There are several solutions to reduce scars, reconstruct the labia minora and clitoris and also to eliminate infibulation. The interventions, in Italy, are free through the NHS, but expert plastic surgeons are needed
According to data from the World Health Organization, more than 200 million women have undergone genital mutilation. Partial or total removal of female sexual organs a practice which, despite being banned in many African states, continues to mark the transition from childhood to adulthood for too many girls and very young girls. The Ginecare sui congress was dedicated to them and to the possible methods to remedy the physical trauma suffered vulvovaginal curative and aesthetic treatments, with a comparison between plastic surgeons and gynecologists held in Padua. The progress of medical-scientific research, also in the field of plastic and aesthetic surgery, has allowed us to develop solutions that help these women to regain possession of a normal or almost normal life – he says Franco Bassetto, director of the Plastic and Reconstructive Surgery Clinic of the Padua University Hospital, organizer of the conference —. Certainly a lot depends on the individual case, on the type of mutilation suffered and on various subjective variables, but it is good that the interested parties know that there are remedies. Is that in Italy they can be performed free of charge through the National Health System.
Different degrees of gravity
Even today, the statistics tell that every year about three million girls, most before the age of 15, are at risk of being subjected to a seal of chastity and respectability which in some African societies takes the form of female circumcision. The excision of the external genitalia, followed by a stitching, a drama experienced by about 600,000 female victims of mutilation in Europe, 88,000 of whom live in Italy. Still too many live, silently, with a drama to which they believe they are condemned without appeal. Instead there are several options to reduce scars, for reconstruct labia minora and clitoris and also to eliminate infibulation. Female genital mutilation can occur in the first weeks of life, during childhood or at the beginning of puberty – explains Bassetto, who is also a councilor of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery (Sicpre) -. And they are not all the same. When it is removed the clitoris (actually a part of it) we are talking about degree 1 mutilation; when beyond that the labia minora are reduced or eliminated yes in the face of a grade 2 mutilation; when adding the narrowing of the vaginal entrancethe so-called infibulation, a degree 3 and 4 mutilation was practiced, depending on the extent of the closing suture.
Specialist visit in a public hospital
Even for the rudimentary methods with which they are usually performed, these practices often cause serious infections (which can also leave serious consequences for the fertility of girls, as well as causing their death) and obviously of a psychic trauma that almost always leaves permanent wounds not only in the body, but also in the mind, in the emotional experience and in the affective relationships of the victims. A woman who has undergone genital mutilation can find out what can be done in her situation book a visit to a plastic surgery department of a public hospital, via Ssn – suggests the expert -. The specialist will then direct you, if necessary, to more specialized departments in this specific area, to more experienced plastic surgeons and with a large number of cases in the treatments needed in these cases. What can concretely be done?
Scar reduction
possible to perform the reduction of scars after genital mutilation using different surgical techniques depending on the severity of the scar – clarifies Bassetto -. Using the so-called Z plastics we can “break” the organization of the collagen fibers underlying the scar and make them less evident. If not enough, if necessary restore volume or give a “regenerative” stimulus to the affected areaIt is also possible to use autologous adipose tissue graft (ie derived from the patient herself, the so-called lipofilling). They are all methods that can be performed under local anesthesia, with sedation and in a regimen of day surgerythen with daily hospitalization.
Reconstruction of the labia minora and clitoris
Even the labia minora can be reconstructed through flaps of skin and tissue taken from the perineal region. They are slightly more complex operations, everything varies according to the seriousness of the mutilation of the patient – continues the surgeon -. Depending on the reconstructive technique chosen, the operation is performed in day surgery either with hospitalization, with local anesthesia and sedation or under general anesthesia. In addition, if it is necessary to provide more volume to the “new” flaps, we can resort to lipofilling. A similar argument applies to the clitoris: there are different methods that may or may not require a couple of days of hospitalization and local or total anesthesia. The achievable goal for not only aesthetic, but also functional: by bringing the sensitive nerve fibers of the clitoral region back to the surface, women can regain possession of the sensations of pleasure during the sexual act.
Elimination of infibulation
Finally, you can proceed to the so-called de-infibulation by laser or with a scalpel (cold blade). The purpose of the operation is the same: to re-expose the genital organs underlying the seam, removing the scarred skin. To recover as much as possible, then, both the aesthetic aspect and the functionality of the area, other methods can be added, depending on the case: Z-shaped microplasties, grafts of autologous adipose tissue or with infiltrations of platelet-rich plasma (PRP) concludes Bassetto.
November 29, 2022 (change November 29, 2022 | 1:04 pm)
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