flexibility
- Eliminates the complications that exist with other vaginal tightening procedures.
- Incisionless Laser Vaginal Tightening is a unique, innovative laser technology designed for the treatment of Vaginal Relaxation Syndrome.
Dr. Vitasna Ketglang and Vaginal Rejuvenation Surgery: One cosmetic surgery procedure that is gaining a lot of popularity, but not a lot of headlines is vaginal rejuvenation surgery. Given that most cosmetic surgery procedures are performed to enhance physical features that can be flaunted in public, vaginal rejuvenation surgery is a bit of an anomaly in cosmetic surgery circles, because it is not a surgery that most women talk about and certainly not one they flaunt in public.
Vaginal rejuvenation surgery or “posterior vaginal repair surgery” is performed to reshape and tighten the vaginal canal after one or more childbirths. It is one of the fastest growing cosmetic surgery procedures being performed today, particularly among women in their 30s, who have given birth one or more times and now find sexual activity less satisfying than it once was.
One surgeon who specializes in this surgery is Dr. Vitasna Ketglang, Yanhee Hospital’s resident expert in the field. After spending most of her career practicing the more common procedures of Obstetrics and Gynecology, Dr. Ketglang found that many of her patients has similar complaints so she built a practice around vaginal rejuvenation, and has performed over 6,000 vaginal rejuvenation in the past 13 years.
Dr. Ketglang notes that there are no “textbooks” written about this, and that her expertise and techniques were perfected over the years from her own research and experiences in the operating theatre.
Since there is such a strong psychological element to these kinds of surgeries, Dr. Ketglang wants to ensure that her patients aren’t doing this just to please their partners or to fix a failing relationship, but because it is something important to them as well.
An important consideration for any patient who undergoes vaginal rejuvenation is recovery time. While the hospital stay is only 1 night, the healing process requires a two month period of abstinence from sexual intercourse after the surgery. Therefore, it is important that couples view the procedure as a step they can take to enhance their relationship, not a cure-all or last resort.
“My focus is helping women regain a part of themselves that they feel they have lost with childbirth. There is nothing to be embarrassed about. Our bodies change with time, and this is simply a rejuvenation technique to help turn back the clock.”
A pose after receiving our certificates from Prof. Adam Ostrzenski, M.D., Ph.d.,
at the Bay Medical Center, St. Petersburg, Florida, USA
Prof. Ostrzenski doing the traditional Thailand greetings, Sawadee “The wai”
Labiaplasty – an operation to reduce one or both of the labia minora, or inner lips of the vagina – is rapidly gaining popularity as women go under the knife for health-related or purely cosmetic reasons.In the West, the rise in the operation’s popularity is startling. In Britain, for example, there’s been a five-fold increase in the past five years to more than 2,000 surgeries in 2011 in the public health system alone; while American women spent US$6.8 million on the procedure in 2009, according to the American Society for Aesthetic Plastic Surgery.
Dr. Supot Sumritvanitcha, Managing Director of Yanhee International Hospital, disclosed that the hospital is seriously preparing for the implementation of the new international policy on Trade Facilitation Support for ASEAN Economic Community (AEC). As part of its preparations for this, the hospital has launched the Cosmetic Gynecology Center, targeting women in both the local and international scene as its ardent consumers.
Cosmetic Gynecology, being a new sub-specialty under Cosmetic Surgery, has rapidly gained worldwide popularity among women in Thailand and all over the world. The opening of this center falls in perfect timing with the implementation of this new international policy. It will help achieve the hospital’s vision of leading in the long list of cosmetic hospitals in Thailand, in providing convenience and optimum customer satisfaction particularly to its gynecologic patients, through its highly trained and experienced medical sub-specialists.
The hospital has invested over 50 million Baht in the purchase of the physician’s training, the latest laser machines, and medical equipment to be used in this center for new special procedures. These procedures include those for vaginal rejuvenation and for the most current treatment methods of gynecological problems.
