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Traditional face-lift techniques in the modern age of cosmetic surgery have been largely eliminated and replaced with minimally invasive face-lift techniques. These modern facelift techniques are based on the concept of “Wonder Woman surgery” (WWS), which stands for minimal incision, minimally invasive, rapid recovery, and minimal risk.
WWS is named after the superhero, “Wonder Woman,” and is a term that originated in the United States to represent the four standards of modern medicine demanded by the hero figure, Wonder Woman.
Liposuction has become a popular procedure for lipodystrophy of the lower limbs. It is considered safe and efficient when it is performed by highly experienced clinicians using an appropriate tumescent local or hypotonic solution. Traditional suction-assisted liposuction is preferred over other methods, such as the ultrasound-assisted method, super-wet technique, or laser-assisted method. Traditional methods are easy to perform, less costly than others, and associated with minimal complications.
Liposuction can redistribute the subcutaneous fat from the lateral side of the lower limbs to the inner side and restore the normal gait pattern. The vertical position of the knees improved significantly. Post-surgical biopsy of subcutaneous tissue showed no abnormal results.
Skin retraction and regeneration enhanced from the day of surgery. To achieve consistent and desirable long-term results, it is important to assess the elasticity of the skin and soft tissue, determine the site and extent of fat deposit, and determine the type of fat tissue before surgery.
Liposuction surgery is an effective method to reduce fat deposits for generalized lipodystrophy or localized lipodystrophy. Postoperative rehabilitation treatment such as resting, using a pressure garment, and regular exercise may significantly improve post-surgical recovery. Liposuction will help to improve the patient’s quality of life, yield satisfactory functional and cosmetic outcomes, and significantly restore normal gait patterns.
Advances in Wonder Woman surgery, as a concept, efficiently reflect the wide range of options available to deal with what is now a diverse group of women with specific needs and desires. At one extreme are those women born athletic, who wish for a more traditional feminine body shape without losing their competitive edge, and at the other extreme are transgender MTF patients, often presenting with challenging conditions of the thorax.
This chapter will provide an easy-to-understand reference section on many of the most popular concepts regarding surgical options for the upper body, with the potential for extension to the lower limbs. As these initially were all about reduction, they lent themselves to basic female breast cancer reconstruction: a battle-scarred territory in which women often fared worse than they did through the actual war itself. With the advent of sanctioned professional sports, especially those in which women are directly competing against men—like tennis and cycling—the reduction has evolved through repetitive adaptations into augmentation. But now it is a carefully planned transformation with variable potential function and a high probability of good or excellent longevity.
Maintenance attention, like an expensive car, also includes continuing to feed the surgeon’s quality aftercare and a willingness of the patient to have further procedures, should the need arise. By rebranding the increasingly popular mammaplasty as an elective cosmetic procedure, the combination of a largely female surgical interest and substantial amounts of money to impair an otherwise financially poor health system may have obscured the essence of the amazing evolutionary journey involved. Leisure surface water recreation and organized swimming are also popular.
Women between the ages of 40 and 50 years emerge as the most likely to invest in their breasts with what is referred to in the modern era as “The Wonder Woman Surgery.” The 21st century must be the era of wonder women. In earlier times, they competed covertly in athletic events dressed as men. They wore the oldest model of mammoplasty prosthesis that was created in the mid-20th century to help young women with different gender orientation.
Times have changed. The modern era elective cosmetic procedures are operated on women from all walks of life. They are women who are preparing to join the ever-increasing ranks of professional sportswomen or are actively competing against men. They may be recovering from the setbacks of cancer, transforming after a sex reassignment, or simply updating to enhance the visual effect. Their main objective in each case is to be proud of what they are aiming to achieve, thanks to advances in surgical style, offering sculpted feminine or its more outlandish resistant form.
Labiaplasty refers to the unification of various techniques for resection and reshaping of the labia minora to reduce their size, change their shape, or improve symmetry. The primary sources of anxiety and interest in this operation are patient complaints of enlargement of the labia minora that are not of tumescent cyst origin.
A retrospective study demonstrated that the overwhelming majority of women seeking genital cosmetic surgery, labiaplasty, requested labia minora alteration. Furthermore, over 30% of African American women were shown to be seeking this procedure. This plastic surgical option rounds out the female patient’s range of corrective genital surgical possibilities.
Sometimes labia minora augmentation is performed secondary to an initial inadequate resection that denominates this procedure labiapexy. Aesthetic goals are better matched after minor alterations of the clitoral hood, pudendal deep fat, large subcutaneous perioral suture tacking, and fat grafting and fat pad (of the dorsal part of the labia majora) previously were performed.
