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) About 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 pre & post-operative instructions
Accurate, clear, and proper pre & post-operative instructions will be given in order to avoid postoperative complications.
- You have to refrain from drinking water or food for at least 6 hours prior to the surgery in order to decrease the risk of aspirating gastric contents during or after the surgery. This complication is very serious, and you need to strictly follow our recommendations. Within the day of the appointment, you should not drive yourself after the surgery to avoid any accidents caused by dizziness, an effect of the Intravenous Sedative or the General Anesthesia used during the surgery.
- You should take a rest (refrain from any physical activities) and be still for at least 2-3 days after the surgery to enable the wound to heal faster. You may return to work within 3 to 5 days after surgery, you should have little movement as possible to avoid wound disruption for 1-2 weeks after the surgery. You should refrain from some types of exercise affecting pelvic muscle movement and sexual intercourse for at least 6-8 weeks after the surgery.
3.2) Most common risks & complications for Laser Cosmetic Gynecology Surgery
- Abnormal bleeding
- Infection of the wound
- Poor healing of the wound
- 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.
Therefore, please be informed that despite an excellent surgery by the best physician, it is of no use in case of the complications resulting from infection. You should cooperate and adhere strictly to the post operative instructions.
3) The Patient’s realistic expectations should be discussed before undergoing surgery
- An optimal Cosmetic Gynecology Surgery by Laser candidate will understand not only what Cosmetic Gynecologic Surgery by Laser can accomplish, but also the limitations of the procedure.
- After all these have been assessed and considered, then a decision for surgery may be made.
The Third factor–The Technology: LASER
Modern technology & scientific breakthroughs are constantly changing the world we live in. Following this pattern, cosmetic gynecology also continues to develop every day. One of the newer technologies being used today is the Surgical Laser; Vulvovaginal Rejuvenation by Laser provides a whole new array of benefits. The Cosmetic Gynecology Center of Yanhee International Hospital, provides the following Laser Cosmetic Gynecology Services.
1) Incision (Cutting) Laser
1.1) For Vaginal Repair, Perineoplasty, Labiaplasty, and Hymenoplasty
- As a substitute for the traditional scalpel method: A Surgical Laser is a precision-cutting medical instrument that minimizes bleeding and bruising, seals lymphatic, and promotes faster healing.
- During Vaginal Rejuvenation, the Laser is used to open the vaginal mucosa, thus providing clean-cut access to the muscles and supporting tissues found in the upper and lower vaginal sectors, then sutured closed with absorbable stitches. This process strengthens the muscles and improves their overall tone.
2) Incisionless Laser
2.1) Incisionless Laser for Vaginal Tightening
- This is a new trend of innovation to Cosmetic Gynecology, which has been initiated in Thailand by Cosmetic Gynecology Center of Yanhee International Hospital.
- Patients will experience no pain and no bleeding, compared with the surgical laser or incision cutting laser method. The post-operative care is only refraining from sexual intercourse for 2-4 weeks after the procedure.
2.2) Incisionless Laser for Stress Urinary Incontinence
- Moreover, this laser method can be applied to Stress Urinary Incontinence. This method is suitable for women with mild to moderate levels of the symptoms of stress urinary incontinence, or for the woman with some existing diseases who cannot be operated on by the surgical method –TVT-O.
The key factors affecting the success of Laser Cosmetic Gynecology Surgery include the physician, the patient, and the technology. They are equally important in the success of Cosmetic Gynecology practice and helped me get through the surgeries, avoiding complications.