Clitoral hood reduction, also termed clitoral hoodectomy,[1] clitoral unhooding, clitoridotomy,[2][3] or (partial) hoodectomy, is a plastic surgery procedure (a form of vulvoplasty) for reducing the size and the area of the clitoral hood in order to further expose the glans of the clitoris.
| Clitoral hood reduction | |
|---|---|
 Plastic surgical reduction of the clitoral hood (prepuce) for aesthetic reasons. Left: before, right: after the surgery. | |
| Specialty | plastic surgeon |
It is usually performed as an elective cosmetic surgery meant to improve sexual satisfaction and to change the aesthetic appearance of the vulva. The reduction of the clitoral hood usually is done together with a labiaplasty that reduces the labia minora, and occasionally within a vaginoplasty.
Though patient surveys have indicated satisfaction with the outcome of such procedures, the American College of Obstetricians and Gynecologists cautioned in 2007 that for this type of vaginal surgeries, which are not medically indicated, women should be informed about the lack of data on their efficacy and potential complications.[4]
Surgical procedures
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The procedures for labiaplasty occasionally include a clitoral hood reduction.[5] One technique for reducing the clitoral hood is the bilateral excision (cutting) of the prepuce tissues covering the clitoral glans, with especial attention to maintaining the glans in the midline.[6] Another technique cuts away (excises) the redundant folds of clitoral prepuce tissue, with incisions parallel to the long axis of the clitoris.[7]
Clitoral hood reduction can be included in the extended wedge resection labiaplasty technique, wherein the extension of the exterior wedge sections is applied to reducing the prepuce tissues of the clitoral glans. Yet, occasionally excess prepuce-skin, in the center of the clitoral hood, is removed with separate incisions.[8]
Results
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Studies have reported a high rate of patient satisfaction with the aesthetic changes to the vulvo-vaginal complex after labioplasty, and a low incidence rate of medical complications.[6][8][9][5] The study Aesthetic Labia Minora and Clitoral Hood Reduction using Extended Central Wedge Resection (2008) reported that of a 407-woman cohort, 98 per cent were satisfied with the labial reduction outcomes; that the average patient satisfaction score was 9.2 points on a 10-point scale; that 95 per cent of the women experienced reduced pudendal discomfort; that 93 per cent of the women experienced improved self esteem; that 71 per cent experienced improved sexual functioning; that 0.6 per cent (one woman) reported lessened sexual functioning; and that 4.4 per cent of the women experienced medical complications.[8] The study Expectations and Experience of Labial Reduction: A Qualitative Study (2007) reported that the women who underwent labiaplasty had great expectations for the elimination of pubic discomfort and pain, improved cosmetic appearance of the vulva, and improved sexual functioning. Most of the women experienced improved self esteem; yet the study also reported that formal psychological counselling before the surgical operation about what to expect and what not to expect from a labia minora and clitoral prepuce reduction procedure might better serve the prospective patient by assisting her in establishing realistic expectations for her genital beauty and mental health after such a procedure.[10][11]
Criticism
editPartial or total hoodectomy is classified by the World Health Organization as female genital mutilation (FGM) Type 1A.[12] However, this classification is criticised as being "overly-simplified" and "culturally insensitive" by some. They argue that hoodectomy is no different than male circumcision, which is legally permitted in most countries, and is often less invasive in practice.[13]
The American College of Obstetricians and Gynecologists (ACOG) published Committee Opinion No. 378: Vaginal "Rejuvenation" and Cosmetic Vaginal Procedures (2007), the college's formal policy statement of opposition to the commercial misrepresentations of labiaplasty, and associated vaginoplastic procedures, as medically "accepted and routine surgical practices". The ACOG doubts the medical safety and the therapeutic efficacy of the surgical techniques and procedures for performing vaginoplastic operations such as labiaplasty, vaginal rejuvenation, the designer vagina, revirgination, and G-spot amplification, and recommends that women seeking such genitoplastic surgeries must be fully informed, with the available surgical-safety statistics, of the potential health risks of surgical-wound infection, of pudendal nerve damage (resulting in either an insensitive or an over-sensitive vulva), of dyspareunia (painful coitus), of tissue adhesions (epidermoid cysts), and of painful scars.[4]
Risks
editThe dorsal nerves of the clitoris travel above the clitoris along the clitoral body. Permanent injury to these nerves can occur with clitoral hood reductions.[14]
See also
editReferences
edit- ^ Renganathan, Arasee; Cartwright, Rufus; Cardozo, Linda (2009). "Gynecological cosmetic surgery". Expert Review of Obstetrics & Gynecology. 4 (2): 101–104. doi:10.1586/17474108.4.2.101. ISSN 1747-4108.
