Laser Vaginal Tightening: A Star is Born

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LASER VAGINAL TIGHTENING: A STAR IS BORN

Enter the plight of three very common groups of women living in the United States and the incredible promise of an amazing new technology. Keep in mind that most women belong to more than one of these groups.


A Treatment for Vaginal Looseness:

Less than one year ago, an American woman with vaginal laxity –the looseness which so commonly afflicts those who experience vaginal childbirth – had but two choices for improving her condition: Kegel exercises or surgery. In the 65 years that have passed since Dr Kegel introduced them, the thousands of gynecologists who have treated millions of women worldwide have learned one thing – Kegel exercises don’t fix vaginal laxity. Essentially, the only effective choice was surgery. Surgery works very well and yields solid long-lasting results that remain the gold standard. Despite this, not every woman wants surgery, needs surgery, or is at a point in her life where she is ready for surgery.


A Treatment for Urinary Incontinence

The other great sequela of vaginal childbirth is urinary incontinence. Responsible for unmatched social inconvenience and embarrassment and affecting almost half of all middle-aged women, it too had a limited menu of not-too-pleasant therapies less than 12 months ago. Don’t sign up for yoga classes unless you’re game for submitting to diapers, pessaries, drugs or a mesh sling operation. If you’re one of the lucky few, Kegel exercises might do the job. But for everyone else, a truly convenient no-strings solution simply did not exist.


A Treatment for Menopausal Vaginal Changes

Our third group of women is women in the menopause. It’s all women...eventually. The inescapable second half of every woman’s life brings vaginal atrophy as an unwelcomed guest. Vaginal atrophy is the natural thinning of the vaginal skin that occurs from a lack of estrogen. It produces symptoms that range from mild to devastating. Vaginal dryness, vaginal burning, pain with sex, pain too severe to have sex, etc were certainly treatable last year, but the best treatments – the ones that really worked – were limited to estrogens. Let’s face it, not everyone can take estrogen safely (e.g. breast cancer survivors, stroke victims) and not everyone wants to take hormones in a state of anxiety over what may or may not happen as a side effect.

Laser resurfacing of the vaginal canal treats vaginal laxity, mild degrees of urinary incontinence, and menopausal vaginal atrophy in a few quick treatment sessions. It is painless, it requires no medications, no downtime and can be repeated without adverse sequelae.

Dubbed laser vaginal tightening (LVT) by the Europeans and South Americans who pioneered and perfected the technology over the past six years, it is also known as laser vaginal resurfacing, non-surgical vaginal rejuvenation, and the branded FemiLift procedure, the Mona Lisa Touch procedure, the IntimaLase procedure, and the Petit Lady procedure. Regardless of the name, the strategy is to stimulate tissue remodeling with either CO2 or Erbium:YAG lasers modified for vaginal use.

All of the currently available laser vaginal tightening technologies utilize fractional laser techniques that deliver tiny spots or pixels of energy to the skin of the vaginal canal and they all require a series of 2-3 sessions spaced 4-6 weeks apart for maximum effect. Fractional laser technologies are the same as those used on the face for laser peels. However, there are three major differences between a laser peel of the face and laser vaginal resurfacing. First, there is no peeling of the vaginal skin. The laser settings are tuned to deliver less energy to the vagina because the skin is much thinner. Second, the vaginal skin lacks melanin even in women with very dark skin. This means that women who would normally be unable to have a facial laser treatment could safely undergo LVT without fear of burns. Third, as a consequence of the lower energy laser settings and the lack of tissue melanin, the procedure is painless.


The Results are Excellent

The results of laser vaginal tightening outside of the United States have been very promising. The most common observation by all groups who have been studying this technology for all of the conditions mentioned above is that the treatment effects are seen very rapidly – within days.

For the treatment of vaginal laxity, studies to date, although small have noted improvement rates of over 90 percent and satisfaction rates of over 70 percent in addition to significant changes in vaginal tone with measurements of vaginal pressure. This is a major technological breakthrough considering that the only other effective option in this setting is surgery.

Patients with urinary incontinence treated with laser vaginal resurfacing have demonstrated subjective improvement of their symptoms for at least 6 months. The key point in this group of women is that symptomatic improvement carries none of the side effects of current therapies – surgical or nonsurgical, and despite the absence of long term data, and does not harm women or worsen their condition.

The most impressive results of both subjective and objective improvement to date have been in women undergoing treatment for postmenopausal vaginal atrophy. Satisfaction rates of over 90 percent are being reported consistently in small early studies. Time and experience will better define the longevity of these effects. One thing is clear – for women who can’t take estrogen, laser vaginal resurfacing might be the only treatment that works.


It's a Safe Procedure

The risks of laser vaginal tightening are few, if any. Precautions already in place for laser treatments for other parts of the body include avoiding treatments in the presence of active infections or implanted prosthetics (meshes, slings), avoiding certain medications which affect healing and thin the blood, and avoiding treatment in individuals with rare connective tissue disorders that are known to respond poorly to laser therapy. Most of the skin-tone based concerns with nonvaginal treatments don’t apply since the vagina lacks melanin.

Viewed in a broad perspective, laser vaginal tightening brings to cosmetic gynecology a non-surgical dimension where none existed before. It offers women who don’t care for surgery the opportunity to enhance the quality of their sexual lives in a very convenient fashion.


REFERENCES

Fistonic I, Findri-Gustek S, Fistonic N. Novel minimally invasive laser procedure for early stages of stress urinary incontinence (SUI). Journal of the Laser and Health Academy 2012; 1:67-74.

Fistonic I, Manestar M, Perovic D, et als. Laser vaginal tightening for sexual dysfunction. Climacteric 2011;14(suppl 1):85

Gaspar A, Addamo G, Brandi H. Vaginal fractional CO2 laser: A minimally-invasive option for vaginal rejuvenation. American Journal of Cosmetic Surgery 2011; 28(3):156-162

Gaviria JE, Jose A, Lanz L. Laser vaginal tightening (LVT) – evaluation of a novel noninvasive laser treatment for vaginal relaxation syndrome. Journal of the Laser and Health Academy 2012; 1:59-66.

Isaza PG. Menopausal vaginal atrophy treatment with microablative fractional CO2 laser. A new approach. X Congreso Colombiano de Menopausia 2013. Bogota, DC – Colombia.

Lee MS. Treatment of vaginal relaxation syndrome with an Erbium:YAG laser using 90° and 360° scanning scopes: A pilot study & short-term results. Laser Therapy 2014; 23(2):129-138.

Perino A, Calligaro A, Forlani F, et als. Vulvo-vaginal atrophy: A new treatment modality using thermos-ablative fractional CO2 laser. Maturitas 2015; 80:296-301.

Salvatore S, Nappi RE, Parma M, et als. Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. Climacteric 2014; 17:1-7.

Salvatore S, Nappi RE, Zerbinati N, et als. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: A pilot study. Climacteric 2014; 17:363-369.

Vizintin Z, Rivera M, Fistonic I, et als. Novel minimally invasive VSP Er:YAG laser treatments in gynecology. Journal of the Laser and Health Academy 2012; 1:46-58.
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Jersey City OB/GYN