ABSTRACT
In the current chapter we will discuss some of the controversy surrounding these topics and review the background and history of these procedures, the available data to support them as well as review techniques and complications of these procedures. Finally, we will also attempt to shed light on what is myth and what is science in this relatively new field of elective vaginal surgery for sexual function and cosmesis of the female vagina and vulva. The chapter is divided into two sections: 1. Vaginal rejuvenation procedures and 2. External vaginal/ vulvar cosmetic surgery. Many use the term “vaginal rejuvenation” to encompass all elective vaginal/vulvar surgery, however, we feel that it should be used only to refer to functional procedures of the internal vaginal canal and introitus that are designed to enhance sexual function, which includes ensuring adequate support of the pelvic floor and then internal vaginal canal repairs and repair of the introitus. Similarly, cosmetic vaginal surgery to many just means labiaplasty or labial minora reduction; however, one will see in the second section of the chapter that it is much more comprehensive than this. Therefore, we have defined “cosmetic vaginal/vulvar surgery” as cosmetic or aesthetic procedures of the outside of the vagina and/or vulva, including labiaplasty, labia minora reduction, excess or redundant clitoral prepuce reduction, labia majora reduction or augmentation, labia majora divergence repair, perineal skin reduction, and mons pubis reduction. In most instances, to achieve the outcome desired by the woman, a combination of these external cosmetic procedures needs to be done, truly bringing in the “art” of aesthetic surgery.
