Cosmetic Gynecology: The Important Terms You Need to Know

While recently preparing a chapter on cosmetogynecology, I reviewed a mountain of material and reflected on the issues that arise repeatedly. One of the very first and very basic things was the absence of a guide to the terminology of cosmetic gynecology. Even the topic itself goes by half a dozen names, including cosmetic vaginal surgery, aesthetic vaginal surgery, female genital cosmetic surgery, and cosmetic female genitoplasty.

The terms aesthetic, cosmetic, and plastic are related, but they’re not synonymous. By understanding this, your ability to articulate your message will improve instantly.

Aesthetic derives from the Greek word aisthetikos, which means to perceive and judge sensory input as beautiful. When used as an adjective (ex: an aesthetic contour), it defines the subject as beautiful. With this is mind, we can see that the intended meaning of the term aesthetic surgery is incorrect. Aesthetic defines surgery (i.e. a beautiful surgery) instead of how the phrase is commonly used, which is a surgery to enhance the aesthetics of the patient.

Cosmetic derives from the Greek word kosmetikos, meaning to adorn or make beautiful. Cosmetic surgery identifies any surgical process that aims to enhance the aesthetics of the patient, regardless of whether the surgical process itself is beautiful. A cosmetic process creates an aesthetic product.

Plastic derives from the Greek word plastikos, which means to reshape. Unlike the previous two terms, plastic doesn’t define the reason for the action. When used in the term plastic surgery, further classification may be required (ex: reconstructive plastic surgery). Note that plastic surgery is performed for both cosmetic and non-cosmetic purposes, various surgical specialities reshape the body for various reasons, and surgeons from many specialities provide such surgery.

Diving deeper into the terminology that applies specifically to cosmetic gynecology...

Clitoral hood reduction, excision of excess prepuce, and excision of periclitoral labial reduplication are procedures that target loose skin at and around the clitoris either during labiaplasty or as an independent procedure. The term “hoodectomy" shouldn’t be used as it implies the clitoral hood is being partially or entirely degloved, neither of which are performed in cosmetic gynecology.

Clitoroplasty refers to surgical alterations to the clitoris that address conditions associated with increased tissue volume rather than for cosmetic enhancement. This can also be performed for the creation of a clitoris in transsexual and transgender women.

Dermolipectomy is a term frequently used in cosmetic and plastic surgery to describe the en bloc excision of skin and fat. It’s usually performed in tandem with procedures such as a tummy tuck, thigh lift, and, in cosmetic gynecology, mons pubis "lift" procedures and reductions of the labia majora.

Designer laser vaginoplasty™(DLV™) is a term trademarked by Dr. David Matlock’s franchise business, referencing the entire category of labiaplasty procedures, as well as alterations of the loose skin near the clitoral hood, all performed with laser techniques. This term is often misunderstood as it includes vaginoplasty in the name despite the fact that no vaginoplasty is performed during the procedure.

Genitoplasty refers to any procedure that reshapes the male or female genitalia. It doesn’t imply cosmetic or therapeutic intentions, so it must be further classified whenever it’s used. The most common utilization is feminizing genitoplasty, which describes procedures intended to give ambiguous genitalia a female appearance.

Hymenoplasty describes procedures that create a pseudo hymenal membrane from either existing hymenal tissue or non-hymenal soft tissue, typically with the intent to cause bleeding when the membrane is torn during sex. Synonyms include hymenorrhaphy, hymen reconstruction, and hymen restoration. Revirgination is a poor term because the loss of virginal status is a matter of personal history, not anatomy.

Labiaplastycan refer to any procedure which alters the contours of either the labia majora or the labia minora, whether it involves reduction, reconstruction, or augmentation. The most requested labial alternation is the reduction of the labia minora. The most frequently performed labia majora alterations are augmentation by fat injections and excisional reduction. The more specific terms labia minoraplasty and labia majoraplasty are less frequently used.

Laser vaginal rejuvenation™(LVR™) is a term trademarked by Dr. Matlock’s franchise to reflect vaginoplasty procedures performed with laser techniques. Others use the term vaginal rejuvenation to indicate vaginoplasty with or without the use of lasers.

Monsplasty refers to any procedure that alters the contours of the mons pubis. These procedures include liposuction to reduce excess fat, as well as the removal of skin and subcutaneous fat. These can be performed alone or in conjunction with a tummy tuck. The use of any technology to assist in the liposuction process, such as lasers or ultrasound, is typically indicated by adding the technology as a prefix (for example, laser-assisted liposuction).

Nymphectomy and nymphoplasty are terms synonymous with labia minoraplasty. They are less commonly used in contemporary English, but are sometimes used in French (nymphoplastie) and commonly in Spanish (ninfectomia, ninfoplastia).

Vaginoplasty refers to any procedure targeted at reducing the width of the vagina. These include tightening of the perineal muscles and repairing the rear vaginal wall. This is often performed along with a labiaplasty. Neovaginoplasty refers specifically to procedures that either partially or totally construct or reconstruct the vagina.

Marco A. Pelosi III, MD is a cosmetic gynecologist based in Jersey City, N.J.

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