Aesthetic and Regenerative Gynecology

Acknowledgement
Contents
Editors and Contributors
Co-Editors
Chief Editor
Contributors
1: Introduction to the Rising field of Aesthetic and Regenerative Gynecology
1.1 Introduction
1.2 Why is There a Sudden Interest in this Field?
1.3 History
1.4 Present Scenario
Bibliography
2: Epidemiological Perspective in Aesthetic and Regenerative Gynecology
2.1 Introduction
2.2 Complaints for Which Aesthetic and Regenerative Treatment Is Sought
2.3 Problem Statement
2.3.1 Globally
2.3.2 High-Income Countries
2.3.3 Low- and Middle-Income Countries
2.4 Aesthetic and Regenerative Procedures: History and Current Status
2.5 Cosmetic Indications
2.6 Functional Indications
2.7 Caution
2.8 Conclusion
References
3: Anatomy and Physiology in Relation to Invasive and Non-invasive Procedures in Aesthetic and Regenerative Gynecology
3.1 Introduction
3.2 Anatomy And Physiology
3.3 Indication and Contraindications
3.4 Practical Tips
3.5 Various Committee Statements
References
4: Counselling Before Cosmetic Gynecology
4.1 Introduction
4.2 Aesthetic and Regenerative Gynecology Counselling
4.2.1 Counselling Environment (Fig. 4.1)
4.2.2 Counselling Should Be
4.2.3 Auditory
4.2.4 Visual
4.2.5 Kinesthetic
4.3 Recommendations for Counselling
4.4 Summary
References
5: Medico-legal Aspects in Aesthetic and Regenerative Gynecology
5.1 Introduction
5.1.1 Who Can Do Cosmetic Surgeries? Who is a Cosmetologist?
5.1.2 Counselling
5.2 Ethical Dilemmas
5.2.1 Can We Do Surgery When You Think That it is Not Medically Indicated on Demand?
5.2.2 What to Do When Everything is Normal Physiologically but Still Patient Demands Correction?
5.2.3 Documentation
5.2.4 Complications
5.2.5 Confidentiality
5.2.5.1 Indian Medical Council (Code of Conduct, Etiquette and Ethics) Regulation, 2002 [3]
5.2.6 Disclosure of the Patient’s Secret Without Valid Reason Amounts to Misconduct
5.2.7 Certain Typical Medico-legal Issues in Cosmetic Gynecology
5.2.8 Certain Procedures Not Yet Proved: Can One Practise [4]
5.2.8.1 Ministry of Health and Family Welfare (Department of Health and Family Welfare) by Notification: New Delhi, the 11th March, 2020 [5]
5.2.9 Minor Patient Coming to Take Advice: What to Do?
5.2.10 Insurance
5.3 Conclusion
References
6: Energy-Based Devices: Comparisons and Indications
6.1 Introduction
6.2 Lasers
6.2.1 Carbon Dioxide (CO2) Laser
6.2.2 Erbium-Doped Yttrium Aluminum Garnet (Er: YAG) Laser
6.2.3 Fractional Lasers
6.2.4 Lasers in Gynecology
6.3 Radiofrequency (RF)
6.3.1 RF-Tissue Interactions
6.3.2 RF Devices and Configuration
6.3.3 Radiofrequency in Gynecology
6.4 High-Intensity Focused Ultrasound (HIFU)
6.4.1 HIFU in Gynecology
6.5 High-Intensity Focused Electromagnetic Technology (HIFEM)
6.5.1 HIFEM in Gynecology
6.6 Light Emitting Diode (LED)
6.6.1 LED in Gynecology
6.7 Conclusion
References
7: Laser in Aesthetic and Regenerative Gynecology: Physics, Types, Applications, Safety Profiles
