What is Vaginal Rejuvenation?
“Vaginal Rejuvenation” is a vague expression that must confuse women. It certainly confused me as a man. Here is some history to learn how this all started. A number of years ago practitioner’s started to wonder “Since we have CO2 lasers that improve the appearance of an aging face, could we use these lasers to improve the changes that women experience in the vagina and vulva that occur with aging and childbirth?” We know that CO2 laser treatment to the face can help tighten the skin and achieve healthier looking younger appearing skin. Why not do that for the female genital tract? Back then, I have to admit that as a man I thought the whole idea was somewhat shocking. As a doctor I was trained to follow the Latin expression “primum non nocere” which translates to “first do no harm”. Was the idea of inserting laser probes into the vagina a good idea? Would it risk doing more harm than good? So I stood on the sidelines, curious to learn how this idea would turn out. And as expected, in the early going there were some problems with lasers causing burns and scarring to the vagina. These adverse outcomes were reported to the FDA, leading them to issue a warning that patients who were receiving laser vaginal treatments were placing themselves at risk of experiencing these serious side effects. But the treatment settings got better and a variety of laser manufacturers brought CO2 lasers to market for vaginal treatments. They came under names such as MonaLisa Touch, FemTouch and FemiLift and they continue to be available today. I was still hesitant to get involved in this new treatment. But that’s not the end of the story….
In aesthetics we have two main categories of energy based treatments – lasers and radiofrequency (RF). Lasers use light, RF uses radio waves. Over the past five years there has been a rapid growth in RF based treatments for all parts of the body. Why is that? The reasons are results and patient comfort. RF treatments penetrate deeper than lasers, and this is of particular interest in the vaginal area because sitting on top of the vagina is the urinary bladder and stimulation of the muscle layer with RF strengthens the support and lessens urinary stress incontinence. RF is also much more comfortable for the patient when a gradual warming technique is used (such as Votiva FormaV wand), and recovery time is essentially zero. Now I was interested to invest in a vaginal rejuvenation treatment – it was safe, comfortable and effective. For all of the right reasons I bought Votiva FormaV RF wand to treat the vagina, strengthen the muscle and improve the appearance of the vulva. I’m excited to help women. Now that we have several female providers, trained and certified in this procedure, we can confidently and discretely offer this tremendous treatment.
Back to the Question “What is vaginal rejuvenation?”
Childbirth, menopause and general aging can cause the following problems for women. When we talk about vaginal rejuvenation we are trying to treat one or more of these problems.
Laxity of the vaginal walls – this can affect sensation for both partners during intercourse. Both laser and RF work to tighten the vagina. RF works best at strengthening the muscles.
Pain with intercourse – after menopause the vaginal lining and muscle layer thin out causing discomfort for women. Both laser and RF can help, but I believe RF heats deeper and has a greater positive effect on the muscle layer.
Urinary Stress Incontinence – women will dribble or lose urine when lifting, exercising, during intimacy and when straining during a cough or sneeze. Both laser and RF can help, but I believe RF works better, for the same reason that the heat penetrates deeper into the muscle layer and provides the best chance of seeing improvement.
Change in appearance of the labia and vulva – over time the labia can become large and cause discomfort during intercourse. Some women do not like the appearance of their vulva after childbirth and aging. There are surgical options to address these concerns and the procedure is called a labiaplasty. RF is now being used by wand or combined with microneedling to achieve impressive non-surgical results. I prefer to have my providers use the RF wand on its own as it causes no discomfort and anesthesia is not needed.
Unipolar vs Biploar RF – an important difference for you to know about!
Older and less expensive systems use unipolar RF. The radio waves are released by the wand or handpiece, and they disperse throughout the pelvis searching for an exit point for the RF to leave the body. Unipolar devices use a “neutral plate” to create the point of exit of the RF energy. To the patient the neutral plate is a flexible pad with gel and adhesive, connected by wire to the RF machine. The problem with unipolar RF devices is that the RF energy quickly disperses away from the treatment area. Less energy and heating to the treatment area equals less impressive results. Bipolar RF is more expensive, but works better and offers the best possible results. The bipolar wand delivers and retrieves the RF energy in a closed loop. Add temperature sensors and safety shutoff settings and the treatment is both safe, comfortable and effective. No risk of burns. A company called InMode (Invasix) owns the patent on bipolar RF for vaginal rejuvenation, making them the only system on the market in the USA. Because bipolar RF is better for the patient, it is the system that Omaha Med Spa purchased (Votiva FormaV wand).