Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The consultation is the diagnostic foundation of the treatment. It is a safe, confidential space where the patient discusses intimate symptoms that are often ignored. The physician acts as a diagnostician, distinguishing between symptoms that can be treated with a laser and those that require surgery or medication.
This phase involves a detailed medical history review, focusing on obstetrical history, menopausal status, and specific symptoms like leakage or pain. The goal is to determine if the patient’s anatomy and goals align with the capabilities of non-invasive laser therapy.
A thorough pelvic examination is mandatory before any treatment. The physician visually inspects the external genitalia for lesions, atrophy, or anatomical variants. An internal manual exam helps assess the tone of the vaginal muscles and the integrity of the vaginal walls.
This exam is critical for ruling out conditions that would contraindicate laser treatment, such as active infections, severe prolapse, or pelvic masses. It allows the physician to map the areas of most significant laxity or atrophy to target during the procedure.
To quantify laxity, physicians may use a perineometer or a simple manual feedback scale (Modified Oxford Scale) to assess the strength of the pelvic floor muscles. The patient is asked to contract the muscles around the examiner’s fingers.
This assessment distinguishes between muscle weakness (which requires physical therapy) and tissue laxity (which requires laser therapy). Often, both are present. Understanding the muscle component helps set realistic expectations: the laser tightens the “fabric” (skin), but the patient must exercise the “muscle.”
A current routine Pap smear is a prerequisite for treatment. The physician ensures that there are no cervical abnormalities or pre-cancerous cells. Laser energy should not be applied to dysplastic tissue.
The consultation also verifies general gynecological health. Any abnormal bleeding, discharge, or pelvic pain must be investigated and resolved before scheduling cosmetic or functional laser treatments. This ensures the procedure is performed on a healthy foundation.
Laser vaginal rejuvenation is generally not effective for Grade 3 or 4 pelvic organ prolapse (where organs protrude past the vaginal opening). During the exam, the physician asks the patient to bear down (Valsalva maneuver) to assess the degree of descent of the bladder, rectum, or uterus.
If severe prolapse is identified, the patient is referred for surgical repair. Using a laser on severe prolapse is ineffective and delays proper treatment. The laser is best suited for Grade 1 or mild Grade 2 prolapse, where tissue tightening can provide adequate support.
Understanding the patient’s hormonal status is key. If the patient is menopausal, the physician assesses the severity of the estrogen deficiency. In some cases of extreme atrophy, a short course of topical estrogen cream may be prescribed before the laser treatment.
This “priming” of the tissue helps thicken the lining slightly, making the laser treatment more effective and comfortable. It prepares the cellular environment to respond vigorously to the thermal stimulation.
While internal 3D mapping is rare, external imaging systems such as Vectra can be used to document the appearance of the external genitalia when aesthetic treatments are planned. For internal issues, anatomical diagrams and digital models are used to explain the procedure to the patient.
These visual aids help the patient understand the difference between the urethra, the vaginal canal, and the muscle layers. It allows the physician to show precisely where the laser energy will be applied and how it will support the structures.
Not every woman is a candidate. Ideal candidates are those with mild to moderate SUI, vaginal laxity, or atrophy who wish to avoid surgery. Patients with unrealistic expectations or those seeking a “tightness” that prevents intercourse are screened out.
The physician evaluates the patient’s potential for compliance. The treatment requires a series of sessions and maintenance. Patients who are unwilling to commit to the complete protocol are advised that single sessions are unlikely to yield satisfactory results.
Patients are instructed on pre-procedure hygiene to minimize infection risk. This typically involves showering on the morning of the procedure and avoiding sexual intercourse for 24 to 48 hours prior.
Patients should arrive in a clean area. Menstruation is not a strict contraindication, but most providers and patients prefer to schedule treatments when the patient is not on their period for comfort and to ensure the laser energy is not absorbed by menstrual blood.
A medication review is conducted to identify photosensitizing drugs (which make the skin sensitive to light) or anticoagulants. While internal bleeding is rare, minimizing blood thinners can reduce spotting.
Patients with a history of genital herpes (HSV) are prescribed prophylactic antiviral medication to be taken before the procedure. The laser’s heat can trigger a viral outbreak, so suppression is a mandatory safety measure.
The consultation assesses the patient’s emotional readiness. Discussing sexual function can be emotional. The physician ensures the patient is pursuing treatment for herself, not solely due to partner pressure.
Patients should feel empowered and informed. The physician addresses any anxiety about pain or modesty, reassuring the patient that the procedure is professional and discreet.
The final step is creating a customized treatment plan. The standard protocol is usually three sessions spaced 4 to 6 weeks apart. However, severe atrophy or laxity may require more sessions.
The physician outlines the timeline, the cost, and the maintenance schedule (usually one treatment per year). This roadmap ensures the patient understands the financial and time investment required for success.
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It is not strictly necessary to be fully shaved, but trimming the hair can make the procedure easier and cleaner, especially if external treatment is being done. Your provider will give you their specific preference.
It is technically possible, but generally discouraged. Blood can interfere with laser absorption, potentially reducing its effectiveness. It is also more comfortable for you to schedule the treatment for when you are not menstruating.
No. No sedation or general anesthesia is used. You will be fully alert and able to drive yourself home or return to work immediately after the procedure.
You can still have laser vaginal rejuvenation if you have an IUD (intrauterine device). The laser energy is delivered to the vaginal walls and does not penetrate the uterus, where the IUD is located. It is perfectly safe.
Doctors who perform this procedure are highly trained professionals who deal with these issues daily. They understand the sensitivity and will make every effort to make you feel comfortable, respected, and heard. There is nothing to be embarrassed about.
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