At the turn of the century our computers didn’t crash with Y2K, everyone was getting a cell phone, and women started waxing off most (if not all) of their pubic hair. This ability to actually see what everything looked like down there added one more thing for us to critique about our bodies and along with it came a wave of presentations at plastic surgery meetings on labiaplasty to make everything look “nicer.” I would wrinkle up my nose, hope these lectures didn’t fall just before lunch, and typically found it a convenient time to get another cup of coffee or step out and make a call. I felt we women had enough to worry about. Seriously, did we have to feel our vaginas didn’t measure up too?
My first labial surgeries were direct referrals from pediatric urologists to help patients born with urologic birth defects, who now as young women had symptomatic functional issues from their excess labial tissue. It was intensely gratifying to be able to help, but I honestly still felt the cosmetic cases I was doing made me a bit sad that possibly someone else was making these women feel badly about their appearance. It is funny that I have found this stereotype to be very untrue with my cosmetic surgery patients (people generally are internally motivated to have surgery), yet here I too was kind of judging this specific subgroup of patients.
Years went by and while this whole area of “vaginal rejuvenation” began to boom, I did not feel the need to actively pursue patients, and phone calls from my Thermi rep about ThermiVa (I already had the Thermi device for skin tightening, so why not offer the procedure?) were met with adamant “no thank you.” Then I watched a webinar on ThermiVa, and my entire perspective changed.
The focus of vaginal rejuvenation had shifted somewhat, had expanded with less emphasis on looks, and more on function, which was where my heart initially found gratification. No longer was this about the rare unfortunate patient with significant problems, it was something that could benefit a huge number of women, even myself. And if cosmesis was an issue, that might be treated too.
Now I don’t want to scare my younger patients, but when menopause hits and you go through “the change” these are some of the unfortunate things no one mentions until it happens to you. Your lovely moist vaginal tissue can just dry out seemingly overnight. You can loose elasticity, and sex can change from a pleasure to a painful activity shockingly quickly. Younger women may also have some concerns. Did your bundle of joy stretch everything out down there? And who doesn’t love urinary stress incontinence with that embarrassing squirt of pee when you laugh, cough, or with exercise?
For years I have been using lasers and radiofrequency (a specific form of tissue heating) to rejuvenate skin. Who knew that same technology could be taken downstairs and create such a change? ThermiVa uses external radiofrequency to deliver the energy using a small hand piece (about the size of your pinky finger, only longer) to your labia, clitoral area, opening of the vagina, and inside the vagina for what feels like a half hour warm stone massage. Three sessions are recommended (the first two are a month apart and the timing of the third is based on goals and results).
The treatments provide:
- A significant increase in vaginal moisture.
- A significant improvement in vaginal laxity.
- Increased elasticity in tight (painful) tissue.
- A significant improvement in urinary stress incontinence.
- Increased sensitivity with increased orgasms and reduced time to orgasm.
- Tightening of the labia minora and majora.
- No downtime.
- Maintained results for approximately 9 months to a year.
There is absolutely still a role for surgical rejuvenation and treatment of urinary stress incontinence for those with more severe symptoms and physical findings. ThermiVa is to vaginal rejuvenation what Botox and fillers are to facial rejuvenation (that’s an analogy I can grasp easily).
To prepare for your procedure it is best to have very short pubic hair around the labia for maximal skin contact and to prevent tangling. This cannot be performed on patients who are pregnant or who have an active STD (prophylaxis for herpes patients is a good idea). Patients with pacemakers or cochlear implants cannot have radiofrequency procedures.
When I learned about ThermiVa I called some of my OB GYN buddies because this was certainly a procedure in their wheelhouse. I was surprised by the range of responses from “There is no need for this. I wrote 4 new prescriptions for estrogen cream just this morning” to “It sounds great but we don’t know how to take cash for a procedure in our office” (by the way treatments are $1,000 each).
This area is booming, and there are many devices including lasers that treat inside the vagina only (no cosmetic improvement) and do have some downtime, but all are effective for tightening and lubrication. I never thought this would be something I would be offering, but after my own treatment, I was sold. I have found that my patients care about quality of life, and this is just one more area to add happiness and fulfillment to yours.