Süleyman Eserdağ

Altinbas University, Department of Obstetrics and Gynecolog, Istanbul, Turkey

We propose “sandwich technique” (Eserdag) as a new regenerative multimodal approach for the treatment of severe lichen sclerosus, including autologous microfat grafting, SVF, and PRP injections in the same session. In this technique, in accordance with the histologic layers of skin texture, microfat is injected into the hypodermis, SVF is injected...

As in every surgical operation, the equipment used is important in Aesthetic Genital Surgery (AGS) to achieve the best results.

In this section, the opinions on genital aesthetic operations of some important obstetrics and gynecology associations, especially the American College of Obstetricians and Gynecologists (ACOG), the American Food and Drug Administration (FDA) warning, the World Health Organization (WHO) definition of health, Patient Rights, Patient Perspective, and...

As a border between internal and external female genitalia, the hymen is a mucous fold that is located 2–3 cm beyond the vulvar entrance and has different anatomical variations. It has sociological role rather than functional. Hymenoplasty, which is considered to be an AGS operation, is a reconstructive surgery known with terms such as “hymenorrhap...

Vaginal enlargement and sagging are often due to connective tissue weakness or fascia defects. The most important factor in the structure of collagen connective tissue in the whole body is our genetic features. Loosening (relaxation) due to vaginal collagen reduction generally develops due to difficult births, pregnancy, smoking, old age, menopause...

Another operation in AGS that is performed, especially in combination with vaginoplasty operations, is perineoplasty, that is, aesthetic repair and/or reconstruction of the perineum. Different techniques and tips-and-tricks in perineoplasty are described in this chapter.

The clitoral hood or “preputium” is the superior part of the labia minora. The tissue excess here disrupts sensitivity and sexual function and produces dissatisfaction in terms of aesthetic appearance [1].

Dermal fillers, also known as “injectable implants,” “soft tissue fillers,” or “wrinkle fillers” are medical device implants approved by the FDA for use in helping to create a smoother and/or fuller appearance in the face, including nasolabial folds, cheeks, chin, lips, and the backs of the hands. Hyaluronic acid fillers are the most preferred in c...

Female external genital cosmetic surgery procedures are viewed by many plastic surgeons and gynecologists as being technically simple operations. They often are. However, they involve many tips and tricks to get the optimum results. Labia majora operations aim to reduct labia majora, and give an aesthetic appearance. In this chapter, different tech...

Labiaplasty is an aesthetic surgery performed to reduce the size of the labia minora and to provide bilateral symmetry. It is also known as “labial reduction.” In actuality, the term labiaplasty covers both internal and external genital labial aesthetics, but the term has mostly reserved for internal genital labia because these surgeries are much f...

The interest of women in their genital areas, the social meanings they attribute to this region, and the genital practices applied have continued from the time of the Pharaohs to the present. Traditional genital area decorations, painting, tattoos, piercing-like jewelry, procedures to reduce or enlarge tissues, and operations such as genital circum...

As with the whole body, there are great differences between countries and cultures in the aesthetic perception of the genital area. For example, wide labia minora shaped like “butterfly wings” are found more attractive in Japanese society. In the Khoikhoi (Hottentot apron) tribe living in southwest Africa, it is a living tradition for girls startin...

For centuries, there has been mention of the existence of an important region of high erotic sensitivity and engagement in the anterior vaginal wall. Although a large survey has shown that 84% of women believe there is such a sensitive area in their vagina, G-spot still remains as an “anatomical UFO.” G-spot injections are among the applications in...

Evaluations before the art of Aesthetic Genital Surgery (AGS) are very important. The surgeon performing the aesthetic operation should act like a “psychologist” during the consultations and as an “artist” while performing the surgical art, remembering that each patient is different from the others. It is extremely important to approach the externa...

The common desires of many women who prefer aesthetic genital surgery are that the inner lips do not protrude outside the outer lips while standing and with their legs closed and that the labia majora have a flat, plump, and tight structure. One of the annoying situations for women who care about aesthetics is sagging and large outer lips. Labia ma...

Vaginal rejuvenation (VR) includes all applications that include optimal repair and correction of the vagina and adjacent organs, both aesthetically and functionally. The concept of VR was first defined in the texts “On Treatments for Women” written by Trotula in 1050 as the suturation of postpartum lacerations, restoring virginity and treatment of...

A wound is the disruption of the normal integrity of the body due to physical damage after trauma, accident, or voluntary procedure. The word wound can also be expressed with terms such as “erosion,” “ulcer,” and “fissure.” In reality, erosion refers to focal epidermal losses that do not progress to the dermis. Fissure marks epidermal and/or dermal...

Demands by patients for ano-genital bleaching have rapidly increased, especially in recent years. Bleaching treatments are also referred to as “vulvar bleaching” or “pudenda bleaching.” However, the term “genital whitening” is not correct. As a matter of fact, the process is not whitening but bleaching in the color tone. CO2 laser, Er:YAG laser, an...

Our skin, the largest organ of our body, has different thicknesses in different parts of our body. Five different tasks of the skin are defined:

With aging, there are important changes in vaginal histology as in the whole body. These changes affect all layers of the vaginal epithelium. Extracellular matrix components, fibroblast number, vascularization, and water retention capacity decrease. As a result, collagen and elastic fibers decrease, elasticity is lost, the rugae are flattened, the...

Carbon dioxide therapy, better known as “carboxytherapy”, relates to percutaneous (intradermal and/or subcutaneous) infusion of medical carbon dioxide with therapeutic approaches. It has been suggested that by improving oxygenation, interacting with the tissue perfusion regulators, and disrupting the adipose cell membranes, the method can lead to n...

Vaginismus and dyspareunia were classified in DSM-V as female sexual dysfunctions in “Genito-Pelvic Pain and Penetration Disorders (GPPPD),” which describes persistent or recurrent difficulty/pain on sexual intercourse or penetration attempts. It is not easy to differentiate vaginismus, dyspareunia, and provoked vestibulodynia (PVD) because of thei...

Objective Provoked vestibulodynia (PVD) is a challenging and distressing problem for women. The aim of this study was to examine the effect of hyaluronic acid (HA) in the management of this condition. Method This is a retrospective review of 12 women diagnosed with PVD and treated with HA (19 mg/mL) applied, point-by-point, to the vestibular regio...

We evaluated the treatment outcomes of the patients with primary vaginismus in a specialized clinic. Cognitive-Behavioral Therapies (CBT), finger exercises, and vaginal dilators were used. Symptom Checklist-90 Revised, Martial Adjustment Inventory, Female Sexual Function Index and Golombok-Rust Index for Sexual Satisfaction were applied pre-and pos...

Objective: To examine retrospectively sexual dysfunction in the male spouses of 425 female patients who had presented to our clinic and were diagnosed with primary vaginismus. Materials and methods: Seven questions related to age, profession, educational status, number of marriages, personality structure, sexual experience, and sexual dysfunction...

Background: We aimed to present the demographic information, treatment protocol, and results of 482 female patients that presented to our clinic specialized in sexual dysfunction with the complaint of no or only partial sexual intercourse and were diagnosed with primary vaginismus.Methods: The female patients were asked eight questions about demogr...

Study objective Labia minora reduction is the most common operation requested by women concerned with the appearance of their vulvar area. In most cases, a concomitant clitoral hoodoplasty should be done to achieve better aesthetic outcomes. There are different surgical methods for removing excess tissue in the clitoral hood area. This study aims t...

Objective Vaginismus and dyspareunia are together categorized as a genito-pelvic pain and penetration disorder. We aimed to evaluate the threshold of pain and the pain sensitivity in women with vaginismus. Study design In this prospective case-control study; 32 women with vaginismus and 29 healthy women were enrolled. Sociodemographic Information...

Abstract Aim In this study, we aimed to analyze the impact of a detailed anamnesis and gynecological examination findings of women with vaginismus on its treatment success in a tertiary therapy center with 18 years of experience. Methods The socio‐demographical factors, gynecological examination notes and the treatment results of 281 vaginismus pa...

Abstract Introduction: Localized provoked vulvodynia (LPV) is a gynecological disease that is difficult to manage. Despite the wide spectrum of pathophysiological mechanisms and treatment modalities, there is limited success in the management of this disease. Surgical treatment is usually performed as the last resort. We aimed to investigate the hi...

Background Hymenoplasty in genital cosmetic surgery has a distinct location with its ethical and psychological issues. It is performed in order to narrow the vaginal opening to ensure vaginal bleeding with a penetration. There are various kinds of techniques with different success rates. Objectives We report a new hymenal reconstruction technique...

OBJECTIVE: There are many predisposing factors associated with vaginismus, but there is lack of data in the literature regarding which and how of these factors influence the success rate of treatment. Our aim is to investigate the effects of factors that are considered as predisposing factors for vaginismus on treatment prognosis and success rate,...

Background Hypogonadotropic hypogonadism (HH), or secondary hypogonadism, results from reduced secretion of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), by the pituitary gland, resulting in lack of production of sex steroids. The aim of this study was to evaluate self-reported sexual function in sexually...

To determine the predictive value of middle cerebral artery (MCA) to uterine artery pulsatility index (PI) ratio in preeclamptic patients. This prospective cross-sectional study was performed on 64 preeclamptic and 131 normal pregnancies at or beyond 26 weeks of gestation between June 2007-August 2008 in the high-risk pregnancy unit of Dr. Zekai Ta...

Monochorionic monoamniotic twin gestations have been associated with perinatal mortality rates as high as 28% to 47%. Umbilical cord entanglements and knots, twin-to-twin transfusion syndrome, congenital anomalies, prematurity and intertwin locking during labor are responsible for their high perinatal morbidity and mortality. We report here two cas...