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| == Risks == | == Risks == | ||
| The dorsal nerves of the clitoris travel above the clitoris along the clitoral body. Permanent injury to these nerves can occur with clitoral hood reductions.<ref>{{Cite journal|last=Ginger|first=Van Anh T.|last2=Cold|first2=Christopher J.|last3=Yang|first3=Claire C.|date=2011-02-04|title=Surgical anatomy of the dorsal nerve of the clitoris|url=https://onlinelibrary.wiley.com/doi/pdf/10.1002/nau.20996|journal=Neurourology and Urodynamics|language=en|volume=30|issue=3|pages=412–416|doi=10.1002/nau.20996|issn=0733-2467}}</ref> | The dorsal nerves of the clitoris travel above the clitoris along the clitoral body. Permanent injury to these nerves can occur with clitoral hood reductions.<ref>{{Cite journal|last=Ginger|first=Van Anh T.|last2=Cold|first2=Christopher J.|last3=Yang|first3=Claire C.|date=2011-02-04|title=Surgical anatomy of the dorsal nerve of the clitoris|url=https://onlinelibrary.wiley.com/doi/pdf/10.1002/nau.20996|journal=Neurourology and Urodynamics|language=en|volume=30|issue=3|pages=412–416|doi=10.1002/nau.20996|issn=0733-2467}}</ref> Despite this, the anatomy of the dorsal nerve is never mentioned in peer reviewed literature on techniques for clitoral hood reductions. | ||
| The fact that most OB/GYNs and plastic surgeons are usually not educated about this anatomy and are not trained to do these procedures during residency makes them especially dangerous. Training standards have yet to be established, despite efforts from experts to standardize training and improve privileging. The controversy around these procedures precludes professional organizations from taking action to help make them safe.<ref>{{Cite web|url=https://www.wiley.com/en-us/Female+Genital+Plastic+and+Cosmetic+Surgery-p-9781118848517|title=Female Genital Plastic and Cosmetic Surgery|date=2016-04-18|website=Wiley.com|language=en-us|access-date=2018-05-08}}</ref> | |||
| ==See also== | ==See also== | ||
Revision as of 03:42, 8 May 2018
"Clitoridotomy" redirects here. For other uses, see Female genital mutilation.
Clitoral hood reduction, also termed clitoral hoodectomy, clitoral unhooding, clitoridotomy,or (partial) hoodectomy, is a plastic surgery procedure for reducing the size and the area of the clitoral hood (prepuce).
It is sometimes done as a form of elective surgery where the therapeutic goal is the aesthetic refinement of their vulva. It is a form of hoodplasty. The reduction of the clitoral prepuce tissues usually is a sub-ordinate surgery within a labiaplasty procedure for reducing the labia minora; and occasionally within a vaginoplasty procedure.
Surgical procedures
The procedures for labiaplasty occasionally include a clitoral hood reduction. One technique for reducing the clitoral hood is the bilateral excision (cutting) of the prepuce tissues covering the clitoral glans, with especial attention to maintaining the glans in the midline. Another technique cuts away (excises) the redundant folds of clitoral prepuce tissue, with incisions parallel to the long axis of the clitoris.
Clitoral hood reduction can be included in the extended wedge resection labiaplasty technique, wherein the extension of the exterior wedge sections is applied to reducing the prepuce tissues of the clitoral glans. Yet, occasionally excess prepuce-skin, in the center of the clitoral hood, is removed with separate incisions.
Partial or total hoodectomy is classified by the World Health Organization as female genital mutilation (FGM) Type 1A.
Results
The functional corrections and perceived aesthetic improvements to the vulvo-vaginal complex indicate that labiaplasty procedures have a high-rate of patient satisfaction with the surgical outcome, and a low incidence-rate of medical complications.
Moreover, regarding the woman’s satisfaction with the plastic surgical outcome, the study Expectations and Experience of Labial Reduction: A Qualitative Study (2007) reported that the women who underwent labiaplasty had great expectations for the elimination of pubic discomfort and pain, improved cosmetic appearance of the vulva, and improved sexual functioning. Most of the women experienced improved self esteem; yet the study also reported that formal psychological counselling before the surgical operation, about what to expect and what not to expect from a labia minora and a clitoral prepuce reduction procedure, might better serve the woman (as the patient) by assisting her in establishing realistic (feasible) goals for her genital beauty and mental health, which might be derived from a genitoplastic procedure.
Criticism
See also: Labia prideThe American College of Obstetricians and Gynecologists (ACOG) published Committee Opinion No. 378: Vaginal "Rejuvenation" and Cosmetic Vaginal Procedures (2007), the college’s formal policy statement of opposition to the commercial misrepresentations of labiaplasty, and associated vaginoplastic procedures, as medically "accepted and routine surgical practices". The ACOG doubts the medical safety and the therapeutic efficacy of the surgical techniques and procedures for performing vaginoplastic operations such as labiaplasty, vaginal rejuvenation, the designer vagina, revirgination, and G-spot amplification, and recommends that women seeking such genitoplastic surgeries must be fully informed, with the available surgical-safety statistics, of the potential health risks of surgical-wound infection, of pudendal nerve damage (resulting in either an insensitive or an over-sensitive vulva), of dyspareunia (painful coitus), of tissue adhesions (epidermoid cysts), and of painful scars.
