VAGINAL COSMETIC SURGERY
Edward Jacobson, M.D., F.A.C.O.G.
The Greenwich Center for Restorative Vaginal Surgery
Dr. Edward Jacobson is a Board certified gynecologist who has been in private practice for over twenty five years in Manhattan and Greenwich, Connecticut. He trained at the New York Hospital-Cornell University Medical Center where he remained an attending physician until moving his practice of vaginal surgery to Greenwich 25 years ago. He is a Fellow of the American College of Obstetricians and Gynecologists and a member of the American Academy of Cosmetic Gynecologists. He is one of the only physicians in the United States with advanced training in both laser and high frequency surgery.
Dr. Jacobson has the experience of thousands vaginal surgeries over the past two decades and has done more than 2,000 sexual enhancement procedures. He utilizes both laser and most recently, state-of-the-art high frequency (no scalpel) surgery for reduced post-operative discomfort, minimal scar formation, enhanced healing and excellent cosmetic results.
His office is located in Greenwich, Connecticut, just outside of Manhattan and close to three major airports. Surgery is conducted at the Summer Street Ambulatory Surgery Center, a fully accredited and licensed ambulatory surgery center, and at Greenwich Hospital, Greenwich, Connecticut.
Dr. Jacobson periodically consults with patients from the United Kingdom and Europe in his office at 112 Harley Street, London, England. All surgeries however, are performed in the United States.
The New York Hospital
North Shore University Hospital, Manhasset, NY
Norwalk Hospital, Norwalk, CT
Olympia Medical Center, Los Angeles, CA
Our office can assist you in arranging a low interest payment plan. We also accept cash, cashiers checks and credit cards (Visa, MasterCard). We do not accept debit cards.
Multiple procedures undertaken at the same time will reduce the total surgical fee by $500. Facility/anesthesia fees usually range from $1,900 to $2,600 per procedure depending upon time in the operating room.
Surgery Center, Stamford, CT
Where to Stay
If you are coming from out of town we can assist you with local hotel accommodations. If you choose our concierge travel package you would fly to New York the day prior to surgery. After being brought by private car to your hotel (we recommend The Hyatt Regency or the Delamar in Greenwich) and settling in, you will be seen at my nearby office for your comprehensive consultation. All medications will be provided for our international patients at that time. Your surgery would be undertaken the following day. When you are ready to be discharged a private car would return you to your airport of departure or take you into Manhattan if you choose to extend your stay.
Labiaplasty by High Frequency Radiosurgery vs. Laser Surgery
If you have visited the many vaginal rejuvenation and labia reduction websites on the Internet you have probably discovered several different techniques promoted as the best for aesthetic vaginal reconstruction, especially laser surgery. As someone who was personally trained by the two top two pioneers in the specialty and who has over eight years experience with aesthetic vaginal surgery, let me share with you my thoughts on this subject.
For the first five years working in this subspecialty I used the laser for all of my vaginal rejuvenation and labia reduction procedures. The laser was highly marketable and well known to the public, literally and figuratively the ‘cutting edge’ of medical technology, and achieved very good results. Even today, many women believe if their surgeon isn't using a laser he is behind the times. Well, if the laser is so outstanding, what convinced me to switch to high frequency surgery to perform the same procedures?
Before we go there, let’s talk about the laser first. This is a device that focuses and concentrates light energy into a very precise cutting instrument. The type of laser used for vaginal rejuvenation uses a wavelength designed to seal small blood vessels as it cuts. The result: a precision incision with virtually no bleeding. However, there is a significant downside. The laser generates intense heat. The remaining tissue edges that need to be stitched together sustain a lot of thermal damage, resulting in swelling, peeling and inflammation that lasts for days or even weeks. A significant amount of post-operative discomfort persists and it takes a long time to heal, especially after vaginoplasty. During labiaplasty, if the inner labia are thin the residual heat damage can be very traumatic and result in distortion and prolonged discomfort, even it the best of hands.