7.1 Introduction
7.2 Patient Evaluation, Consultation, and Consent
7.3 Contraindications
7.4 Fractional Lasers
7.5 Laser Tissue Interaction
7.6 Histological Changes Seen with Fractional Lasers, RF, and Other Energy-Based Devices
7.7 How to Perform a Fractional Laser?
7.8 Adverse Effects and Complications
7.9 Radiofrequency (RF) Devices
7.10 How to Perform an RF for Vaginal Rejuvenation
7.11 Ultrasound-Based Devices
7.12 Laser Safety
7.13 Hazards Involved Due to Laser Beam
7.14 Non-Beam Hazards
7.15 Laser Hazard Safety Measures
7.16 Safety Measures Against Aerosoles
7.17 Conclusion
References
8: Laser in Vaginal Rejuvenation
8.1 Introduction
8.1.1 Histology
8.1.1.1 Collagen
8.1.1.2 Elastin
8.1.2 Tissue Remodelling and Clinical Impacts
8.1.3 Histological Changes [21]
8.1.4 Role of Energy-Based Devices (EBD) [21]
8.2 Lasers
8.2.1 Technology Parameters
8.2.2 Laser Technology Categories
8.2.3 Clinical Applications in Vaginal Conditions
8.2.4 Vaginal Atrophy
8.2.4.1 Mucosal Responses Following Fractional Laser Treatment
8.2.4.2 Biomolecular Effects of EBD Application on Vaginal Mucosa
8.2.5 Stress Urinary Incontinence (SUI)
8.2.6 Laser Tightening for Vulvar Laxity [58]
8.3 Conclusion
References
9: Other Lasers in Aesthetic and Regenerative Gynecology
9.1 Erbium Lasers
9.1.1 Introduction and History
9.1.2 Indications for Use in Gynecology (Er: YAG Smooth)
9.1.3 Contra-indications (Er: YAG)
9.1.4 Understanding the Smooth® Mode
9.2 Histological Evidence
9.3 Conclusion
Diode Laser in Aesthetic and Regenerative Gynecology
References
10: Radiofrequency in Aesthetic and Regenerative Gynecology
10.1 Introduction
10.1.1 Biological Interaction Rationale (Critical and Bibliographical Analysis)
10.2 History
10.3 Conclusions
10.3.1 Action Rational in Neuro-Muscular Tissues
10.3.2 Rationale to Use Different Types of Electromagnetic Energy (Multifrequency, Capacitive, Resistive, Monopolar, Bipolar)
