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| ==Clitoral Hood Reduction== | ==Clitoral Hood Reduction== | ||
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Clitoral Hood Reduction
Clitoral hood reduction is a surgical procedure to reduce the size of the clitoral hood. Clitoral hood reduction is performed most often as part of a labiaplasty (labia minora reduction). , , , Some doctors recommend against clitoral hood reduction as part of labiaplasty. , The goal of clitoral hood reduction may be to contribute to the overall goal of labiaplasty: to improve the aesthetic and functional nature of the labia minora. Sometimes, clitoral hood reduction is performed to allow greater exposure of the glans clitoris during stimulation with the goal of improving a woman's sexual experience, including the likelihood of orgasm.
Techniques
There are many different techniques for performing labiaplasty, and most of them include recommendations for performing clitoral hood reduction.
The deepetheliazed reduction labiaplasty does not include a method for clitoral hood reduction. However, a commentator offered the addition of a V-to-Y plasty of the clitoral tissue to provide improved aesthetic and functional results of labiaplasty.
One technique for reducing the clitoral hood is to excise tissue lateral to the clitoris on each side. This results in the exposure of the clitoris. Care must be taken to maintain the clitoris in the midline.2
Another technique is to remove redundant folds of the clitoral hood with incisions parallel to the long axis of the clitoris. The proponent of this technique recommends against exposing the clitoris.1
Clitoral hood reduction is an integral part of the wedge resection labiaplasty technique. In most cases, the extension of the exterior wedge sections is used to effect clitoral hood reduction. However, sometimes excess skin in the center of the clitoral hood is removed in a separate set of incisions.3
Results
In terms of improving appearance and functionality, labiaplasty procedures have a high rate of satisfaction and a low rate of complications.2,3,4 Only 4.4% of patients in Alter's study experienced significant complications.3 Alter's published rate of satisfaction indicates that 98% of patients would have labiaplasty again.3 "Almost all patients" in Alter's sample of 407 patients had concurrent clitoral hood reduction, although exactly how many and how they correlated to satisfaction rates is not given in detail. Other results from Alter's study included an average patient satisfaction score of 9.2 out of 10, with 95% of patients experiencing reduced discomfort, 93% of patients experiencing improved self esteem, and 71% experiencing an improved sex life. Only one respondent (0.6%) indicated a worsened sex life following clitoral hood reduction. It should be noted that only 166 of 407 patients responded to the postsurgical questionnaire.3
Attitudes and Expectations
A study of attitudes toward labiaplasty in The Netherlands revealed that about 95% of women were familiar with the procedure. For most (78%) women, the source of knowledge was a mass media source, mostly television and magazines. According to the study 95% of women frequently examined the appearance of their labia, and about 71% considered the appearance of their labia minora to be normal. About 7% of women had considered labiaplasty. About 38% of all participants paid regular attention to the appearance of the labia minora in other women, and 14% had received negative or positive comments on the appearance of their labia minora from partners. Seven percent had received comments from other women.
In detailed interviews with labiaplasty patients, it was discovered that women had many expectations for results from a labiaplasty that included not only an improved appearance and less discomfort, but also an improved sex life and sometimes a hope that labiaplasty "would improve or save a relationship." Women interviewed did experience improved self-esteem about the appearance of their genitals. However, "Not all women experienced an improved sex life postoperatively, and those hoping for an improved relationship were disappointed." The study authors note, "It may be helpful for specialist staff to provide psychosocial interventions in the context of gynecological services"10 to help create realistic expectations from the procedures.
In its 2007 recommendations, the American College of Obstetricians and Gynecologists (ACOG) noted, "Women who want to improve their sexual response should be evaluated for sexual dysfunction, and nonsurgical interventions, including counseling, should be considered." It also noted that "published studies that assess the safety, complication rates, and long-term satisfaction"11 of labiaplasty and clitoral hood reduction were sparse. It did not note studies that showed either inefficacy or significant risks. It has not issued an updated statement that addresses more recent findings.
References
Hunter, JG. Considerations in Female External Genital Aesthetic Surgery Techniques. Aes Surg J. 28:1 (2008) 106-107.
Felicio, Y. Labial Surgery. Aes Surg J. 27:3 (2007) 322-328.
Alter, GJ. Aesthetic Labia Minora and Clitoral Hood Reduction Using Extended Central Wedge Resection. Plas Recon Surg J. 122:6 (2008) 1780-1789.
Scholten, E. Female Genital Cosmetic Surgery--The Future. J Plas Recon Aes Surg. doi:10.1016/j.bps.2009.01.002
Maas, SM and Hage, JJ. Functional and Aesthetic Labia Minora Reduction. Plas Recon Surg J. 105:4 (2000) 1453-1456.
Solanki, NS, et al. Aesthetic and Functional Reduction of the Labia Minora Using the Maas and Hage Technique. J Plas Recon Aes Surg. doi:10.1016/j.bjps.2009.05.053
Choi, HY and Kim, KT. A New Method for Aesthetic Reduction of Labia Minora (the Deepithelialized Reudction Labioplasty). Plastic and Reconstructive Surgery J. 105:1 (2000) 419-422.
Laub, DR. Discussion: A New Method for Aesthetic Reduction of Labia Minora (the Deepithelialized Reudction Labioplasty). Plas and Recon Surg J. 105:1 (2000) 423-424.
Koning, M, et al. Female Attitudes Regarding Labia Minora Appearance and Reduction with Consideration of Media Influence. Aes Surg J. 29:1 (2009) 65-71.
Bramwell, R; Morland, C, and Garden AS. Expectations and Experience of Labial Reduction: A Qualitative Study. B J Obs Gyn. 1144 (2007) 1493-1499. Via Obs Gyn Surv. 63:3 (2008) 145-6.
American College of Gynecologists. ACOG Advises against Cosmetic Vaginal Procedures Due to Lack of Safety and Efficacy Data. September 01, 2007.
http://www.acog.org/from_home/publications/press_releases/nr09-01-07-1.cfm
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