Sharon Osborne, the 61-year old co-host of The Talk and X-Factor judge, revealed last week that among her many cosmetic surgeries, the most painful was her vaginoplasty.
“It was just excruciating,” Osbourne told he audience of the British talk show The Graham Norton Show about the vaginal tightening procedure. We asked some of our LocateADoc.com doctors about Osborne’s experience and what they tell their patients about pain associated with the procedure.
“When I counsel patients about their postoperative pain level following a vaginoplasty, I don’t sugar-coat it,” Englewood, CO Cosmetic Surgeon Oscar A. Aguirre, MD, said. “It can be very painful, but not different from the pain some women experience following an abdominoplasty. In fact, in our ‘Real Mommy Makeover’ procedures where women undergo a vaginal cosmetic procedure at the same time as an Aesthetic Body Contouring procedure such as an abdominoplasty, breast augmentation, Hi Definition Liposculpture, or Brazilian Butt Lift, their primary pain complaint is split evenly between the vaginoplasty and the abdominoplasty. Some patients will indicate that the abdominoplasty pain was greater than the vaginoplasty pain, and visa-versa. And yet some patients will say that their 'Butt Pain' following the Autologous Fat Transfer to the buttocks was the most painful.”
Dr. Aguirre is the Founder and Director of Aguirre Specialty Care who feature surgical sub-specialists in women’s health issues and specialize in urogynecological disorders. Urogynecology is a subspecialty of obstetrics and gynecology that is dedicated to the treatment of pelvic floor disorders leading to problems with urinary, bowel, or sexual functioning. Dr. Aguirre emphasized that when counseling patients, it’s important to explain that everyone’s pain threshold is different.
“I’ve had patients experience the full spectrum following a vaginoplasty; some will report minimal discomfort yet some will be very uncomfortable for 3-4 weeks. I feel these are the outliers, the 10% on either side of the ‘bell curve’. Patients should expect moderate discomfort for the first 1-2 weeks during which time they won’t be able to sit comfortably, urinate easily/normally, or even have normal bowel movements. This should never be sugar coated.
What is key in decreasing the number of patients who are in the 10%, like Sharon Osbourne could have been, is aggressive pre-operative pain management.”
Dr. Aguirre outlined the three areas he handles pain management for vaginoplasty patients:
1) Preoperatively – “before we go to the operating room they are all given a “cocktail” of medications to decrease a postoperative rebound of pain. This consists of I.V. Tylenol, oral Celebrex (strong NSAID), and oral gabapentin (blunts nerve receptors).”
2) Intraoperatively – “before an incision is ever made I give them an intravaginal pudendal nerve block of a long acting local anesthetic (Ropivicaine). This is an old trick I borrowed from obstetricians before epidurals were available. I also inject local anesthetic to the perineum and vaginal tissues. Most women will wake up pain free as a result of this and are discharged home within the hour.”
3) Postoperatively – “they are instructed to take a combination of the maximum dose of Tylenol and Advil every 6 hours on schedule for the first 3-5-7 days, no alternating or skipping. Added to this regimen, for breakthrough pain, they are given an oral narcotic plus a muscle relaxant to take as needed.”
Obsorne didn’t reveal the reasons for choosing the surgery. In general, Dr. Aguirre said the best candidates for this procedure are women who have experienced decrease sensation with intercourse and have no history of pelvic pain or pain with sex.
“There are women who have high tone pelvic floor muscle dysfunction (muscle spasms), or who have Painful Bladder Syndrome (Interstitial Cystitis) who are very susceptible to an exacerbation of their condition,” Dr. Aguirre said. “These women will most likely experience moderate to severe pain for weeks following a vaginoplasty and thus are not candidates for the procedure. They will very likely be one of the 10% who experience great difficulty in recovery. I try to identify these patients and suggest other treatments for their sexual dysfunction which typically includes pelvic floor physical therapy.”
Dr. Aguirre added that new treatments will soon be available in the U.S. that are currently available in Europe and South America. Since these will be in-office, non-surgical laser treatments, this will be a great option for women who do not want surgery, nor the downtime associated with it, according to Dr. Aguirre.
“It won’t be helpful to those women, however, who have a significant gaping introitus (open vagina) and as a result have minimal to no sensation with intercourse, or for those women who desire an improved cosmetic appearance of the vaginal opening or labia,” Dr. Aguirre said. “Only vaginoplasty and/or labiaplasty procedures would help these women.”
Learn about costs, recovery time, doctor reviews and more within the Vaginal Rejuvenation Resource Guide, which includes an extensive before and after picture gallery. To consult with vaginal rejuvenation doctor, look through LocateADoc.com profiles to find a specialist in your area.
Sharon Osbourne Photo by Wiki edit Jonny (Transferred from en.wikipedia) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons