Laser Vaginal Rejuvenation - San Antonio Express-News
By Nicole Foy, Express-News Medical Writer
Dr. Troy Hailparn flips through the photo album on her desk, proudly showing off "before" and "after" shots of her patients.
"See, look at this," the obstetrician/gynecologist says, pointing at a set of pictures. "And look how much better it looks after surgery. It's really an amazing difference."
Hailparn, a board-certified OB/GYN, likes to describe herself as a sort of sculptor. The medium showcased in her photo album? The vagina. Her artistic tool? A ballpoint pen-sized surgical laser.
Welcome to the final frontier in self-improvement and cosmetic surgery. In addition to tummy tucks, breast augmentations, thigh liposuctions and nose jobs, women now are seeking vaginal "enhancement" procedures — everything from surgical tightening techniques to "vaginoplasties" aimed at improving the overall genital look.
But this latest self-improvement trend isn't without its critics, who see it more as an extreme vaginal vanity quest. Many question the lengths women — and doctors — are willing to go to in order to achieve idealized notions of physical perfection.
"It's really selling appearance over substance," said Carol Ellison, an Oakland, Calif., psychologist and licensed marriage and family therapist specializing in sexuality and intimacy.
"Besides, my definition of sexual success is when you come to the end and you've had a good experience that has enhanced the relationship and has been nurturing," Ellison said. "All of the cosmetic stuff in the world won't give you that kind of pleasurable effect if you didn't have those emotional skills to begin with."
Hailparn, who has not undergone the procedure, readily acknowledges the blurring lines between what is medically necessary and aesthetically desired. As she points out, the "laser vaginal rejuvenation" she offers is actually a variation of a common surgical procedure performed by many doctors for patients with urinary incontinence or other pelvic support problems.
But you wouldn't immediately get that message from the sales pitch.
"You won't believe how good sex can be!" exclaims Hailparn's Web site, cosmeticgyn.net. It goes on to detail how the doctor can help women who are "not happy with the look of their vagina." Advertisements for her practice, The Laser Vaginal Rejuvenation Institute of San Antonio, also stress the purported, yet clinically unproven, sexual benefits.
The cosmetic services aren't covered by insurance, but Hailparn's office accepts credit cards or can help set patients up with financing. The procedures can cost anywhere from $4,000 to $9,000.
Hailparn says her practice is about meeting the needs of women whose concerns have been brushed aside by other doctors. But others see the focus on sex and aesthetics as an attempt to seduce women into striving for some homogenized sexual model.
"If you start thinking that your labia or your vagina needs cosmetic work, then you have to wonder, 'Do you really want it, or has the market been created?'" says Beverly Whipple, a nationally known sexual issues expert and a retired nursing professor from Rutgers University.
"I think women like that need some work in terms of self-esteem," says Whipple, president of the Society for the Scientific Study of Sexuality. "We're all unique. We're all different. That's the beauty of it."
Still, women are flocking to Hailparn's Medical Center-area practice from all parts of the country. Some drive all night to get here, from places including Florida and Michigan, seeking the transformation promised by testimonials on her Web site.
Hailparn says she is the only one in the area using this specific laser technique for cosmetic vaginal rejuvenation. She took a training course under Dr. David Matlock, a gynecologist/plastic surgeon with a bustling Beverly Hills practice largely due to his laser vaginal rejuvenation techniques.
Matlock's work has been profiled in numerous magazines, including Playgirl and Playboy. And he has even appeared on shockjock Howard Stern's radio show to promote his techniques.
Hailparn, who calls Matlock her "mentor," is unabashed about her new foray. She still delivers babies and sees patients for other gynecological issues, but she says she's passionate about building up the laser vaginal rejuvenation side of business.
But she says her main reason for undergoing training in the laser techniques was years of listening to women express frustration over decreased sex drives and vaginal relaxation problems. She says she's gained many patients who sought a female OB/GYN after male doctors either ignored or dismissed their concerns.
One woman came to her complaining that a physician brushed off her sexual problems and displeasure over her vaginal appearance as "normal," adding that she should "just deal with it."
Hailparn says she told the patient: "You are normal, but you don't have to like it. And if you are not happy with your body — just like women who go and have their breasts augmented or reduced or their noses done or lipo done — you can do your labia. And if that will make you feel better about your body and enhance your sexual life, then go for it!"
Many other OB/GYNs say they're not at all comfortable with Hailparn's approach. Cosmetic work on the genitals or surgery for "sexual enhancement" is not considered mainstream, says Dr. Antonio Cavazos Jr., a local OB/GYN.
Cavazos and many others perform a procedure known as anterior/posterior repair that is close to Hailparn's vaginal rejuvenation approach — except it's done with a scalpel, not a laser. The procedure strengthens the vaginal wall, thus providing support for the pelvic floor, bladder and the rectum.