10.4 Bipolar Radiofrequency
10.4.1 Frequency
10.4.2 Monopolar/Bipolar Applicator
10.5 Monopolar Radiofrequency
10.6 Resistive/Capacitive Applicator
10.7 Radiofrequency Treatment Protocol
References
11: Carboxytherapy in Aesthetic and Regenerative Dermatology
11.1 Introduction
11.2 Treatment
11.3 Technique
11.4 Precautions
11.5 Advantages
11.6 Disadvantages
11.7 Side Effects
11.8 Complications
11.9 Aesthetic Indications of Carboxytherapy
11.9.1 Flaccidity; Skin Rejuvenation
11.9.2 Periorbital Area
11.9.3 Cellulite and Gynoid Lipodystrophy
11.9.4 Localized Adiposities
11.9.5 Stretch Marks
11.9.6 Chronic Wounds
11.9.7 Skin Grafts
11.9.8 New/Other Indications
References
12: Micro-focused Ultrasound in Aesthetic and Regenerative Gynecology
12.1 Introduction
12.2 Pathogenesis of Age-Related Skin Laxity Deterioration
12.3 Mechanism of Action
12.4 Micro-focused Ultrasound (Ultherapy)
12.4.1 Indications
12.4.2 Treatment Time
12.5 Pain and Comfort Management
12.5.1 Recovery and Down Time
12.5.2 Side Effects and Complications
12.5.3 Treatment Protocols
12.5.4 Contraindications
12.5.5 Precautions
12.5.6 Patient Safety
12.5.7 Results
13: Minimal Invasive Treatment of Varicose Veins
13.1 Introduction
13.2 Thermal Tumescent Techniques (TTT)
13.2.1 Methods
13.2.2 Indications of Intervention
13.2.3 Contra Indications
13.2.4 How It Works
13.2.4.1 EVLA (Endovascular Laser Ablation)
13.2.4.1.1 Principle
13.2.4.1.2 Equipment
13.2.4.1.3 Procedure
13.2.4.2 RFA (Radiofrequency Ablation)
13.2.4.2.1 Procedure
13.2.4.3 Steam Ablation
13.2.4.3.1 Procedure
13.2.4.3.2 Principle
13.2.4.4 Endovenous Microwave Ablation (EMWA)
13.2.4.5 Echotherapy Using High Intensity Focused Ultrasound (HIFU)
13.3 Non-Thermal Non-Tumescent Technique (NTNT)
13.3.1 Methods
13.3.1.1 Glue Closure
13.3.1.1.1 Procedure
13.3.1.1.2 Outcomes
13.3.1.2 Mechanochemical Ablation (MOCA) Method
13.3.1.2.1 Mechanism
13.3.1.2.2 Device Description
13.3.1.2.3 Outcomes
13.3.1.3 V-Block
13.3.1.3.1 Outcomes
13.3.1.4 Foam Sclerotherapy
13.3.1.5 Polidocanol Endovenous Microfoam
13.3.1.6 Cutaneous Lasers and Intense Pulse Light (IPL)
13.3.1.6.1 The Various Laser Systems
13.3.1.6.2 Principle
13.3.1.6.3 Lasers
13.3.1.6.4 Procedure
13.3.1.6.5 Complications [30, 41, 42]
13.4 Conventional Surgery
13.4.1 High Ligation
13.4.2 Stripping of GSV
13.4.3 Stripping Under Tumescent Anaesthesia
13.4.4 Saphenous Sparing Operations
13.4.4.1 CHIVA
13.4.4.2 ASVAL
13.4.5 Ambulatory Phlebectomy
13.5 Summary
References
14: Chapter on Testosterone Therapy
14.1 Introduction
14.2 Basic Physiology of Testosterone Production, Function, and Metabolism
14.2.1 Testosterone Excess
14.2.2 Testosterone Deficiency
14.2.3 Testosterone Replacement Methods
14.3 Pellet Insertion
14.4 Conclusion
References
15: Laser Hair Removal
15.1 Introduction
15.1.1 Laser and Light Assisted Hair Removal
15.1.2 Principle of Hair Removal
15.1.3 Photothermal Destruction
15.1.4 Wavelength
15.1.5 Pulse Duration
15.1.6 Fluence
15.1.7 Spot Size
15.2 Indications for Hair Removal
15.2.1 Contraindications
15.2.2 Laser Therapy
15.3 Procedure
15.3.1 During Procedure
16: Thread Lift in Aesthetic and Regenerative Gynecology
16.1 Introduction
16.2 Facial Aging
16.3 Types of Threads
16.4 Polydioxanone (PDO Threads)
16.5 How Can We Achieve Facial and Body Contour Restoration?
16.6 Concept
16.7 Two Stage Effect
16.8 History of Thread Lifting
16.9 Introduction of PDO
16.9.1 PDO (Polydioxanone) as Shown in Fig. 16.1
16.9.2 PDO (Polydioxanone)
16.10 Types of Thread (Fig. 16.1)
16.10.1 Vaginal Threads
16.10.2 Procedure of Tightening
16.10.3 The Uses of Vaginal Threads
16.10.4 Benefits of this Procedure
16.10.5 Complication of Vaginal Looseness
16.10.6 Contraindications
16.10.7 Functions of PDO
16.10.8 Effects (Post-Procedure)
16.10.9 Mechanotransduction
16.10.10 Sequen.ce of Events
16.10.11 Effect at the Tissue Level
16.11 Applications (Fig. 16.4)
16.11.1 How to Perform the Procedure
16.11.2 Procedure Protocol
16.11.3 Factors Determining the Success of the Procedure
16.11.4 Aftercare Instructions
16.11.5 Complications
16.11.5.1 Issues from Technical Problem (Improper Procedure)
16.11.5.2 Generate Elasticity and Contour Changed
16.12 Conclusions
17: Chemical Peels and Vulval Whitening in Aesthetic and Regenerative Gynecology
17.1 Introduction
17.1.1 Scope of This chapter
17.1.2 Definition
17.2 Classification of Peels
17.3 Mechanism of Action
17.4 Common Superficial Peeling Agents
17.4.1 Glycolic Acid
17.4.2 Salicylic Acid
17.4.3 Lactic Acid
17.4.4 Mandelic Acid
17.4.5 Jessner’s Solution
17.5 Medium-Depth Peels
17.5.1 Trichloroacetic Acid
17.6 Deep Peels
17.7 Indications and Contradications of Chemical Peels
17.7.1 Indications
17.7.2 Contraindications [2, 7]
17.7.2.1 Absolute
17.7.2.2 Relative
17.8 Procedure of Peeling
17.8.1 General Steps
17.8.2 Pre-Peel Steps
17.8.3 Peel
17.8.3.1 Termination of Peel
17.8.4 Post-Peel Steps
17.8.5 Complications
17.9 Emerging Concepts in Chemical Peels
17.9.1 Newer Peels
17.9.2 Combination Peels
17.9.3 Party Peels
17.10 Combination Treatments [2]
17.10.1 Microdermabrasion
17.10.2 Microneedling
17.10.3 Lasers
17.11 Conclusion
References
18: Scars in Aesthetic and Regenerative Gynecology
18.1 Introduction
18.2 Management of Acne Scars [4–7]
18.3 Management of Striae/Stretch Marks [8–11]
18.4 Conclusion
References
19: Hypo and Hyperpigmentary Disorders of Vulva
19.1 Introduction
19.2 Disorders of Hyperpigmentation
19.3 Physiological Pigmentation
19.4 Lichen Simplex Chronicus
19.5 Lichen Planus (LP)
19.6 Fixed Drug Eruption (FDE)
19.7 Contact Dermatitis (CD)
19.8 Post-Inflammatory Pigmentation (PIH)
19.9 Acanthosis Nigricans (AN)
19.10 Pigmented Condyloma Acuminate/Anogenital Wart
19.11 Vulval Lentiginosis
19.12 Genodermatosis Characterized by Lentigines
19.13 Benign Melanocytic Nevi
19.14 Melanoma
19.15 Pigmented Basal Cell Carcinoma
19.16 Disorders of Hypopigmentation
19.17 Vitiligo
19.18 Lichen Sclerosus Et Atrophicus (LSA)
References
20: Breast Lifting and Reduction in Aesthetic and Regenerative Gynecology
20.1 Introduction
20.1.1 Surgical Anatomy of the Breast
20.1.1.1 Anatomically the Woman’s Breast Extends From
20.1.2 The Breast Suspensions
20.1.3 Breast Reduction
20.1.3.1 Tenets of an Ideal Breast Reduction
20.1.3.2 Preoperative Evaluation
20.1.4 Patient Profiles Coming for Breast Reduction [9]
20.1.5 Operative Technique
20.1.5.1 Breast Ptosis
20.1.5.2 Principles of Mastopexy
20.1.6 Surgical Approach
20.1.7 Postoperative Advice
20.1.8 Complications [27, 28]
20.1.8.1 Early
20.1.8.2 Late
20.1.8.3 Summary
References
21: Butt Reshaping/Gluteal Recontouring Surgeries in Aesthetic and Regenerative Gynecology
21.1 Introduction
21.2 Gluteal Aesthetics
21.2.1 Aesthetic Units/Zones
21.2.2 Relevant Anatomy
21.3 Gluteal/Butt Reshaping Surgery [10]
21.4 Implants
21.4.1 Implant Size
21.4.2 Implant Shape
21.4.3 Post Operative Care
21.4.4 Buttock Augmentation with Fat Grafting (AFG)
21.5 Autologous Gluteal Flap (AGA) Surgeries
21.5.1 Operative Technique (Fig 21.12)
References
22: Hymenoplasty, Vaginoplasty, and Perineoplasty in Aesthetic and Regenerative Gynecology
