Pink Prescriptions - January 2019

Vaginal Rejuvenation: Your Doctor Has a Solution


January 2019 Issue

There's no need to be embarrassed or shy.

There’s good news and lots of it in the world on vaginal rejuvenation! Our Pink medical and aesthetics experts discuss their favorite, newest treatments and procedures, and each one is more than happy to walk you through the process.

Ultra Femme 360
Pinnacle Plastic Surgery and Pure Medical Spa

For years it’s been “ok” to talk about men’s sexual health and erectile dysfunction. Ladies, now it’s our turn! Vaginal Rejuvenation is the next topic we as women are ready to talk about ... thank goodness! If you have ever experienced symptoms such as stress urinary incontinence, internal laxity, decreased sensation, inability to orgasm from intercourse, or looseness of the external tissues like the labia majora and minora, then it’s time to get in on the conversation yourself.

Women are no longer passive when it comes to our health and now that includes sexual satisfaction, as well as taking control of other embarrassing issues like stress incontinence.

With age come plummeting levels of estrogen, leading to changes in the supportive collagen of the vaginal wall and external tissues. The result is loosened, dry tissues, a lack of sensation, and stress urinary incontinence (urine that leaks with coughing, sneezing or other pressure). None of us should have to take these symptoms lying down—pun intended.

There are different technologies out there, but I chose the Ultra Femme 360 because radiofrequency is safe, effective, painless, and has zero downtime. Our patients love it! Treatment time is only 8-15 minutes depending on whether patients want to treat internally, externally or both. The series is 3 treatments spaced 1-2 weeks apart. Patients may return to all activity immediately after each treatment, including intercourse.

Almost every woman benefits from this technology and 8 minutes is faster than waiting in line for coffee at Starbucks. Don’t do this for anyone else... do it for you!

Dr. Audrey A. Klenke, owner of Pinnacle Plastic Surgery and Pure Medical Spa, is a board-certified plastic surgeon. She is on staff at the Bluffton-Okatie Outpatient Center, Hilton Head Hospital, and Beaufort Memorial Hospital. For more information go to:

Mona Lisa Touch
Serendiptiy, a medical spa

Mona Lisa Touch is intended for the treatment of painful intercourse caused by vaginal dryness due to low estrogen (postmenopausal state). It is also used to treat mild urinary incontinence and improve mild prolapse of the vagina (cystocele/rectocele). Mona Lisa Touch is a fractional CO2 laser. It works by causing micro injuries to the mucosal surface, causing thermal injury to the underlying tissue. During the healing process, new vascularity and collagen are recruited to the area, increasing vaginal moisture and vaginal strength. Many women also report increased post-procedural sensation, which is a nice bonus!

The actual treatment takes just a few minutes to complete and is administered in a series of three treatments, best scheduled six weeks apart. The results last for up to 18 months, but a single annual retreatment is recommended so the results are maintained. There is immediate improvement in vaginal moisture for nearly everyone. After the whole series of treatments, most women report increased moisture vaginally, improvement in stress urinary incontinence, and increased sensation during intercourse.

There is little to no downtime! Usually it is best to refrain from intercourse for a few days afterwards and there may be some very mild irritation of the vulva for a short time, as well. There is very minimal discomfort for most women during and after the procedure. No medications are required post-procedure, there is a topical anesthetic applied prior to the procedure, which minimizes any intraprocedural discomfort.

Patients report the results as life changing, especially those who cannot use hormones to treat vulvovaginal atrophy! It is one of our most satisfying procedures and is highly rated by the majority who choose it! We have had women say, “You’ve given me my life back!” at the end of the treatment regimen.

Tracey Leaver-Williams, MD. Tracey practices at Hilton Head OBG partners and performs aesthetic procedures at Serendipity Medical Spa, 23 Main Street suite 102 Hilton Head Island (843)342-2609.

Weniger Plastic Surgery

Labiaplasty is one of the fastest-growing plastic surgery procedures, but it’s still a secret! Many women don’t know that labiaplasty is a simple, one-hour procedure that can help a woman’s confidence and sometimes even help painful symptoms. This operation, which reduces, or re-shapes, the labia is now the hottest surgery in the specialty, increasing 217 percent in the last five years. In fact, more than 10,787 of these surgeries were performed last year.

Labiaplasty has become common because so many women either develop unusual, asymmetric, or very long labia. Others become terribly stretched, or even torn from childbirth, and are unable to wear tight clothes or ride a bike, and often have pain with sex or exercise/running.

Usually, labiaplasty is performed in the office while the patient is awake but sedated with pills, such as valium, while the topical numbing cream takes effect. Topical numbing cream and local anesthesia is used. (There are some patients who prefer to be put to sleep.) In most cases, excess hanging skin of the labia minora (inner lips) is trimmed and re-shaped. Often, some skin is removed from the clitoral hood to enhance stimulation. Some patients benefit from plumping the labia majora (outer lips) with small amounts of fat removed with micro-liposuction from other areas like the tummy. A combination of these techniques can be used together as well.

Patients have little pain with the surgery and rarely take pain medicine for more than one or two days. Still, recovery involves being gentle with the tender area; patients need to refrain from having sex for three or four weeks. Swelling decreases over several weeks.

If you suffer from any of these issues, or simply want to improve your intimate appearance, a consultation with Dr. Weniger will help you understand what can be done to help.

Board Certified, Frederick G. Weniger, M.D., F.A.C.S. has 19 years of experience providing cosmetic plastic surgery and is a member of American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons and Fellow of the American College of Surgeons. Author of Facial Rejuvenation: Surgical and Non-Surgical Procedures for a Younger-Looking You.