"If you want to say that you're helping to support a bladder that has fallen, then OK," he says. "But as far as creating a 'new vagina' for better lovemaking — how do you define that? Besides, a lot of things having to do with lovemaking occur between the ears rather than below the belt."
In his 16 years of practice, Cavazos says he has never had a patient tell him she was unhappy with the appearance of her vagina.
"I really don't see that there is a big need," he says. "But I think Dr. Hailparn is definitely trying to find a niche for herself, and there may be patients who say they want this."
Joannie, a patient of Hailparn's who didn't want her last name used, says she began thinking about laser vaginal rejuvenation and a possible labioplasty, a technique to "resculpt" the labia, after losing close to 170 pounds following a gastric bypass surgery.
The excess skin hanging around her midsection put intense pressure on her bladder, and she has been on expensive medication to control urinary tract infections for years.
Joannie remembers the moment she decided to look for a doctor who might address her concerns.
"We were sitting around on the Fourth of July with all my children and grandchildren and laughing about boob jobs and (my husband) said, 'I think if I was a woman after children I'd want the other end worked on first.' And I thought, 'Yeah, well, that makes sense.' So I went to the computer and I started researching and I found Dr. Troy."
Joannie, who's from East Texas, underwent Hailparn's laser procedure for vaginal tightening and anterior/posterior repair and hopes to have a labiaplasty next. After the outpatient surgery, she stayed for several days in a local hotel while still catheterized.
"I wasn't a happy camper then, but I can tell there is a big tightening difference," she said recently. "For the first time, I'm able to use the magnifying mirror and not be scared at what I see."
But an overt interest in the look of the vagina concerns many critics.
Kirsten Gardner, an assistant professor of history at the University of Texas at San Antonio, notes that, by definition, there isn't even a cosmetic or aesthetic nature to the genitals.
But on Hailparn's Web site, under the section of "designer laser vaginoplasty," it states:
"Many people have asked us for an example of the aesthetically pleasing vulva. We went to our patients for the answer and they said the playmates of Playboy."
Gardner, who specializes in gender and medical issues, says she finds the Web site's phrases and images incredibly suggestive.
"I find the use of the word 'aesthetic' remarkable," she says. "She is literally telling you that your vagina should be more beautiful. But it's deplorable to suggest that your vagina needs to conform to a certain model. It's feeding into a neurosis that you need to be perfect."
For feminists, vaginal "enhancement" takes personal improvement to an outrageous level.
At the core of feminism is the idea that women should be able to choose to have this sort of surgery if they want to, says Ruth Stewart, a nurse with 40 years of experience as a nurse educator. "If it's done for medical reasons that's one thing, but for aesthetic enhancement, I think it's ridiculous. I can't see how it would help self-esteem. And if a woman feels she needs this to hold on to her partner, that's very sad."
"This just seems to me so shallow-minded," said Alice Neufeld, a member of the San Antonio chapter of the National Organization for Women. "Women should focus on the real medical issues, like breast cancer, not just focus on external beauty. And who's to say you have to have a 'pretty one' to attract a man?"
Ellison, the California psychologist who has also written a book titled, "Women's Sexualities: Generations of Women Share Intimate Secrets of Sexual Self-Acceptance," questioned the safety of cosmetic surgery in such a sensitive area.
There is no information on the long-term effects of using a laser to cut through genital tissue, which is replete with tiny nerve endings that, if severed, could affect sexual stimulation, she noted.
"We just don't know what can happen to a woman down the road after she does something like this," she said.
Hailparn says she remains true to her oath as a physician: Do no harm. That's one of the reasons she prefers the laser over the scalpel. She says it causes less blood loss and promotes faster healing for patients.
Hailparn also stresses she does not advocate unnecessary surgery and will perform a complete evaluation of a patient before recommending any course of treatment.
If she feels like a patient is seeking her services for the wrong reasons — simply to please a controlling spouse, for example — she'll recommend psychotherapy. If a woman's problems can be corrected without invasive surgery, she'll suggest doing exercises, known as Kegels, to strengthen the pelvic floor muscles.
"I try and approach the whole person. I can't fix every problem, but I can direct you to the people who can help," she says.
"But you have to respect a person's choice if they're not happy with their bodies," she says. "I will respect any woman's right to say 'I want this changed.' If I can provide that and it's not harming the patient, then it's OK with me."
Staff writer Marina Pisano contributed to this story. This article appeared in the San Antonio Express-News on Jan. 11, 2004. Dr. Hailparn is a Board-Certified OB-GYN with advanced training in cosmetic-plastic gynecology procedures. She has performed over 3,500 vaginal rejuvenation, labiaplasty and other cosmetic gynecology procedures since 2003. To contact the Cosmetic Gynecology Center of San Antonio, call 210-615-6646 or use our contact form. We're happy to answer your questions or help you book a consult.
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