Although individual opinions differ, it has been our experience that extended labia minora can lead to functional concerns of discomfort with participating in sports, sexual intercourse, and generally wearing tight-fitting clothes. To me, surgical sculpting of the labia minora with labiaplasty or other aesthetic vulvovaginal procedures improves the attractiveness, self-esteem, and comfort of many women and thereby represents an expanded indication when noninvasive solutions are unsatisfactory.
The limitations of contemporary paradigms in feminine genitoplasty include regulatory and societal constraints on access to medical pseudo-cosmetic genital knowledge and the access to medical and cosmetic genital care.
The large majority of requests for cosmetic genital surgery arise from women who are interested in surgical modification of the external genital lips (labia majora and/or minora). Excess tissue in the clitoral region (clitoral prepuce), pigmented and darker labia, mons pubis, sagging labia, bulky labia, spreading apart of the labia, scars and irregularities, deformed areas in the external genital area, such as hypertrophic, deformed, and irregular shapes and size of labia minora, etc., are new problems affecting a different age and demand that women consult, from different socio-economic levels, a specialist’s intervention to find a solution.
Large labia minora could hypertrophy, which brings them unwanted attention as they become evident, as they give genital contact or appear in the patient’s gym outfit or swimsuit. Although the fears of tissue hypertrophy and its consequences are frequent, in many cases, it is positively correlated, at least in the labia region, with maternal hormones, which are involved in the adaptation of the vulva to the demand of childbirth, as they are formed by estrogen receptors.
Let us try to understand this desire with a different approach. In the evolutionary process of the female external genitalia, the labial region is located in the center of both sexes. Hanging fat crusts develop in the region to protect the structures inside. They are similar in structure and function to the labia in the male reproductive system. The labia protect the internal female structures. As in the breast, the pointed and fuller external genital lips have drawn the same discriminatory attention.
The addition, maturing aspects of fashion with locations close to resorts and synch the introduction of the bikini lifestyle, have stigmatized the external genitals, bringing them unwanted attention. The volume/shape adaptation and correction of the deformed genital structure can be performed using modern plastic and cosmetic surgery. The patient’s desire here is not medical but social and normal, as generally abnormal genital lip appearance.
The tissue excision technique combined with tissue mold-shaped synthesis can be surgically performed, achieving very good results and patient satisfaction as in other face, body, buttock, breast, and labial areas. The vulnerability that arose after being deformed by the need for exaggeration, the emergence of the subject and the insertion of intimates, brought to life a new social demand. There is plastic, aesthetic, and cosmetic surgery to fill it.
One of the common complaints from women is the external appearance of the vagina, along with decreased sensation after childbirth such as genital fullness. At present, the demand for cosmetic surgery of the vulva has increased and a new terminology called “Barbie doll vagina” has appeared. Surgeries for the external appearance of the vagina are divided into two types: one to make the labia minora less prominent, and the other to rejuvenate the lost contour after childbirth.
Many patients who visit the hospital want not only the surgery to make the labia minora less prominent, but also tattooing around the labia in order to increase sexual stimulation. This is very understandable when considering current sexual themes. However, meticulous decision making and ethical judgment must be accompanied, and true demand with clear reasoning must be given first priority when performing surgery.
The labia minora vary in appearance, causing many patients to find fault with the appearance. Such women may suffer from decreased sexual desire and decreased activity in social life. The surgery to make the labia minora less prominent is called reduction labioplasty. For elongation, it can be called enhancement or rejuvenation surgery. The surgery to make the labia minora less prominent will be explained briefly. The labial incision technique is most commonly used.
These attempts should be gentle to avoid loss of pigmentation, which is the main source of plumpness. Then, excision is performed along clarity with anesthesia and bleeding control. After this, the cut part is sutured meticulously so as to not show the mark, and there is no secondary deformation. Macrona is a decreased vulvar appearance that occurs due to vaginal delivery.
The surgery takes a very long time because it has lost its shape. It also needs a lot of cutting and suturing because there is redundant tissue around the mons pubis. It is a complicated surgery similar to other lifting surgeries. It needs a lot of knowledge and skills. Be careful about these surgeries. In reality, these operations often accompany vaginoplasty because the degree of improvement in vaginal sensation is very high..
Vaginoplasty is not truly a part of the W-W group of surgeries, as it is largely part of GRS (gender reassignment surgery) for male-to-female transgender individuals. In these patients, it focuses on allowing penetration by a neo-vagina. It’s no secret amongst our target demographic that these types of patients generally fare worse than they did in terms of what is perceived as quality.
