Do You Really Talk to Your Gynecologist?

Whether its botox, breasts, or Brazilian butt lifts, Miami loves to look good. In fact, inhabitants of this great city spend millions of dollars every year in the search of the perfect look. We can debate the ethics, negative social pressure, and psychological benefits of cosmetic surgery all day, but the fact remains that plastic surgery is a well established part of modern medicine.

However, there is another realm of cosmetic surgery that rarely is in the spotlight but is gaining popularity as patients become more informed and open to discussion of intimate issues.

The term cosmetic gynecology applies to several procedures involving the lips, opening, and inside of the vagina. It is sometimes marketed under the term vaginal rejuvenation. It is cosmetic in the sense of altering appearance, but unlike many cosmetic procedures, the majority of patients also benefit from a functional improvement. The conditions that are addressed range from dissatisfaction with vaginal appearance, unsatisfactory sexual relationships, loss of urine or feces, or painful intercourse. Many of these complaints are the result of damage caused by child birth or due to pre-existing weak vaginal tissue.

Traditional gynecology has focused training on surgeries that address only loss of urine or feces, without an appropriate emphasis on appearance or sexual satisfaction. This results in patients having only some of their symptoms addressed when undergoing surgery.

The reality is that patients are complex and their issues are very individualized. What may seem as a minor problem to one patient may be a life altering condition to another. A common example is enlarged or uneven vaginal lips. Although a normal variant in many women, for some it can cause a negative self image and in some cases can cause pain with certain clothing or intercourse. Women are often times reluctant to discuss these concerns with their partner or her physician. The result could be a lifetime of unhappiness due to an easily correctable issue.

Loss of urine and sexual dissatisfaction are other concerns that many women are reluctant to discuss. I tend to see patients vocalize these issues when they are older, but almost all will admit that the issue began several years before. Sometimes, the lack of mutually satisfactory intercourse results in marital problems, especially when there is poor communication as a couple. Correcting these issues as early as possible also produces better results since the tissue is healthier and heals better.

In summary, cosmetic gynecology is a somewhat confusing term that involves much more than physical appearance as the name would imply. Whether addressed as cosmetic gynecology, vaginal rejuvenation, or vaginal repair, the surgeon needs to individualize the procedure to the patient’s needs. Advances in modern medicine are driven by the patient; who relies on the increase in access to medical education. Our society has also become more open to discussions of what used to be very intimate, often taboo topics. Progressive gynecologists have a responsibility to invite open conversation with their patients and to never dismiss a patient complaint as frivolous or unimportant.


Ernesto Cardenas MD, FACOG

Appointments: 786-953-7651