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    Clitoral membrane surgery

    Klitorishäutchen OP

    The clitoral hood, also known as the “clitoral mantle”, is a special tissue made of skin and mucous membrane that covers the clitoris. The clitoral hood protects against irritation and hypersensitivity. The size of the clitoral hood is different. In some cases, the clitoral hood can protrude above the outer labia. These changes are often hereditary.

    The excess foreskin can take on different dimensions, which can be corrected surgically. In around 15% of patients, the clitoral hood is corrected in conjunction with a reduction in the size of the inner labia. The clitoral hood is reduced in size using a gentle technique, whereby the subcutaneous tissue and thus the sensitivity to touch are spared.

    The incision when reducing the size of the clitoral hood can influence the position of the clitoris. For aesthetic or functional reasons, the clitoris can be moved towards the vaginal entrance as part of the foreskin reduction. Thus, the excitability of the clitoris can be increased during sexual intercourse.

    The anatomy of the clitoris

    The Greek doctor Rufus of Ephesus described the center of female sexual pleasure around 110 AD. So he called the place clitoris (kleitoris) called, from which the word kleitoriazein (literally “tickle” or “clitorize” in ancient Greek) is derived (Charlier P, et al., 2020, Arch Sex Behav). The first modern description of the clitoris is ascribed to Colombo in 1559. The mean diameter of the glans is about 3.5 by 5 millimeters with a total length of the clitoris of about 16 millimeters (Sales BS, et al., 1992, Obstet Gynecol). The clitoris is about 25 millimeters above the urethral opening (Kreklau A., et al., 2018, BJOG). The externally recognizable components of the clitoris are the glans (glans), the foreskin (prepuce) and the paired atrial erectile tissue (bulbus vestibuli). The paired legs (crus clitoridis) and the paired erectile tissue (corpus cavernosum clitoridis), the retaining strap (ligamentum suspensorium clitoridis) and the clitoris root cannot be seen from the outside. The glans contains a high density of sensory cells. The cells include the Pacinian corpuscles, which react to vibration, and the Meissner corpuscles, which are very sensitive to touch. The sensory stimuli move along the pair of nerves placed headward to the pubic nerve. The nerves enter the spinal cord at the level of the sacrum. In nerve circuits, impulses are then sent to the splanchnic nerves of the pelvis. The nerves increase blood flow and cause certain muscles, such as the vagina, to contract.

    Facts about the loss of sentience

    One of the most common concerns with clitoral cloak surgery is decreased sensation or hypersensitivity. On the Internet there is often polarizing, crude information. A distinction is often not made as to which operation, at what age, for what reason and with what expertise in the genital area. The feeling after tightening the clitoral jacket and reducing the size of the labia was therefore specifically investigated by researchers. Your work has been verified by independent reviewers. The surgical results were examined by women in the USA between the ages of 18 and 51 (mean 34 years) who opted for an intimate operation mainly for aesthetic reasons. It turns out that a clitoral jacket tightening and labia correction do not lead to a decreased sensitivity of the genital area. Forty-four percent of women had more frequent sexual intercourse six months after surgery. In 35 percent of women, the climax was reached more often and felt more intense than before the operation (Placik OJ, et al., 2015, Plast Reconstr Surg). The results are not surprising as similar breast skin tightening techniques do not affect nipple sensitivity. Sex life is influenced by a variety of factors. The influencing factors range from emotions to physical problems. An aesthetic experience, whether in nature or in art, can touch or move us, even give us goose bumps. It stands to reason, therefore, that aesthetic satisfaction associated with an improvement in self-esteem can lead to an improvement in sexual function.

    How is clitoral membrane correction performed?

    Before each operation, a routine check is made several times to ensure that all necessary precautions have been taken to ensure the patient’s maximum safety. The operation is only started when all requirements according to the checklist have been met.

    If the clitoral hood correction is performed in twilight sleep, you will be given medication that will relieve your anxiety and noticeably reduce the sensation of pain. Then a numbing cream is applied so that you do not even feel the numbing injections. Already within 5 to 10 minutes the operation areas are numb, so that you can at most feel that something is happening on the surface of your body, if you are not already deeply asleep.