Very rare indeed, and among a small percentage of women, the majority of such operations are revision procedures after birth traumas or those carried out because of a malformation or another entity that was there since birth. Such cases rue the decision to have GRS and regret the fact that after the normal or even lenient childhood, they never felt female enough due to all the troubles that a neo-vagina might bring.
Aesthetic genitoplasty procedures make up a vast proportion of the new surgeries known as Wonder Woman surgeries. This term is coined due to the fact that these surgeries aim to make the patient as aesthetic and functional as a superhero. The term Wonder Woman is now gaining wider acceptance in this application in other female surgeries, excluding cosmetic surgeries.
These surgeries aim to increase the aesthetic, sexual, and functional satisfaction of patients and to create genital characteristics desirable for the opposite sex. These indications can overlap with functional genitoplasty patients who prefer a fuller and larger labia majora.
Patients with congenital anomalies or genital mutilation may also require labia majora enlargement for a more natural appearance or sexual function. However, without doubt, the majority of labia majora augmentation procedures are performed for aesthetic purposes only. In this chapter, different surgical techniques (injection, fat filling, liposhaping, dermal fat flaps, autologous tissue, filler substances, autologous or alloplastic fillers, implants (silicone), or dermal-fat grafts), local tissue deformity reduction, local tissue stimulation, liposuction, and monsplasty) for functional and/or aesthetic labia majora reconstruction, their advantages and disadvantages, complications, possible solutions for complications, ideal patients, informed consent, preoperative preparation, operation techniques, and postoperative care principles will be reviewed with the intention of reconstructing a sourcebook for the patients and health professionals such as nurses or physician assistants considering these surgeries.
Clitoroplasty refers to the reduction of the glans clitoris, but often also involves the reduction of the clitoral hood to provide a more traditional female appearance. Clitoroplasty can restore sexual function in several ways, but should only be performed in a manner that preserves neurovascular function and sensation.
Otherwise, clitoral sensitivity or orgasm might be compromised. In infants, less obvious clitoral hypertrophy can be managed with the judicious use of topical estrogen cream and attention to avoiding urinary stream obstruction. Cacheosis resection is frequently performed as part of the clitoroplasty to preserve sexual function.
Enlargement of the clitoris, such as that seen with clitoral cysts, clitoral tumors, or other clitoral hypertrophy with or without clitoral malfunction, must be evaluated and treated as separate entities prior to performing clitoroplasty. Disorders such as adrenogenital syndromes, congenital adrenal hyperplasia, pseudohermaphroditism, and phallic enlargement may require clitoral reduction along with other procedures to feminize the external genitalia.
If clitoroplasty is used for secondary correction only, the indication is related to cosmetic correction. Unlike a newborn where the procedure may be combined with other surgical procedures, in a grown woman, clitoroplasty is typically a stand-alone procedure that may be performed under local anesthesia.
Technological advancements in genital correction surgery allow refined modifications of the genital structures. This contributes to superior aesthetic and functional outcomes in transgender individuals. We aimed to review advances in techniques and outcomes of the clitoris, labia minora, labia majora, vagina, and mons pubis surgeries.
Surgical refinements and anatomical considerations for gender-affirming genital surgery lead to satisfactory and reliable results. The current trend towards gonad sparing surgery can further improve the surgical outcome by preserving the natural hormonal environment that enhances postoperative conversion of the clitoris into a neophallus.
The clitoris is analogous to the male penis. The clitoral body of the transgender male can be released, bifurcated, and buried as inverted V-Y plasty flaps or can be buried as an inlay. Nerve transfer techniques using clitoral dorsal nerves and the intumescentia in situ ensure sensation. Both techniques achieve excellent cosmetic and functional outcomes.
The appearance of the clitoris postoperatively is very similar to the glans of a natal penis when stent-free techniques are employed. Deep bundles of the clitoris contribute to penile rigidity postoperatively when used as a phallic donor. Clitoral function is restored over time with sexual excitement and use. A small proportion of patients may undergo outpatient slave conversion later.
Modern surgical procedures should not only be motivated by the creation of aesthetically beautiful labia, but also by functional improvement and preservation of the natural anatomical details. The fundamental anatomical improvement to the labium majus takes into account the fact that every new cosmetic technology, such as laser or radiofrequency, can not only harm the intimate microbiological environment, but also the natural and individual aesthetic criteria of the woman.