22.1 Introduction
22.1.1 Hymenoplasty
22.1.1.1 Definition
22.1.1.2 Anatomical Consideration
22.1.1.3 Why Females Request for Hymen Restoration?
22.1.1.4 Patient Selection and Preoperative Considerations
22.1.1.5 Contrindications
22.1.1.6 Procedure
22.1.2 Technique
22.1.2.1 Other Methods Discussed in Literature Are
22.1.2.2 Postoperative Risks, Complications, and Follow-Up Instructions
22.2 Maintenance of Cleanliness and Local Hygiene
22.2.1 Medico Legal Consideration
22.3 Vaginoplasty and Perineoplasty
22.3.1 Definitions
22.4 Anatomical Considerations
22.4.1 Pelvic Floor
22.4.1.1 The Vagina—Anatomy, Orientation, and Structural Support
22.4.2 Epithelium
22.4.3 Lamina Propria
22.4.4 Muscularis
22.4.5 Adventitia
22.5 Embryology and Innervation of the Vagina
22.6 External Genital Anatomy
22.6.1 Labia Majora
22.6.2 Labia Minora
22.6.3 Clitoris
22.6.4 The Vulvar Vestibule
22.6.5 Bartholin’s Gland
22.6.6 Skene’s Gland
22.6.7 Patient Selection
22.6.8 Contraindications
22.6.9 Evaluation
22.6.10 Operative Technique
22.6.11 Patient Evaluation
22.6.12 Preoperative
22.6.12.1 Perioperative Care
22.6.12.2 Postoperative Care and Instructions
22.6.12.3 Take-Home Message
References
23: Labiaplasty and Cliteroplasty
23.1 Labiaplasty
23.1.1 Definition
23.1.2 Introduction
23.2 Anatomy of Labia Minora
23.2.1 Desire for Labiaplasty (L. Minora)
23.2.2 Labia Minor Hypertrophy Classification
23.2.3 Contraindications
23.2.4 Techniques of Labioplasty for Labia Minora
23.2.4.1 Edge Resection
23.2.5 Advantages
23.2.6 Disadvantages
23.3 Diagram
23.3.1 Wedge Resection
23.3.1.1 Advantages
23.3.1.2 Disadvantages
23.3.2 De-Epithelialization Technique
23.3.2.1 Advantages
23.3.2.2 Disadvantages
23.3.2.3 Special Notes
23.4 Diagram
23.4.1 Labia Minoraplasty with Zig-Zag Incision
23.4.2 Labiaplasty Done with Extended W Plasty Incision
23.5 Diagram
23.5.1 Labioplasty with Clitoral Hood Resection
23.5.1.1 Method
23.6 Diagram
23.6.1 Laser Labiaplasty
23.6.1.1 Advantage
23.6.1.2 Disadvantage
23.6.1.3 Post-Operative Care
23.6.1.4 Post-Operative Complications, Risks and Side Effects
23.7 Labia Majora Plasty
23.7.1 Definition
23.7.2 Introduction
23.8 Diagram
23.8.1 Anatomy
23.9 Diagram
23.9.1 Desire for Labiaplasty
23.9.2 Procedure
23.9.2.1 Hanging Lip of Labia Majora (Fig. 23.12)
23.10 Diagram
23.10.1 Labia Majora Plasty
23.11 Diagram
23.11.1 Key to Successful Healing
23.11.2 Conclusion
23.11.3 Rejuvenation of Labia Majora by Non-Surgical Procedures
23.11.3.1 Use of Hyaluronic Acid
23.11.3.2 Contraindications