High frequency surgery provides the best of all worlds. It generates a radiowave emitted by a fine wire. This cool tip doesn't even touch the skin as it cuts. As a result there is virtually no thermal effect, charring, swelling or inflammation. In fact the cut edges are ‘cleaner’ compared with a scalpel or knife because the width of the incision is so fine. Patients who waddled into my office the day after laser surgery now walk in with minimal discomfort, whether they had undergone vaginoplasty or labia reduction. Where I previously ordered Percocet and Oxycontin for post operative pain with laser surgery I now only use a mild narcotic such as Vicodin, and even then only as a backup medication. Needless to say, you can be up and about and can return to normal activities faster and with greater comfort compared with the laser.
The problem with high frequency surgery is that women don’t know about it and not many surgeons are trained in its use. It’s actually been around for a long time and has been used by neurosurgeons, ENT surgeons and dermatologists. This is simply a new application of a well established instrument. It may not be sexy but it makes for a wonderful marriage of technology and aesthetic vaginal surgery.
The Labiaplasty Procedure
Labia reduction is done under twilight anesthesia along with long acting local anesthesia that will provide six to twelve hours of pain relief after surgery. I can contour the labia to form either a tapered, Natural Look or make the edges very narrow to produce a Thin Look. It’s your choice. Examples of the Natural vs. Thin Look can be seen in the Photo Gallery on the website. Reduction of the clitoral hood can be undertaken if needed. Next the skin is marked according to the planned surgery. I follow the markings on your labia with the minimally traumatic Ellman Surgitron. It is a unique instrument because it has a cool tip so thermal damage to the underlying tissue is measured in microns instead of in millimeters. Compared with the laser you read about for vaginal rejuvenation high frequency (no scalpel) surgery produces far less post-operative swelling, inflammation and pain yet achieves superb cosmetic results. I have used a laser for many years but now my patients experience the remarkable difference the Surgitron makes. It is without comparison in its finesse and ‘no touch’ technique. To help with occasional bleeding sites I use fine point electrocautery.
There are two basic techniques used to sculpture the inner lips. I have already mentioned the first method above. The second, known as the wedge or V technique is the one preferred by plastic surgeons which removes a horizontal wedge of labia tissue. The edges of the V are brought together horizontally with fine sutures. Unfortunately it has the potential for many complications and can often pull apart. There can be too much tension and not enough suture strength to keep the edges together. A variable blood supply can also impair healing. Most gynecologists, including myself, use the technique that vertically contours the edges to the size desired without the high-tension wedge incision. There is less wound breakdown and fewer problems with restoration of blood flow. I favor this technique because of its precision and flexibility. You do not have to guess how the top will line up with the bottom. The edges always line up.
Once all the excess labia tissue is removed meticulous suturing begins. Very fine dissolving sutures are used in several layers to ensure proper alignment of the edges and wound healing. Various suturing methods can be used but I prefer to stay with a tried-and-true technique developed over the years. It is the safest method of all to ensure wounds do not open up and at the same time preserves the most natural of looks. If excess friction against the healing labia causes separation of the edges, the good news is that they come together again naturally with excellent cosmetic results. The key to a successful labiaplasty is to blend the upper portion of the labia and skin next to the clitoris into the reconstructed lips so the edges flow evenly. This is where the art and experience of the repair come together.
When your surgery is completed you wake up within two to three minutes, transfer to the recovery suite and go home or to your hotel shortly thereafter, pain free for hours. On rare occasions slight irregularities or small skin tags may develop during the healing process. If this occurs, as part of your overall care ‘touch-ups’ can be done in the office painlessly with local anesthesia.
A Candid Discussion With Dr. Edward
It is unfortunate that although I can consult in the UK I am unable to perform cosmetic and restorative vaginal surgery in Great Britain. Yet, in spite of this many of you continue to inquire about obtaining these surgeries from me, in the United States, when these procedures are available in the United Kingdom. So, the real question becomes, “If labiaplasty, vaginoplasty and perineoplasty are available in the UK, why would you come to the United States to have the same surgery?”
Does it make good financial sense that you should travel a great distance and incur expenses coming to New York when you could easily go to Harley Street? Furthermore, what happens when you return home?
These are valid concerns that need to be addressed before any decisions are made. With that in mind, I’d like to help by providing some substantive answers.
Why come to Greenwich (Connecticut USA, that is) for your surgery?
