Key Factors of Cosmetic Gynecology by Laser is dependent on the following 3 factors. (1)
By Dr. Vitasna Ketglang
The First factor–The Physician.
1.) The physician has to be educated about the surgical techniques and the surgical materials used.
1.1) About the surgical techniques.
- For example: For Vaginoplasty surgery; foreign women who have to return to their countries 5 days after the operation may need a special suture technique (s) to avoid postoperative wound disruption.
1.2) The surgical material used.
- To avoid postoperative wound disruption a special absorbable suture material is required. The suture materials must be absorbable in order to become decayed after complete healing. This is also to avoid wound disruption leading to serious complications such as excessive bleeding from the surgical wound.
2) The physician has to be educated about the appropriate pre-operative antibiotics and post-operative antibiotics.
- Patient is more likely to get infection from cosmetic gynecological wounds than the surgical wounds in other body areas. This is due to these procedures being near the urinary tract and alimentary (fecal) tract. This leaves it at risk of complications such as bacterial infection.
- To prevent wound infections from all kinds of laser cosmetic gynecologic surgeries, a proper regimen of antibiotics for preoperative prophylaxis of infection must be adhered to. For prophylaxis in surgery, only antibiotics with good tolerability should be used. Cephalosporins remain the preferred drugs for perioperative prophylaxis due to their low toxicity.
3) The physician has to educate the patient regarding pre & post operative care instructions, risk & complications, and the consent form.
3.1) Accurate, clear, and proper post-operative instructions.
Accurate, clear, and proper post-operative instructions will be given in order to avoid postoperative complications.
- Within 3-5 days after the surgery, take a rest (refrain from work), be still and avoid constipation. This will enable the wound to heal faster.
- Have little movement as possible to avoid wound disruption for 1-2 weeks after the surgery.
- The patient should refrain from swimming in the pool, some types of exercise affecting pelvic muscle movement, and sexual intercourse for 6 weeks after the surgery.
3.2) Most common risks & complications for Laser Cosmetic Gynecology Surgery.
- 1) Bruising
- 2) Abnormal bleeding
- 3) Infection of the wound
- 4) Poor healing of the wound
- 5) Unsatisfactory results of surgery such as asymmetry, the need for a revision, and change in sensation
3.3) Preoperative agreement (patient consent form).
- Informed consent is very important to protect the patient and the surgeon also. It must be signed before any surgical procedure is performed. It is important for patients to fully understand the procedure.
4) The physician must be open-minded, honest, and responsible with the surgical procedures.
- The physician should deal honestly and openly with patients and inform them of all the necessary facts to ensure that they understand all the processes of the procedure.
- In case of unexpected surgical results or complications, corrective surgery is an option and will be discussed between the physician and the patient.
- The surgeon has to be open minded to others’ opinions, embracing new techniques and the constant changes to modern technologies weighing the best options for the good of the patients.
The Second factor–The Patient
1) Patient selection.
Here are some points in selecting a potential patient.
1.1) The primary vulvovaginal structures of the patient.
- Cosmetic Gynecological procedures have limitations and cannot absolutely ensure results and satisfaction. For example: For Labia Minora Reduction surgery, the procedure may result to incomplete symmetrical of the Labia Minora or non-proportional Labia Minora depending on patient’s former anatomical structure of Labia Minora.
1.2) Any existing disease.
- Any existing disease such as DM, Heart disease, Anemia, Renal disease etc, affecting the healing process, beyond the control of the physician.
1.3) Aging of the patient.
- Aging of the patient should not be too young which could affect the postoperative protocols to avoid postoperative complication.
- Aging of the patient should not be too old as to not affect the rate and success of the healing process.
2) Post operative manners of the patient.
One of the most important things associated with the patient, beyond the control of the physician, is ‘POST-OPERATIVE MANNERS’. As the laser cosmetic gynecology surgical wound is inside the vagina and around the vulvar area, it may get contaminated with vaginal secretion or vaginal fluid. This consequently leads to a longer healing process than surgical wounds in other body areas.