23.11.4 Complications
23.11.4.1 Fat Augmentation
23.11.5 Side Effects
23.11.5.1 CO2 Laser
23.11.5.2 Radio Frequency Laser Treatment of Labia Majora and Labia Minora
23.11.5.3 Platelet-Rich Plasma
23.11.6 Clitoral Hood Resection
23.11.7 Complications
23.11.8 Contraindications
23.11.9 Clitoral Reduction Surgery
References
24: Vulvodynia
24.1 Background
24.2 Classification of Vulvar Pain
24.3 Pathophysiology
24.4 Evaluation
24.5 Treatment
24.6 CO2 Laser
24.7 Conclusion
References
25: Non Energy Based Modalities in Cosmetic Gynaecology
25.1 Introduction
25.2 Physiological Changes in the Female Genitals
25.2.1 Indications
25.2.2 Evaluation for Procedures: [7]
25.2.3 Contraindications
25.2.4 Modalities for Vulvovaginal Rejuvenation
25.2.5 Aesthetic Medicine
25.2.5.1 Fillers
25.2.5.2 Labia Majora Augmentation:
25.2.6 G-Shot
25.3 Fat Transfer
25.4 Botulinum Toxin
25.4.1 Regenerative Medicine
25.4.1.1 Platelet-Rich Plasma Therapy
25.4.1.2 O-Shot Therapy
25.4.1.3 PRP in Vaginal Rejuvenation
25.4.2 Stem Cells
25.4.3 Chemical Peels:
25.4.4 Other Therapies
25.5 Conclusion
References
26: Genitourinary Syndrome of Menopause
26.1 Introduction
26.1.1 Anatomy and Physiology
26.2 Clinical Manifestations
26.2.1 Assessment
26.2.2 Treatment
26.2.3 Principle
26.3 Conclusion
References
27: Management of Urinary Incontinence in Aesthetic & Regenerative Gynecology
27.1 Introduction
27.1.1 Pathophysiology of SUI
27.1.2 History
27.2 Medical Diagnosis
27.2.1 Incontinence Symptom Classification System with S/UIQ
27.3 Examination
27.3.1 Endoscopy
27.3.2 Treatment
27.3.2.1 Behavioral Therapies
27.3.3 Weight Loss
27.4 Who Is a Candidate for Behavioral Therapy?
27.4.1 Physiotherapy
27.5 Pessaries and Devices for Stress Urinary Incontinence
27.5.1 Increasing Outlet Resistance (Table 27.1)
27.5.1.1 Antidepressants
Duloxetine
Imipramine
Estrogens
27.5.2 Injectable Bulking Agents
27.6 Which Bulking Agent to Choose?
27.7 Complications
27.7.1 Surgery for Stress Incontinence
27.7.2 Retropubic Suspension
27.7.2.1 Colposuspension Versus Laparoscopic Colposuspension
27.8 Complications
27.8.1 Perioperative Complications
27.8.2 Postoperative Complications
27.8.2.1 Overactive Bladder
27.8.2.2 Voiding Difficulties
27.9 Conclusions
27.9.1 Transvaginal Suspension
27.9.2 Pubovaginal Slings
27.9.3 Synthetics
27.9.3.1 Tension-Free Vaginal Tapes
27.9.3.2 Author’s Conclusion
References
28: Non-cosmetic Uses of Laser in Aesthetic and Regenerative Gynecology: Vulvodynia, Urinary Incontinence, Infections, Warts