    The excess skin is first measured and the incision marked. The operation plan is being reviewed. The cut is always based on the individually adapted planning, usually as an inverted “V” in the folds of the envelope. In order to be able to work with the greatest precision, the operation is performed with magnifying glasses. The excess skin is then gently removed. The wound is finally closed with fine sutures. These dissolve by themselves after about three weeks.

    The outpatient procedure takes about 30 minutes. Immediately after the operation you will be continuously monitored in the recovery room. When you are fully awake afterwards, you can drink something. If you feel well enough, it is already allowed to eat something if you tolerate it well. When you go to the toilet for the first time, you will be assisted by the CenterPlast nursing staff. Subsequently, control appointments are arranged and the behavioral measures are discussed with you in detail. Before you leave the practice, you will also receive a comprehensive written report and a telephone number. Under this you can reach the surgeon in case of emergency, 24 hours a day.

    Before, after and even during the operation, you can watch movies or your favorite series with virtual reality glasses. Not only is this entertaining, the distraction has also been shown to decrease sensitivity to pain.

    What are the risks of clitoral hood tightening

    The tightening of the clitoral jacket is usually carried out in combination with a reduction of the inner labia in a single operation. Numerous studies report an overall satisfaction of 90 to 95 percent after clitoral jacket tightening and labia reduction. Sex life has improved in 80 to 85 percent of the patients. Complications such as wound healing disorders occur in around four percent of cases. Careful preparation and the observance of precautionary measures after the operation will help to reduce the risk. Swelling is usually temporary, but in individual cases it can last up to three months. A slight cooling in the first few days and a physical rest for a few weeks prevent swelling. Nerve injuries and scar pain are not excluded, but are unlikely (Iglesia CB, et al., 2013, Int Urogynecol J).

    How can you prepare for clitoral skin reduction?

    You have been considering clitoral hood reduction for a long time. Therefore, make sure you are well prepared. On our page about intimate surgery you will find some information and advice to help you to be as calm and relaxed as possible about the procedure.

    What do you have to consider after clitoral surgery?

    As with any surgery, you should exercise caution after a clitoral hood lift. Certain behaviors and physical activities can negatively influence or endanger the surgical result. In addition, you can speed up the healing process and have a positive effect on it through active aftercare. The postoperative guidelines and recommendations can be found on our page about intimate surgery.

    What are the costs associated with clitoral membrane surgery?

    With our price calculator you can find out in advance the price range of the clitoral mantle lift. The exact costs for an operation to lift the clitoris will be determined in an individual consultation.

    Experience reports on a clitoral hood reduction

    To view reviews of our practice and read patient experiences visit our testimonials page.

    Before and after pictures of a clitoral membrane correction

    Before and after pictures may not be published on the Internet. You can find more information on the before and after pictures page.

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    The author

    Dr. Adelana Santos Stahl

    “Our goal is to provide the best, most discreet and precise treatment based on our extensive expertise in plastic surgery. „

    Dr. Adelana Santos Stahl is distinguished by a unique international perspective with a feminine view of plastic surgery. Her personalized and detailed approach is key to the beautiful and natural results she achieves. Having trained in Brazil, one of the largest and most well-known countries for aesthetic and reconstructive plastic surgery, she understands her patients’ desire to look and feel their best.She completed her medical studies and her training as a specialist for plastic and aesthetic surgery in Brazil. In 2009, she also successfully passed the German equivalence examinations for the medical state examination. Two years later, in 2011 she received the German and in 2012 the EU specialist recognition (EBOPRAS) for plastic surgery.From 2009 to 2013, she deepened her knowledge of aesthetic and reconstructive facial surgery with world-renowned representatives of plastic surgery such as Professor Gubisch at the Marienhospital and Madame Firmin in Paris.A VDÄPC Fellowship (continuing fellowship for graduate students) in Switzerland, France and the USA has further enriched her professional experience.Dr. Santos Stahl is active in several prestigious professional societies. Besides the DGPRÄC and DGBT, she is also a member of the Brazilian Society of Plastic Surgery – SBCP.She is also the author of several scientific articles and, together with her husband, is dedicated to research and clinical studies in the field of plastic surgery.

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