By Michael Goodman, MD
Copyright 2019. All rights reserved.
This Blog will present a bare-bones outline designed to help the reader choose the best surgeon for your job. Are you considering vulvo-vaginal cosmetic surgery (labiaplasty; vaginoplasty; vaginal reconstruction; “vaginal rejuvenation, etc…) in the U.S. or abroad? What do you look for; how best to choose the person to trust with your desires, your expectations, your precious vulva and vagina. What exactly should you look for?
1. Look for labiaplasty, vaginoplasty, vaginal reconstruction and vaginal rejuvenation “before and after” photos and reviews on your prospective surgeon’s website. Is your prospective surgeon trained and experienced in the specific procedure you wish? Does (s)he have specific individual pages highlighted on their website where they show their knowledge of the procedure? Can they prove to you by means of either individual before and after photos of at least 2 dozen procedures performed, and/or present specific evidence that they have been trained (Certificate of Completion, etc.) by one of the acknowledged expert trainers noted on this site? I’m not talking about merely attending a lecture; you will need to see evidence of at least a 2-day intensive course… Seeing and reading is believing: if your potential surgeon’s site exhibits very few “B&A” pics and/or no evidence of training, you might STAY AWAY from this surgeon..!
2. Make an appointment, either in-person or “virtually” with at least 2 different surgeons. (A “virtual” appointment is when you send a close-up, in-focus photo file of your vulva looking from above, looking straight-on with your legs jack-knifed so that the vaginal opening can be seen, and a look from both left and right “straight-on” angles.) Pay attention to how you are treated by office personnel! Are they knowledgeable, do they treat you with respect, ask the right questions, explain and help, or are they curt, busy, and not knowledgeable? When you speak with the doctor, is he or she easy to communicate with, does (s)he fully understand your feelings, expected outcome, and what you wish to accomplish both aesthetically, functionally and aesthetically. Does (s)he discuss your anatomy, reasonable expectations, recovery, anesthesia, etc? Is this surgeon experienced enough that (s)he is comfortable performing surgery in their in-office surgical suite preferably giving you the choice of “local” anesthesia. While there certainly are exceptions, surgeons who operate under “local” are generally better trained and experienced. Beware of surgeons who offer to perform your surgery “…under insurance,” as while these surgeons are privileged by the facility/hospital for a “partial vulvectomy” type labiaplasty, the procedure whereby most amputations occur, very few are privileged for “Aesthetic Labiaplasty.”
3. Arrangements for immediate and ongoing aftercare are important! Is this discussed to your satisfaction by both office staff and your surgeon? Do you feel safe? Has your prospective surgeon carefully discussed all aspects of surgical planning, the procedure itself, pain control methods, immediate and long-term recovery? Have each and every one of your questions been answered? Have you been clearly prepared for your important role in your recovery?
4. Has your surgeon candidly discussed risk with you and given you careful and complete “Informed Consent?” Careful and experienced surgeons take time for this often overlooked aspect of total care. Inexperienced surgeons, or ones “…too much in a hurry…” frequently overlook this important aspect of total care. If you will be “travelling” for your surgery, is the surgeon’s staff helpful in making local arrangements and understanding the difficulties involved in travelling home a reasonable time after your surgery. Have you been prepared for the minimum time necessary before you can safely travel?
5. Finances are important, and individual surgeon’s fees can give you a window into their experience. Experienced surgeons are aware that virtually all labial reduction and vaginal tightening surgical procedures are considered “cosmetic” by insurance companies, who can withdraw preliminary payments to hospital and surgeon if they realize the truth about an individual procedure. You usually “…get what you pay for.” Beware when a surgeon’s fee looks too good to be true, but understand that some excellently trained surgeons, but relatively novice genital plastic surgeons, will often give their first several dozen patients a meaningful discount.
6. Be sure to check out the “…Patient Experiences…” pages on any prospective surgeon’s website and elsewhere on the W.W.W.