Advanced Women’s Care of the Lowcountry

Votiva is not just for older women! Any woman with vaginal dryness, pain with intercourse, stress urinary incontinence, vaginal laxity, or lichen sclerosis will benefit. Votiva uses radiofrequency energy to stimulate thermal remodeling, which results in new collagen and elastin formation, making the tissue more supple and elastic. This allows the tissue to expand and retract without tearing.
Forma V is applied internally for about 10 minutes and externally to the labia, perineum, urethra and clitoral area for about 10 minutes. If you have any pesky hemorrhoids, we can spend some time in this area to shrink those, too!

Our Votiva patients have improvement in lubrication, decreased pain and vaginal discomfort even after the first treatment. It also will start to help bladder control and mild stress urinary incontinence from the first treatment, but for full effect three treatments are necessary.

There is no downtime for normal activity. I went on a three-hour biking tour right after mine! However, we do recommend no tub bath, sex, or swimming for two to three days after the treatment. Best of all, there is no pain from the procedure. The Forma V wand is smaller than a routine ultrasound probe. Patients feel gentle warmth but nothing painful or too hot during the procedure.

Votiva patients are the happiest patients in our Gynecology practice! Often they have not been able to have sex for years, or have gritted due to pain and gotten through it. We can combine the treatment with testosterone pellets as well so you will not only be able to have sex again, but actually WANT it, too!

Dr. Tracy Blusewicz, M.D., F.A.C.O.G., compassionate, genuine bedside manner has earned her the trust of many women for their health care needs. She can be contacted at Advanced Women’s Care.

Finger & Associates Plastic Surgery Center

ThermiVa treatments use radiofrequency energy to gently heat tissue to rejuvenate collagen without discomfort or downtime. ThermiVa provides multiple benefits for patients who complain about vaginal laxity and other issues associated with vulvovaginal youthfulness and wellbeing. ThermiVa is beneficial to patients with vaginal laxity due to childbirth, and those who have vaginal dryness due to menopause. ThermiVa can also help with those having bladder control issues.

A heated probe is gently inserted into the vaginal area and gently rotated to tighten the muscles and re-vascularize the tissue and promote collagen production. The procedure takes approximately 1 hour and 3 treatments are recommended at one-month intervals. Follow up treatments occur if and when the patient begins experiencing symptoms again, usually 9-12 months. There is no pain, discomfort or downtime and patients have expressed very positive results from the ThermiVa treatment.

Terri Cullina, who performs the ThermiVa treatment procedure, is an RN at Finger & Associates Plastic Surgery Center in Savannah, Georgia.


Bluffton Aesthetics

With age and after childbirth, women start noticing symptoms related to their vaginal health, which affect their lifestyle on different levels. Bluffton Aesthetics is excited to offer FemTouch (a fractional CO2 laser) for improved intimacy, bladder function and overall quality of life by addressing vaginal health-related conditions such as stress urinary incontinence, vaginal laxity, and vaginal atrophy. FemTouch addresses vaginal health-related conditions by restoring the vaginal wall.
Vulvovaginal atrophy (VVA) affects up to 80 percent of post-menopausal women. The symptoms primarily include vaginal dryness, irritation, itching, painful urination and painful intercourse. These symptoms can adversely affect interpersonal relationships, quality of life, and sexual function.
The main cause for VVA is a drop in estrogen levels during menopause. The change in estrogen levels causes the vaginal lining to become thinner, dryer and less elastic. The urinary tract is also estrogen dependent and women with VVA may also have symptoms such as urge incontinence or stress urinary incontinence.

FemTouch is an in-office procedure with minimal discomfort and takes only a few minutes. The fractional C02 laser beam is applied along the vaginal wall, resulting in regeneration of the tissue. Generally 2 to 4 FemTouch treatments are recommended, but some women see improvement in their condition after 1 to 2 procedures.

Savannah Rogers DNP, FNP-C is a board-certified Nurse Practitioner at Bluffton Aesthetics. Follow her on Instagram @aestheticallysavy

Custom Hormone Therapy   
Werner & Glover Women’s Health

Custom hormone therapy is a good choice for perimenopausal or menopausal women who do not have medical conditions that preclude hormone use. Compounded hormone therapy can be tailored for an individual, to achieve results that will improve quality of life for many women better than standardized medical therapy.

Just like some women may find clothes that fit well “off the rack” and others may need alterations, hormone replacement or supplementation is not “one size fits all.” By measuring hormone levels prior to starting therapy, dosages can be modified to best suit the needs of the individual.

Hormone therapy may also improve sleep, energy levels, bladder function, and sexual health. Treatment varies among patients—some may use treatments to transition through menopause; others may continue for much longer periods of time, as they enjoy its quality of life benefits.

Hormone replacement therapy can relieve vaginal dryness, soreness and discomfort during intercourse, as well as urinary frequency and urgency. In addition, patients see improvement in energy levels, sleep, libido and sexual enjoyment. Many women also report improved cognition.
There are different routes to administer custom hormone therapy. Gels or creams are used daily and are painless to apply, and there is no downtime with the treatment. Some choose to have subdermal implants (pellets) inserted under the skin of the buttocks or abdomen under local anesthesia in the office through a 1/8-inch incision. These last three to five months for most women.

Most of our patients love the results of custom hormone therapy. Many of those who choose this treatment have not responded well to other therapies, or are seeking relief from other menopausal symptoms.

Gregory Glover, MD, FACOG, FPMRS, is a board-certified urogynecologist with Werner & Glover Women’s Health in Beaufort. A member of the Beaufort Memorial medical staff, Dr. Glover specializes in female pelvic medicine and reconstructive surgery.

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