Dr. Vitasna Ketglang, Obstetrician-Gynecologist and Head of Cosmetic Gynecology Center announced that Yanhee International Hospital has started her practice in Cosmetic Gynecology in Yanhee International Hospital as early as 1999. This was a part of the services provided in the Obstetrics-Gynecology Center. This included services such as Labiaplasty, Vaginoplasty and Vaginal Repair, Reconstruction of Labia Majora deformed by improper silicone injection, Pelvic Organ Prolapse, and Stress Urinary Incontinence including the performance of over 20,000 procedures performed by gynecologic specialists.
The Cosmetic Gynecology Center provides current specialized treatment procedures using the most advanced technology particularly in laser surgery. This marked Yanhee as the first hospital to include laser surgery in its treatment menu. The presence the Cosmetic Gynecology Center of Yanhee International Hospital as a one-stop-service Center in Thailand has helped boost the country’s success in Medical Tourism. This is mainly through the services provided by its highly trained medical experts who are among the best in their chosen medical field throughout Asia.
Dr. Supot (center), the CEO of Yanhee International Hospital, Dr. Vitasna (left), Head of the Cosmetic Gynecology Center, and Dr. Suthon (right), Medical Director, during the Media Press conference of the opening of the Cosmetic Gynecology Center, held in 22 April,2013
Surgeons do their best to eliminate complications. However, all surgeries are associated with complications and this occurs even with the most experienced physicians. Many still oppose Cosmetic Gynecological procedures due to lack of long-term research on efficacy and risks on the subject.
As a general rule, surgeons apply many precautions to avoid surgical complications. With this said, you must acknowledge that with any surgical procedure, there is always going to be a complication risk-factor. This factor is present even if your surgeon is among the most experienced and highly-trained physicians
Making sure patients understand potential risks and complications is one of the key factors in executing successful surgical procedures.
For any surgeon, being open and honest with patients about potential surgical complications is never easy. During consultations, I inform my patients of the potential risks involved with surgery. I then make it clear that, in some cases, more than one procedure may be required before a patient is satisfied and their full expectations are met.
Similarly, I explain that sometimes scarring can form which requires a re-visionary procedure. Although surgeons, including myself, take many precautions to eliminate the need of corrective surgery, it is still a possibility that patients need to be aware of.
Learning about possible complications and ensuring you understand entailed risks empowers you. Afterwards, you can weigh the risk-factor against your needs and desires, giving you the opportunity to choose which, if any, procedure is right for you.
As long as you are aware of potential risks and complications and then can balance whether you see more potential good than harm, you are given the autonomy to choose for yourself.
Before I perform surgery, my clients are assisted in completing a set of consent forms. Once again, included within the forms, there is a section regarding potential risks and complications.
Every day, I see more and more women coming to me for Labiaplasty. I educate them in regards to potential problems that may arise, for example asymmetry or excessive skin in the surgical area. Both of these problems can be corrected in due time. If these complications are to occur, I give the patient a clear and concrete explanation detailing how the correction should take place.
Labiaplasty requires meticulous attention, timing and patience. All of these components are essential to obtaining beautiful, symmetrical results. A patient must consider that no case I’ve ever seen or dealt with has been the same; everyone has an individual structural composition and unique needs.
In my 17 years of Cosmetic Gynecological experience, I’ve witnessed a low number of complication cases as well as corrective surgery cases. A prompt, accurate diagnosis and effective treatment is very important when a surgical complication presents itself.
My many years of experience, continuing education and specialized trainings have heavily influenced the low number of complications exhibited in the vulvovaginal surgeries I’ve performed.
Please do not hesitate to contact us with any questions or concerns. In case of unexpected surgical results or complications, corrective surgery is an option and will be discussed between you and me. I welcome you to send an inquiry with any questions you may have; after all, that is the first step.
Vitasna Ketglang, M.D.
