Aesthetic gynaecology

Threadlifting is a minimally invasive procedure in which absorbable sutures made of polycaprolactone, polydioxanone, lactic acid, and hyaluronic acid, specially designed for this anatomical area, are placed in the genital area.

Threadlifting is also called mesotherapy. The procedure is very similar to dermatological aesthetic facial procedures. It is performed in sterile conditions through a small opening on the skin of the external genital organs or vaginal mucosa – the size of the opening is about 3-4 mm in diameter, depending on where the sutures will be positioned – on the labia majora (which are part of the external genital organs, or on the vagina.

The threadlifting materials are presented in the form of threads of different lengths and shapes – with or without spikes along their length, which facilitates better positioning in the treated tissues. The threads can be straight or spirally woven – they are selected depending on the problem being treated.

• Vulvo-vaginal atrophy – thinning of the vaginal mucosa, and a decrease in elasticity, especially pronounced in the perimenopausal and postmenopausal periods. These changes lead to impaired moistening, dryness, burning sensation and soreness during sexual intercourse, sometimes bleeding as a result of mechanical trauma to the vaginal mucosa, frequent and recurrent bladder infections.

• Stress incontinence – involuntary urine output when abdominal pressure increases – for example when sneezing, coughing, lifting heavy objects, climbing steps, running. The main cause of this is loss of collagen and elastin in the vaginal tissue and decreased pelvic floor muscle tone. This is the cause of a change in the normal anatomical position of the bladder and urethra and the appearance of symptoms of stress incontinence.

• Vaginal relaxation syndrome – a sensation of a relaxed and dilated vagina, which is the cause of the lack of pleasure from sexual intercourse and a decrease in libido. This condition is a common one after pregnancy and childbirth, due to a change in the structure of elastin and collagen fibers – they stretch, elongate, and become thinner. The decrease in pelvic muscle tone and weakening of the pelvic ligaments supporting the normal position of the uterus and vagina are also important.

• Ptosis (sagging) and loss of volume of the labia majora, a condition resulting from age-related tissue changes, or in natural or artificial menopause;

• Correction of bumps in the intimate area, skin defects after childbirth, resulting from tissue rupture.

The procedure is performed in an operating room, after a consultation with an anesthesiologist, and under short intravenous anesthesia or other type of anesthesia at the discretion of the physician. The sutures are introduced to the tissue via a special cannula in depth of up to 3-5 mm (submucosally or subcutaneously) by way of a single small hole, about 2-4 mm in diameter. The small 3-5 mm depth of suture insertion protects adjacent anatomical structures from damage. The single small aperture with a diameter of 2-4 mm, which is made on the vaginal mucosa or on the skin of the labia majora, ensures the aesthetic appearance of the area after the completed threadlifting.

The sutures are placed by a special technique on the anterior and posterior vaginal wall, describing the shape of an unfolded fan. They are also placed intradermally on the labia majora. The interaction of the sutures with the tissues over time increases the synthesis (formation) of collagen and elastin fibers, which has an effect on the symptoms described above. The vaginal walls are strengthened, their elasticity and normal anatomical position are improved; the volume of the labia majora is increased.

After the procedure, it is advisable to avoid taking non-steroidal anti-inflammatory drugs, especially acetylsalicylic acid; avoid visiting swimming pools, steam baths, jacuzzi, physical activities associated with pressure on the treated area. Sexual abstinence is desirable for about 1 month or more at the discretion of the gynаecologist.

Threadlifting in the genital area is not performed during pregnancy, breastfeeding, and in the menstruation period. It is not administered inside the urethra, immediately adjacent to the urethra, in the labia minora, and in the clitoris.

The procedure is contraindicated in diseases of connective tissue – collagenosis, active infection of the vagina and/or the bladder.

It is perfectly suitable for women with oncological diseases, as long as it is not a disease affecting the vulva, vagina, bladder, rectum. It is up to the gynecologist, of course, to decide exactly when and where to place the stitches, given the woman’s history of cancer.

The average duration of the effect of threadlifting in the genital area is about 1-2 years – this is also the time for complete resorption /degradation/ of the inserted sutures.

The final effect after the application of sutures is achieved at the earliest after 1.5-2 months – the time required for the formation of collagen and elastin fibers.

Threadlifting can be combined with other methods of treatment, such as plasmotherapy, hyaluronic acid injection, vaginoplasty, laser therapy, but after consultation with an obstetrician-gynаecologist.

There are no contraindications for pregnancy, pregnancy keeping and vaginal delivery after vulva and/or vagina threadlifting. Sutures start disintegrating on day 120 after their application, and would not prove to be an obstacle to having a baby.

After childbirth, the intimate area can, once again, be subjected to threadlifting.

Yes, the insertion of meso-sutures in the intimate area can be repeated. There is no precise interval for reinsertion – each case is individual. The decision for a subsequent procedure is made after an examination and discussion between the doctor and patient to determine the success of the first application and the possibility of combining the second with another type of treatment – for example, combined application of laser therapy of the vagina, plasmotherapy, etc.