Genital Surgery: Specialists & Treatment Information

Genital surgery encompasses surgical procedures in the genital area for both men and women. In recent years, there has been a significant increase in genital surgery procedures, particularly in the female genital area. Therefore, this article focuses specifically on female genital surgery. Demand is steadily rising, and the topic is becoming less taboo in the media.

There are two professional associations in Germany dedicated exclusively to genital surgery:

• DGINTIM, the German Society for Intimate Surgery and Genital Aesthetics, e.V., and
• GAERID, the Society for Aesthetic and Reconstructive Intimate Surgery in Germany.

As a new discipline within plastic and aesthetic surgery, female intimate surgery encompasses several areas. Its goal is the aesthetic and functional improvement of the intimate area. There is often an underlying medical indication.

Various factors can cause problems in the intimate area, including

• genetic predispositions such as weak connective tissue,
• the natural aging process,
• one or more childbirths, or
• hormonal changes.

Depending on the severity, functional disorders may occur that significantly impair daily life and sexual function.

Aesthetic concerns must also be taken seriously, as they can sometimes lead to psychological problems that last for years. Especially in young women, this can lead to social isolation and disruptions in psychosexual development.

The goal of genital surgery is the aesthetic and functional optimization of the genital area © illustrissima | AdobeStock

Improvements through intimate surgery are possible in the following areas:

• Inner labia: If the small, inner labia (labia minora) protrude significantly beyond the outer labia, they can become inflamed due to friction from clothing. Moderate to severe infections may occur, and sexual intercourse can be severely disrupted. Aesthetic concerns may also play a role if a woman feels significant embarrassment in front of her partner or in a sauna. Labia reduction surgery can provide a solution in such cases.
• Outer labia: The outer labia are normally meant to cover and protect the inner labia. Due to genetic factors or weak connective tissue, they may be too small or saggy, preventing them from fulfilling their function. In this case, labia augmentation may be considered.
• G-Spot Enhancement: The sensitivity of the G-spot, located within the vagina, can diminish over the years due to tissue laxity. Injections can restore sensitivity and intensify sexual pleasure.
• Mons Pubis: Excess fat deposits on the mons pubis are often resistant to diet. Despite a slim body, fat accumulates here due to hormonal and age-related factors. This can be bothersome when wearing swimwear and during sexual activity. A simple liposuction procedure restores a harmonious transition to the lower abdomen.
• Vagina: The vagina may become more relaxed after childbirth or due to tissue weakness. This can cause significant limitations during sexual intercourse.
• C-section scars: As childbirth procedures have become increasingly controlled, the C-section rate has continued to rise in recent years. However, the scar does not always heal well, and symptoms often arise. If raised scars remain and the abdominal wall shifts, a corrective procedure is helpful.
• Defloration: The hymen can tear as a result of an accident, during sports, or during sexual intercourse. This can pose a problem for the affected woman, for example, for religious reasons. The hymen can be reconstructed through a gynecological surgical procedure.
• Vaginismus: It is only in recent years that vaginismus, or “vaginal spasm,” has been recognized as a medical condition. In severe cases, affected women are unable to insert a tampon, undergo a gynecological examination, or have sexual intercourse because the vagina contracts spasmodically. Often dismissed as psychologically based, the condition has only been recognized as such in recent years. There are numerous therapeutic approaches for treating vaginismus.

Before any surgery, a detailed consultation with the surgeon takes place. The patient discusses her expectations for the procedure with the surgeon. The surgeon explains to her

• how the procedure will be performed,
• what risks are involved, and
• what results can be expected.

The techniques and procedures used in the various areas of genital surgery are explained below.

Intimate Surgery for Labia Reduction

There are two different options for reducing the size of the inner labia. They are used depending on the patient’s anatomy:

• Labiaplasty below the clitoris: In this relatively simple technique, the excess tissue below the clitoris is carefully removed. This procedure can only be performed in certain cases. If this technique is misdiagnosed or applied incorrectly, it can result in an unnatural, “operated-on” appearance.
• Labiaplasty with correction of the clitoral hood: In most cases, the clitoral hood must be tightened, or excess skin must be removed here as well. Only in this way can the aesthetic harmony between the labia and the clitoral hood be taken into account and properly addressed. The clitoris itself is not altered, thus preserving full sensitivity. The result is a harmonious and very natural appearance of the clitoris. The scars are concealed so that they are virtually invisible.

Enlargement of the outer labia in intimate surgery

The labia majora can regain their shape and size through injections. For this purpose, either hyaluronic acid—which is well tolerated by the body—or the patient’s own fat is used.