Using the unique regenerative properties of the human body and natural individual tissue formation processes, a new method of Wonder Woman surgery for labium majus rejuvenation and hypertrophy is proposed. The aim of this work was to present the first worldwide way of filling the labium majus fat, stabilizing the operated volume, and preserving the anatomical contours of the labium majus by mini fat grafts balustering under direct vision through the unique lymphatically permeable stabilized hydrogel inserted before the filling procedure.
Surgical rejuvenation removes a small amount of tissue, not enough to reduce and waste its own body tissues. The applied lipofilling restores the volume of tissue, which was previously reduced by aging changes while rejuvenating the visible skins of the labia. Labium majus hypertrophy rejuvenation with a de-epidermized fold is a low-risk surgical procedure with pronounced differences in individual cases. Therefore, patients choosing this operation should know in advance that this kind of modern surgical intervention in their labia can be performed, but the existing hypertrophy problem may further worsen in older age.
The correct technique for treating hidden nymphs is to excise the clitoral hood’s pocket, which provides the hidden niche, facilitating fungal development. It simultaneously shortens the clitoral hood and suspensory ligaments.
A 20-year-old nulliparous woman underwent symptomatic treatments. She presented with extensive erythema and painful swelling of the clitoral hood. Moreover, she presented with healing scars on the distal part of the labia minora. In the physical examination, mucoid discharge was observed from the depth of the pocket hidden on the distal part of the hood. It seemed to be an enamel-filled cyst with inflammation around it.
After cyst drainage, odorous cheese-like debris and a lot of mucopurulent discharge were removed. The symptoms improved temporarily. However, Candida albicans was identified microscopically from the mucopurulent discharge. Following 3 days of administration of systemic fluconazole, ulcerative erosions with surrounding erythematous changes remained because of the initial draining procedure. She exhibited resolution of her symptoms without recurrence during the follow-up period after the excisional correction of the affected tissue by the side-clipping technique using the Trimedyne(TM) laser system.
An 18-year-old woman presented with a 5 × 2cm subclitoral swelling and chronic discharge. In this pre-pubescent subject, no infective causes or history of female genital cutting were reported. At 3 months, the lesion was excised to perform a craniotomy, revealing fibrous tissue surrounded by inflamed tissue with an abnormally high number of tryptase-positive cells compatible with an IgE hyperresponsiveness.
The suture was infiltrated by histiocytes and associated with an iatrogenic foreign cell inflammatory infiltrate due to the 4-0 prolene foreign bodies. At 12 months, a microdysgenetic scar was evident; no symptoms or swelling was reported.
A 48-year-old married, post-pubescent woman had been experiencing long-lasting itching in the clitoral hood with one previous unsuccessful removal of the labia minora. A ‘clitoritheromy’ was performed with a follow-up conservative clip excision preserving the clitoral hood at 6 months with a microdysgenetic cervical-like clitorophimeric scar. Resectioning using scissors resulted in the vitrification of the edges. No clitoritive symptoms or swelling were reported.
During the follow-up period of these cases, few clitoral hyperaesthesies were observed as persisting post-traumatic methylthioninium chloride (methylene blue) nerve damages similar to the ones previously described at 8-12 months due to neural contaminations.
Definition-wise, these cases are different from adult-older women’s post-war emergency services of African female circumcision, intimate sexual organs, confinements, or non-curative skin diseases where the gynecological-surgical interference does not solve the affected clitoral-impatient neural damage. Due to these facts, we should try to eradicate the prejudices surrounding any regulatory gynecological surgery and promote the de-worming as such of imperforated pre-pubescent clitoral abnormalities with mutagenic excisions similar to those adopted in other non-gynecological areas of hypermutable chronic auto-inflammations.
The G-Shot is a simple, nonsurgical procedure designed to temporarily augment sexual gratification in sexually aroused females. It’s an area-specific, non-traumatic technique which includes the injection of hyaluronic acid gel around the G-Spot. It has been noticed that the G-Shot not only enhances vaginal sensitivity, sexual arousal, and consequently overall sexual satisfaction, but it also has great potential to augment happiness, marital harmony, and mental health.
Published literature shows some evidence of positive results for enhancing sexual pleasure and libido in women receiving the vaginal G-spot augmentation. With minimal discomfort and side effects, sexual function satisfaction is significantly augmented temporarily. It also helps women to improve intimacy and relationship with their sexual partner.
This chapter gives a comprehensive guide, explaining why we require G-Spot augmentation; how and when it should be done; its contraindications, complications, and side effects; and concludes with general patient counseling for those considering the G-Shot.
