PSC Roundtable

Who to Pick for Vaginal Rejuvenation – Plastic Surgeon or Gynecologist?

Who to Pick for Vaginal Rejuvenation – Plastic Surgeon or Gynecologist?

Vaginal rejuvenation procedures are on the rise with a whole population of women looking to correct, augment, or enhance parts of their bodies they never knew that they could. Vaginal rejuvenation takes many forms, whether it’s aesthetic improvement, functional improvement, or both at the same time. The obvious assumption curious patients make is that their OB-GYN is the ideal physician for this space. After all, female genitalia is their specialty, so they should be the ones to perform vaginal rejuvenation procedures, right?

The answer is most vaginal rejuvenation procedures are performed by plastic surgeons. Board certified plastic surgeons discuss why this is the case, as well as how many patients end up receiving vaginal rejuvenation procedures out of happenstance in their offices.

Why Aren’t OB/GYN Physicians in the Vaginal Rejuvenation Game?

The fact that plastic surgeons are the ideal physicians to receive vaginal rejuvenation procedures is partly to do with OB-GYN’s simply not offering the procedures themselves. Some do, but many don’t, which is a curious reality for patients and surgeons alike.

“I’ve asked my OB-GYN colleagues why they aren’t doing these things,” begins board certified plastic surgeon Dr. Pat McGuire of St. Louis. “I think it’s because they’re not comfortable with cosmetic procedures, even though it’s an area that they’re very familiar with. The modalities that are being used – lasers, radio frequency devices – are just not something they’re used to doing. Plastic surgeons have taken this over by necessity.”

Plastic Surgeon or OB/GYN for Vaginal Rejuvenation.

While it is entirely logical that the realm of the vagina should fall to OB-GYN’s, a closer look shows that the logic does actually follow as to why it’s plastic surgeons who perform the procedures. The latter are the physicians who are most knowledgeable and experienced with many of the technologies made recently available to treat the vagina. Whether it’s devices that utilize laser or radio frequency energy, these same devices are used all over the body by plastic surgeons. Some of these devices, such as lasers, have been in use for a handful of decades, allowing a wide body of available experience and research. Since modern offices of plastic surgeons already boast a small to large array of non-surgical devices, it makes sense then that the same devices aimed at vaginal rejuvenation are best wielded by these physicians.

Board certified plastic surgeon Dr. Bruce Van Natta of Indianapolis makes another interesting point: OB-GYN physicians function in the insurance-based medical space, not self-pay like the vast majority of plastic surgery. “OB-GYNs are insurance-based; they don’t get the concept of self-pay,” Van Natta explains. “They don’t know how to deal with it in their offices, they don’t have people there. I think that may be contributing to their reluctance to jump in.” While seemingly unrelated, the hurdles associated with medical insurance – or the lack thereof – can really play an important role in what is and isn’t offered in a practice.

The Real Answer: The Plastic Surgeon-Patient Relationship

While it is true that plastic surgeons are more intimately associated with non-surgical devices in both research, expertise, and experience, these hurdles can be leaped by an ambitious OB-GYN. That said, perhaps the most important distinction between an OB-GYN and a plastic surgeon in this space is the kind of relationship the latter has with their patients. Plastic surgeon patients are coming in looking for cosmetic improvement, and their questions as to improving their vagina may be better asked in that context than at the OB-GYN.

Dr. John Diaz, a board certified plastic surgeon in Beverly Hills, notes a conversation he has routinely with patients when discussing options. “We all have had patients who come to us and say, ‘Oh, well I was interested in this procedure but I didn’t think you did that.'” Patients may have no idea that vaginal rejuvenation is even possible, but because they’re comfortable in an environment speaking about self-paid, cosmetic procedures with a trusted surgeon, they may ask out of curiosity.

Vaginal rejuvenation consult.

I also think we’re having a dialogue with patients about what they don’t like oftentimes about their body,” explains board certified plastic surgeon Dr. Jason Cooper of Florida. “It’s just another step in that conversation where things end up going into, ‘Well, I don’t like my labia. Is this something you guys offer?’ That fuels and facilitates the conversation.”

No matter the procedure, the relationship between patient and plastic surgeon is critical to great results and comfort. Many patients may enter plastic surgeons’ offices with great trepidation, having never ventured into the realm of cosmetic surgery before. If they are consulting with a board certified expert, the chances are their hesitancy will fall away to relief and excitement, perhaps prompting further questions about other, more personal issues that bother them. For these reasons, it is entirely reasonable for plastic surgeons to be the ones performing vaginal rejuvenation procedures.

“I think it’s less about who’s doing it and who’s actually in tune with these patients and able to give them a forum for discussion about what they don’t like about their body,” says Cooper. “We’re uniquely positioned to help these patients and achieve their goals.”

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