The abnormal enlargement of the clitoris is known as clitoromegaly, condition characterized by a larger clitoris of more than 35-45 mm. This condition may be the result of endocrine hormonal imbalance, neurofibromatosic tumors, or can be acquired later in life by masturbation or repetitive manipulation of the clitoris and consequent enlargement.

In the reduction surgery, the clitoris is freed and repositioned beneath the pubis and the prepuce, then is partially resected leaving enough tissue to cover the body of the clitoris. Closure of the wound is done in layers. This condition is associated with labial fusion, which can be corrected by a vertical incision through the membrane down to the muscle. The condition may be corrected at an early age (before 2 years), when detected on time. The reduction surgery may restore the size of an enlarged clitoris, while sensitivity is preserved. This procedure is performed under general anesthesia.

Hymenoplasty

Hymenoplasty is the surgical procedure aimed to repair and reconstruct the hymen. In some cultures the presence of the hymen is particularly important, and is considered an indicator of purity, morality and reputation. Although in our culture these principles do not acquire the same significance, in some religions and even in some segments of our society the presence of an intact hymen is a sign of virginity and innocence. But the idea that woman´s virginity is determined by the state of her hymen, not only is wrong but also frustrated for many women, especially for many Arab and Muslim women.

It is false the idea that hymen must break in the first coitus. The hymen is a fragile but elastic tissue which may break not only in the moment of the first coitus but in any moment during life. The hymen may break during childhood or remain intact after the first penetration.

The procedure

During the hymen reconstruction, the remnant tissues of the hymen are assessed. Subsequently, the mucosa is removed and the edges are approximated. Also, the surgeon may separate a small flap of mucosa from the vaginal wall and design a mucosal flap to restore the hymen.

The mons pubis (mount of Venus) is a rounded mound of fatty tissue over the pubic bone covered with hair. As a consequence of factors such as changes in weight or severe weight losses, the mons pubis may acquire a protruding appearance. Women who have had a tummy tuck or gastric bypass surgery and have lost a great deal of weight may notice a prominent pubis. The accumulated fat tissue in this area may be difficult to eliminate through exercise, therefore many women consider plastic surgery to correct the shape of the pubis.

As women age, and because of gravity, the mons pubis tends to descend forming a fat pad. According to the physical characteristics of each patient, the surgeon may consider using liposuction or lifting. When the problem focuses in the fat of the mons pubis, the answer to reducing it is liposuction. However, if the patient has excess sagging skin and fat around the pubic area, the surgeon may recommend a pubic lift. Through this procedure, the surgeon removes the redundant skin and tightens the muscles of the abdomen wall.

The G-Shot is a surgical technique performed by plastic surgeons and gynecologists aimed to increase pleasure in women by locating her G-spot or Gräfenberg spot. During the decade of the 1950´s, the German physician Ernest Gräfenberg described the existence of a small female genital area located behind the pubic bone and rounding the urethra. The scientist proposed that the stimulation of this specific area of the frontal wall of the vagina creates an intense sensation and the orgasm in women. Although it is a controversial topic, the truth is that this sensitive area has a very rich density of nerve endings which may provide pleasure to women during coitus. Many women, interested in their sexual capability, may increase pleasure through the stimulation of this area.

The procedure to increase the sensitivity of the erogenous G-Spot is performed by exactly locating the G-Spot. Then, collagen is injected in the area.

The G-Shot is a pain-free ambulant procedure which can be performed in the physician´s office, under local anesthesia and with minimum discomfort. The application of the injection may take less than 8 seconds. The procedure may take 30 minutes, while the patient finds her G-Shot. With the patient placed in lithotomy position and using a speculum, after having numbing the area, the collagen is injected. Then a tampon is applied, which must be removed after 4 hours. Slight bleeding may occur. The G-Shot may be amplified in size about a quarter in width, and one fourth of an inch in height (meaning the projection in the vagina). Four hours after the procedure, the patient may have sexual activity. It is important to understand that sensitivity may vary from patient to patient.