The female G-spot has long been thought of as a holy grail in sexual enhancement but has mainly been a disappointing mirage. It is most commonly found on the anterior wall of the vagina, about mid-height. The anatomy is the paraurethral (Skene’s) glands. Its function, at least in part, is orgasm due to its rich secretory nature. Indeed, some authors believe that full and complete orgasm actually requires some activity in these glands. There is no separate nerve for the G-spot. Orgasm can be achieved either from cervical stimulation, clitoral stimulation, or G-spot. Many patients do not enjoy these orgasms, although they can exhibit some degree of ejaculate.
Before G-Spot Augmentation, it is important to complete two periods of 6 weeks of vaginal exercises (Kegel) before surgery and assess their muscle tone. Increase the volume by 1-2cm3 per complain session during the first 2-3 injections targeted at each practical family visit schedule. However, the majority of your patients will likely only have 2-3 differences.
Don’t use too much or too primary filler as the patient will have no enjoyable intercourse or the concentration may block the ducts. The procedure is performed under local anesthetic cream with the patient in gynecological position with a slight Trendelenburg. The surgeon stands between the legs. A small ‘blow-hole’ about 2cm (the length of the 12 o’clock). A fine needle such as a 23 or 25G needle is the smallest option. Enter the gland while stretching the vaginal wall apically at 12 o’clock. Only enter 6-10mm. You might fill 1-2cm (1-2mL) in 3-4 sessions.
Only inject 1-2cm3 of filler per injection so only the lateral-inferior can be treated per session. Fill a little apically and laterally. The filler is only injected into the superficial 4-8mm. Keep clear of the urethra and bladder neck.
Interest has surged in the use of growth hormones and stem cells in plastic surgery because skin and soft tissue components, bones, and hair can be regenerated. Autologous adult stem cells satisfy ethical criteria, relieve worries about immune rejection, and have many medical benefits, including the potential for tissue remodeling.
Local injections of culture-expanded autologous adipose-derived stem cells may enhance rejuvenation of the aging female periorbital area. Stem cells derived from adipose, although isolated by simple, minimally invasive procedures unrelated to the pregnant mother or to pathological conditions of the fetus, provide abundant WH.
Stem cells derived from adipose demonstrate potential to form various types of cell, including cartilage, fat, bone, and muscle. Treatment of esthetic defects using stem cells derived from adipose may help to considerably improve the quality of life of patients. Stem cells derived from subcutaneous adipose can repair damaged tissues efficiently, regardless of long-term cryopreservation.
“As time has passed, women have become multidimensional and stronger,” and according to plastic surgeon Leonard Hochstein, “a powerful woman should be paired with an equally powerful vagina.” In recognition of the growing acceptance and social welfare of genital plastic surgery, the name of these services has gradually shifted from cosmetic to vaginal youth enhancement.
Surgical technology has undergone great advancement in recent years. Their common goal is to restore sexual function. The demand for increased sexual gratification has led to many new technical developments that go beyond cosmetic appearance, including structural amendments which often address sexual function and have more diagnostic functions.
Recent design advances in aesthetic vulva and vaginal surgery allow the surfaces to be smoothed and reinforced. Labiaplasty, clitoral and vestibule aesthetic repair converge to yield a beautiful, aesthetically appealing, and young vulva at the same time with correction of the structural damage caused by the birth canal.
The purpose of this article is to provide information on modern methods of vulvar and vaginal shape correction, especially for practitioners wishing to correct certain vaginal appearance flaws and for patients who complain of deformities after childbirth and during aging which may cause disruption to their normal sexual lives.
Unfortunately, not everyone is allowed to undergo the transformation surgery, and the procedure comes with a few risks. Most Beautiful Program advised steering clear if you’re a smoker, obese, suffer from health problems, are pregnant or breastfeeding, are diabetic or have poor blood flow.
After the surgery, patients can expect to experience redness, irritation, and swelling over the first week. Many post-op patients also experience some mild discomfort in the operated areas, but this is short-lived. Most patients typically go back to work within a few days, but any visible bruising will take 2-3 weeks to improve. They must also wear a compression pad for the first couple of months after the surgery.
In general, it takes around 2-5 hours, depending on the desired number of areas for liposuction and the amount of body sculpting required.
The results are absolutely permanent.
The cost of surgery varies depending on many factors including facility fees, anesthesia, and the specific treatment plan. The all-inclusive “Wonder Woman” package also includes consultations, surgeries, and follow-up appointments! Treatment plans are personalized for that individual’s needs. Please ask what is included when an estimate is given.
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