28.1 Introduction
28.1.1 Vaginal Atrophy
28.2 Pathophysiology
28.3 Treatment
28.4 Principle of Laser
28.4.1 Procedure
28.5 Vulvodynia
28.6 Pharmacological Measures
28.7 How Does Laser Help in Vulvodynia?
28.8 Urinary Incontinence
28.9 Treatment of Urinary Incontinence
28.10 Procedure Protocol
28.11 Recurrent Vaginal Infections
28.12 Warts
28.12.1 Procedure
References
29: Gender Reassignment Surgery in Aesthetic and Regenerative Gynecology
29.1 Introduction
29.2 Magnitude of Problem
29.3 Etiopathogenesis
29.4 Embryology
29.5 Surgical Procedure
29.6 Male to Female
29.7 Female to Male
29.8 Practical Tips from Author
29.9 Discussion
29.10 Conclusion
29.10.1 Myths versus Reality, and the Decision to Undergo SRS
Illustration:
Illustration:
Bibliography
30: Anaesthesia in Procedures of Aesthetic and Regenerative Gynecology
30.1 Introduction
30.1.1 Nerve Supply of External Female Genitalia and Perineum (Fig. 30.1)
30.2 Anaesthesia for Aesthetic Gynecology
30.2.1 Anaesthesia for Invasive/Major Cosmetic Gynecological Procedures
30.2.2 Various Measures Are Taken to Reduce DVT/PE-Associated Risk
30.2.3 Some Other Important Intraoperative Concerns Are
30.2.4 Anaesthesia for Minimally Invasive Cosmetic Gynecological Procedures
30.2.5 Few Considerations for Successful and Less Painful LA Injections
30.2.6 Contraindications for Neuraxial Anaesthesia (Spinal/Epidural/CSEA) Are
30.2.7 Anaesthesia for Non-invasive Cosmetic Gynecological Procedures
30.2.7.1 Daycare Guidelines
30.3 Conclusion
31: Stem Cells and Recent Advances in Aesthetic and Regenerative Gynecology
31.1 Introduction (Incidence, Effect on Society, etc)
31.2 Historical Aspects
31.2.1 Spontaneous Growth of Aesthetic Medicine
31.2.2 For AM Doctors, It Is an Ongoing Personal Process
31.2.3 Doctors Duty to Respond Responsibly and Ethically to Demand
31.2.4 The Ovarian Cycle
31.2.5 Procedure Details (Investigations, Techniques, and Anesthesia)
31.2.6 Role of Fat Transfer and Adipose-Derived Stem Cells (ADSCs) in Rejuvenation and Treatment of Female Genital Area
31.2.6.1 Fat Injections to Improve the Changes by Weight Lost or Aging
31.2.6.2 Labiaplasty of Labia Majora (Augmentation and Rejuvenation)
31.2.6.3 Role of Stem Cell Therapy in the Management of (Postmenopausal Female Genital Atrophy)
31.2.7 Pathological Vulvar Dystrophy
31.2.8 The Scientific Evidence Behind Using Stem Cells for Female Genital Rejuvenation
31.2.9 Stem Cells and Cell Therapies
31.2.10 Best Methodology of Fat Transfer
31.2.11 Process of Fat Transfer Lipo-Aspiration (Harvesting the Fat) Technique
31.2.12 Factors Affecting the Outcome (How to Get the Best Stem Cell Quality from Adipose Tissue)
31.2.13 According to Conde´-Green et al. (2010)
31.3 More Complex Protocols
31.3.1 Platelet-Rich Plasma (PRP) Enriched Lipotransfer
31.3.2 Stem Cell-Enriched Fat Transfer
31.3.2.1 Cell-Assisted Lipotransfer (CAL)
31.4 ADSCs-Enriched Fat Transfer (Cultured Stem Cells)
31.5 Indications and Contraindications
31.6 Conclusion
References
32: PRP and Exosomes in Regenerative Gynecology
References
33: Setting Your Practice and Future of Aesthetic and Regenerative Gynecology
33.1 How to Set up Aesthetic Clinic?
33.2 A Promising Future for Lasers
33.3 Newer Upcoming Technologies in Cosmetic Gynecology
References
Index