How to rejuvenate your vagina to hide your age? Vaginal tightening is a subject in which older women should not overlook. How can the vagina be tightened safely and which procedure is appropriate for each individual?—There are two ways in which the vaginal muscles are tightened: through surgery and without surgery.
1) Without Surgery:
1.1) Kegel Exercise
- Kegel Exercise or squeezing the vaginal muscles: this is the easiest way for patients. The procedure is to squeeze the vaginal muscles and hold for 10 seconds and relax. Then repeat.
- In fact, vaginal exercise can be done in many ways. One example is to squeeze the vagina 100 times in the morning and 100 times in the evening. The principle is just to exercise the vaginal muscles.
- Advantage: Safe, no cost, and the patient can do it by herself.
- Disadvantage: Some patients do not know the correct procedure, so the effect will not be effective and satisfactory. It takes 3-6 months to be noticed.
1.2) Incisionless Vaginal Tightening
- This is a new innovation and has never been used for Cosmetic Gynecology Surgery. The Cosmetic Gynecology Center of Yanhee International Hospital is the first hospital in Thailand which has commenced the Laser Incisionless Vaginal tightening procedure.
- It is a process whereby laser energy is being delivered to the vaginal canal and introitus area, resulting in the treated vaginal tissues becoming tighter. There are 1-2 sessions in one course in between 2 to 4 weeks and it is effective for one year. Unlike undergoing the traditional procedure (by scalpel), this procedure does not hurt. However, the patient has to refrain from sexual intercourse for 2-4 weeks after procedure.
- Before the procedure, the tightness of the vagina will be measured using a medical vaginal measuring instrument. After 4-6 weeks, the vagina will be tightened and measured again and finally after 4 months.
- Laser Incisionless vaginal tightening has limitations. Tightening depends on the collagen anabolism around the vagina and the response of the tissues to the laser treatment to create collagen.
- Laser Incisionless vaginal tightening can resolve stress urinary incontinence; a problem when a woman passes urine when coughing or sneezing. This procedure also has limitations, this procedure may be done to patients, who do not have severe stress urinary incontinence. This procedure may be done to the patients, who cannot undergo the surgical treatment through Incontinence Sling (TVT-O).
- Advantage: Elderly women may undergo this procedure, as can the overweight, diabetic patients, and those who have limitations for surgery.
- Disadvantage: This procedure has limitations. It is only suitable for patients, who have not much vaginal looseness, and those who do not have severe stress urinary incontinence. It is not suitable for ladies, who have many children.
2) With Surgery
2.1) Traditional Surgery
- This is the common surgical procedure which uses scalpel and scissors for surgery. This is a standard procedure, whereby an incision is made and Polydioxanone (PDO) is used to stitch the wound in the vagina.
- The patient has to plan for daily activities for at least 2-3 days after surgery. Patients, who travel abroad, should be careful for at least 1 week, as the wound may be torn and bleed.
- After the surgery, the patient has to refrain from sexual intercourse, and avoid strenuous activities that would cause wound tearing. Constipation, coughing, sneezing, carrying heavy objects, and sports activities should be avoided for at least 6 weeks.
- Advantage: Appropriate pricing suitable for patients with the limited amount of resources they had.
- Disadvantage: This procedure takes longer recovery period and has its limitations in patients who have conditions wherein surgery is contraindicated like existing disease, etc.
2.2) Laser surgery
- This is similar to traditional surgery; but uses laser instead of the scalpel for cutting. The surgery is more precise and accurate, decreases the possibility of bleeding, and achieves minimal damage to tissues and blood vessels.
- The recovery is faster with reduced complications. Polydioxanone (PDO) is used to stitch the incision in the vagina.
- Advantage: Decreased risk for bleeding, precised and controlled accuracy in cutting, and faster recovery. Recovery time for Laser surgery may be shorter than the traditional scalpel surgery.
- Disadvantage: Recovery time is longer than Incisionless Vaginal Tightening.