Risks
The dorsal nerves of the clitoris travel above the clitoris along the clitoral body. Permanent injury to these nerves can occur with clitoral hood reductions. Despite this, the anatomy of the dorsal nerve is never mentioned in peer reviewed literature on techniques for clitoral hood reductions.
The fact that most OB/GYNs and plastic surgeons are usually not educated about this anatomy and are not trained to do these procedures during residency makes them especially dangerous. Training standards have yet to be established, despite efforts from experts to standardize training and improve privileging. The controversy around these procedures precludes professional organizations from taking action to help make them safe.
See also
- Circumcision, the reduction (usually outright removal) of the male prepuce. Prepuce removal of either sex can be done with or without consent, and with or without sterile tools.
- Genital modification and mutilation
References
- "Gynecological cosmetic surgery". Expert Rev. Obstet. Gynecol. 4(2). 2009. p. 102.
The procedures described under female esthetic genital surgery are reduction labiaplasty, vaginaplasty, liposuction to mons pubis, fat injections to labia majora or mons, clitoral hoodectomy, hymenorrhaphy, 'G-spot amplification', and the use of a surgical laser in 'vaginal rejuvenation'.
{{cite book}}:|website=ignored (help) (originally located at http://www.expert-reviews.com/doi/pdfplus/10.1586/17474108.4.2.101) - Carol Downer (1980). "Self-help for sex". Women’s Sexual Development. Springer US. pp. 255–279.
Some therapists refer women for female circumcision (clitoridotomy) to have their clitoral hoods removed so that they can be more sensitive to the thrusts of the penis
- Maria Caterinala Barbera (2009). "Revisiting the anti-Female Genital Mutilation Discourse" (PDF).
Circumcision (also called as clitoridotomy, τομία, Greek for "cut", "incision") is the mildest form of genital cutting. This involves the clitoral hood removal, but it preserves the clitoris and the posterior larger parts of the labia minora. In Islamic culture, circumcision is known as sunna (tradition), because it is mentioned in some ahadith (the sayings of the prophet Muhammad). This kind of cutting can be equated to male circumcision.
{{cite journal}}: Cite journal requires|journal=(help) - Mirzabeigi MN, Moore JH Jr, Mericli AF, Bucciarelli P, Jandali S, Valerio IL, Stofman GM. Current Trends in Vaginal Labioplasty: A Survey of Plastic Surgeons. Annals of Plastic Surgery. 2011 PMID 21346521
- ^ Felicio Y. Labial Surgery. Aesthetic Surgery Journal. 2007. 27:3;322–328.
- Hunter JG. Considerations in Female External Genital Aesthetic Surgery Techniques. Aesthetic Surgery Journal. 2008. 28:1;106–107.
- ^ Alter GJ. Aesthetic Labia Minora and Clitoral Hood Reduction Using Extended Central Wedge Resection. Plastic and Reconstructive Surgery. 2008. 122:6; 1780–1789.
- Template:Http://www.who.int/reproductivehealth/topics/fgm/overview/en/
- Scholten E. Female Genital Cosmetic Surgery — The Future. Journal of Plastic, Reconstructive & Aesthetic Surgery. doi:10.1016/j.bps.2009.01.002.
- Mirzabeigi MN, Moore JH, Mericli AF, Bucciarelli P, Jandali S, Valerio IL, Stofman GM. Current Trends in Vaginal Labioplasty: A Survey of Plastic Surgeons. Annals of Plastic Surgery. 2011. PMID 21346521
- Bramwell R, Morland C, Garden AS. Expectations and Experience of Labial Reduction: A Qualitative Study. British Journal of Obstetrics and Gynaecology. 2007. 114(12);1493–1499.
- Di Saia JP. An Unusual Staged Labial Rejuvenation. Journal of Sexual Medicine. 2008:5;1263–1267.
- American College of Obstetricians and Gynecologists (2007). "Vaginal "Rejuvenation" and Cosmetic Vaginal Procedures" (PDF): 2. Archived from the original (PDF) on December 30, 2008.
{{cite journal}}: Cite journal requires|journal=(help); Unknown parameter|deadurl=ignored (|url-status=suggested) (help) - Ginger, Van Anh T.; Cold, Christopher J.; Yang, Claire C. (2011-02-04). "Surgical anatomy of the dorsal nerve of the clitoris". Neurourology and Urodynamics. 30 (3): 412–416. doi:10.1002/nau.20996. ISSN 0733-2467.
- "Female Genital Plastic and Cosmetic Surgery". Wiley.com. 2016-04-18. Retrieved 2018-05-08.