It’s well known in medical science that if someone performs the same task many times, they generally become very adept at this task. I suppose the same could be said for any repetitive endeavor. The reason, simply, is that as one does a complicated task time and again, they usually also experience many variables in the process. They see a wide variety of cases—from simple to complicated—and as a result they gain something along the way . . . EXPERIENCE.
Never discount this aspect—Experience—when considering a surgeon for your procedure. Yes, many physicians and surgeons claim to have experience performing restorative vaginal surgery but in fact their training, number of cases and surgical experience may vary widely. I urge you to read How To Decide Upon A Surgeon on my website, before committing to have a procedure with any surgeon in England or the United States.
Furthermore, here in the United States, cosmetic surgical services are performed with more frequency than any other place in the world. Simply said, feminine cosmetic genital surgery is listed in the top leading surgeries performed here in America, where these procedures originated, many years ago.
So, what does that mean to you?
It means that you can be assured that you will have a much greater chance of success and can expect excellent results . . . rather than choosing someone who has only done a handful of these delicate procedures, merely because they are in your area.
As a physician who has consulted in London for several years I am aware of what procedures and techniques are available in the UK and Europe. Laser Vaginal Rejuvenation has been marketed as the most technologically advanced method in the UK for these procedures. As someone originally trained in laser surgery, who practiced laser surgery for over five years and subsequently abandoned it, I am qualified to talk about the advantages and disadvantages of the laser. There are other methods far superior to laser surgery that not only provide an excellent cosmetic result but do it with less pain, swelling and discomfort.
In short, the technology and expertise are readily available in America and worth the trip for what will prove to be an outstanding functional and cosmetic result.
What about the cost?
First, compare what it will cost to have your surgery in England. For a top rate surgeon you will have to go private, pay for your laboratory services, hospital and surgical suite, anesthesia, surgical assistants, medications and post-operative care. As in the United States, these services can often be obtained at a very low price. However, you should never use the least expensive physician as your major decision making factor. When it comes to restorative vaginal surgery, and all cosmetic plastic surgery for that matter, it is always worthwhile spending more to achieve the best outcome. Meticulous surgery takes time, and the overall cost of the surgery center and its staff, anesthesia and the surgeon is based upon experience and time. This is not a procedure you want rushed. You are paying for an expert and a team who has devoted a lot of training, expense and effort to provide the best cosmetic result, not to have you realize a less than desired outcome. Let us not forget . . . once tissue is removed (excised) it is NOT possible to replace it!
How about the travel expenses?
Many patients come over with friends or family and spend time in nearby Manhattan before their surgery and allow for this when making their travel plans. In essence, they make it a medical vacation. This is an area where my staff can greatly help. Be assured that over the past eight years we have developed a seamless concierge service for those patients who ask us to make ‘turnkey’ travel arrangements, whereby all of your transportation and hotel needs are cared for from the time you leave the airport until your final departure. You will always be in contact with my office or with me personally to assist you if any problems arise. If you are traveling alone we will arrange for an aide to bring you from the surgery suite back to your hotel and stay with you afterwards. We are greatly experienced in aiding patients coming from overseas, and can assure a smooth arrival and departure. Concierge services are tailored to the individual travel needs of each patient. As for the additional cost of traveling to America, again, DO NOT easily discount the importance of getting a vastly experienced surgeon to do your procedure. To do so could be the worst decision you’ve ever made.
What happens after I return home?
It is my commitment to stay in close touch with you long after your surgery is over. It is very rare to have a problem when you return home that requires the attention of a gynaecologist, but just in case there are physicians in the UK whom we know that are familiar with my surgery and can attend to you, if in the unlikely event they are needed. Alternatively I will communicate closely with your own gynaecologist if the need arises. Lastly, approximately 95% of my patients come from a distance greater than 100 miles. Our surgical techniques are designed with this in mind. Virtually all post operative problems, if they occur at all, are minor and can are handled by telephone or on Skype.
In planning your surgery, please be assured your inquiries will be answered promptly by my office staff, and I am available at all times by telephone. You will always feel you have a physician at the tip of your fingers. Privacy and discretion are an integral part of our practice.
Edward Jacobson, MD FACOG
Tel: 001 203 869 8360
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