- ^ Carol Downer (1980). "Self-help for sex". Women's Sexual Development. Springer US. pp. 255–279.
Some therapists refer women for female circumcision (clitoridotomy) to have their clitoral hoods removed so that they can be more sensitive to the thrusts of the penis
- ^ Barbera, M.C.L. (2009). Multicentered Feminism: Revisiting the "female Genital Mutilation" Discourse (PDF). Compostampa. pp. 485–507. ISBN 978-88-903912-6-2. Retrieved 2024-08-10.
- ^ a b Committee on Gynecologic Practice, American College of Obstetricians and Gynecologists (2007). "ACOG Committee Opinion No. 378: Vaginal "rejuvenation" and cosmetic vaginal procedures" (PDF). Obstetrics and Gynecology. 110 (3): 737–738. doi:10.1097/01.AOG.0000263927.82639.9b. ISSN 0029-7844. PMID 17766626. Archived from the original (PDF) on December 30, 2008.
- ^ a b Mirzabeigi MN, Moore JH, Mericli AF; et al. (February 2012). "Current trends in vaginal labioplasty: a survey of plastic surgeons". Ann Plast Surg. 68 (2): 125–34. doi:10.1097/SAP.0b013e31820d6867. PMID 21346521. S2CID 36163955.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ a b Felicio, Yhelda de Alencar (2007). "Labial surgery". Aesthetic Surgery Journal. 27 (3): 322–328. doi:10.1016/j.asj.2007.03.003. ISSN 1527-330X. PMID 19341661.
- ^ Hunter, J (2008). "Considerations in female external genital aesthetic surgery techniques". Aesthetic Surgery Journal. 28 (1): 106–107. doi:10.1016/j.asj.2007.10.001. PMID 19083515.
- ^ a b c Alter, Gary J. (2008). "Aesthetic labia minora and clitoral hood reduction using extended central wedge resection". Plastic and Reconstructive Surgery. 122 (6): 1780–1789. doi:10.1097/PRS.0b013e31818a9b25. ISSN 1529-4242. PMID 19050531.
- ^ Scholten, Erik (2009). "Female genital cosmetic surgery--the future". Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 62 (3): 290–291. doi:10.1016/j.bjps.2009.01.002. ISSN 1878-0539. PMID 19237147.
- ^ Bramwell R, Morland C, Garden AS (2007). "Expectations and Experience of Labial Reduction: A Qualitative Study". British Journal of Obstetrics and Gynaecology. 114 (12): 1493–1499. doi:10.1111/j.1471-0528.2007.01509.x. PMID 17877771. S2CID 71948922.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Di Saia JP. "An Unusual Staged Labial Rejuvenation". Journal of Sexual Medicine. 2008 (5): 1263–1267.
- ^ "Sexual and reproductive health: Classification of female genital mutilation". World Health Organization. Archived from the original on January 14, 2014. Retrieved 2018-05-08.
- ^ Zakir, Mohammed (2016). "WHO's stance and the criminalization of female circumcision: The protection of or violation of human rights?" (PDF). Dawoodi Bohra Women for Religious Freedom. Archived from the original (PDF) on December 4, 2023.
- ^ Ginger, Van Anh T.; Cold, Christopher J.; Yang, Claire C. (2011-02-04). "Surgical anatomy of the dorsal nerve of the clitoris". Neurourology and Urodynamics. 30 (3): 412–416. doi:10.1002/nau.20996. ISSN 0733-2467. PMID 21298720. S2CID 22501531.