In the autologous fat procedure, fat is first harvested from another area of the body under local anesthesia. The fat cells are processed and then injected into the labia majora.

Reducing the size of the inner labia and augmenting the outer labia can be easily combined. The surgeon then performs both procedures in a single operation.

G-Spot Injections in Intimate Surgery

To enhance sensitivity of the G-spot, it is also possible to use either hyaluronic acid or autologous fat for injection.

After treatment with hyaluronic acid, the effects last for about one year. This makes it a good opportunity to try this form of pleasure enhancement.

G-spot enhancement using the body’s own fat cells can last a lifetime. However, it is not possible to inject a large amount of autologous fat into this area, as the fat tissue would then die off.

If the success of a treatment is still uncertain, treatment with hyaluronic acid is usually recommended.

Mound of Venus Correction in Intimate Surgery

The excess fat that has accumulated in the mons pubis can be easily removed via liposuction in a minor outpatient procedure.

First, the area is marked, and a solution known as a tumescent solution is injected. After a short incubation period, the fat tissue is suctioned out using a thin cannula that leaves barely visible scars.

If deemed necessary, the lower abdomen can be tightened at the same time.

Vaginal Tightening in Intimate Surgery

A vaginal tightening procedure restores the width of the vagina, which has been widened by childbirth or tissue weakness. The tightening is performed through a surgical procedure. The dissolvable sutures disappear completely after a few weeks.

In addition, autologous fat can be injected during the same procedure to further narrow the vagina.

Both the patient and her partner can once again enjoy a more fulfilling sex life after such a procedure.

Scar Revision After a Cesarean Section in Intimate Surgery

A cesarean section can, under certain circumstances, leave very unsightly scars. These can manifest as severe adhesions and fat deposits, and in some cases even a displacement of the abdominal wall.

Treatment must be tailored to the specific symptoms. It may consist of fat redistribution or an abdominoplasty. With

• autologous fat transfer,
• liposuction,
• scar revision, or
• a mini-tummy tuck

can help restore an aesthetic shape to the lower abdomen.

Hymen Reconstruction in Genital Surgery

A torn hymen can be reconstructed using remaining hymenal tissue and the body’s own vaginal tissue.

Absorbable sutures dissolve after about six weeks. After that, the hymen reconstruction is no longer visible.

Vaginismus in Intimate Surgery

The targeted injection of botulinum toxin (Botox) is a highly effective treatment for vaginismus. Various studies have shown that botulinum toxin therapy has a success rate of over 90 percent. Careful follow-up care is also necessary to achieve such good results.

Even in cases that have persisted for many years, sexual intercourse is possible approximately two to three weeks after treatment.

Botulinum toxin causes the muscles in the vagina to relax, thereby preventing reflexive spasms.

The effects of botulinum toxin wear off after a few months. However, by then the vicious cycle has often been broken, and there are usually no further relapses.

Every surgical procedure carries risks. You should inform your doctor of any potential drug interactions, allergies, or health issues during your consultation—even if they are not directly related to the procedure. This helps minimize risks as much as possible.

Postoperative bleeding, inflammation, and swelling can always occur, but they can be treated with medication. They usually subside after a few days.

If you develop a fever or notice any other unusual symptoms, you should contact your doctor immediately.

Most genital surgeries can be performed on an outpatient basis under local anesthesia. For some procedures, brief general anesthesia is recommended.

Healing usually proceeds without complications and relatively quickly, as the genital area has a very good blood supply. This gives it a rapid ability to regenerate. Nevertheless, careful hygiene and postoperative care are necessary, as with all surgical procedures.

Patients should also allow themselves adequate rest after the procedure, depending on its extent. Pain medication and sufficient rest promote the healing process.

Functional disorders can usually be resolved.

The outcome of genital surgery always depends on the individual case.

In cases of vaginismus, treatment can completely resolve the condition in most cases.

Hymen reconstruction can achieve excellent results: without leaving any traces, the natural state is restored just a few weeks after the procedure.

In the case of

• labiaplasty,
• mound of Venus, and
• scar revisions

, in addition to resolving functional problems such as

• inflammation,
• entrapment, and
• sexual dysfunction

, aesthetic considerations always play a role. With specialized techniques tailored to each type of procedure, excellent results can be achieved today.

Procedures in the field of aesthetic and plastic surgery are generally not medically necessary. However, they improve the quality of life for those affected.

Public health insurance plans generally do not cover the costs of cosmetic procedures. Private health insurance plans also cover these costs only in the rarest of cases.

However, the treatment costs can be claimed as a special expense for tax reduction purposes.