HYPERHYDROSIS / GENITALS CARE
Hyperhidrosis Treatment
Osmidrosis Surgery Botulinum Toxin Injection AlCl? Lotion
Labia Minora Reduction
Labia Majora Reduction
Labia Majora Filler Injection
Labia Majora Fat Transfer
Vaginal Thightening
Vaginal Filler Injection
Clitoral Hood Reduction
Circumcision(Phimosis Correction)
Penile Fat Transfer
Penile Filler Injection
Hyperhidrosis Treatment
Perspiration happens mostly in 2 different situation. One is when heat
lets body sweat to regulate body temperature , sometimes called thermal sweating or thermoregulatory sweating. Eccrine sweat gland is the one responsible for this situation by secreting
nonsmelling thinner sweat. The other mainly known perspiration situation
is called emotional sweating, which is partially observed at the armpit, groin parts, palm, sole and
other body parts where apocrine sweat glands discharge thicker smelly sweat
during emotional state. Treatment is usually focused on the emotional sweating because it cannot be easily controlled or avoided.
Axillary Osmidrosis (Excessive Sweating) Surgery
Axillary Osmidrosis refers to the smelly sweat of the armpit. Usually
treatment is done by surgery. Apocrine sweat glands are removed by surgical
scissors, which sounds so old-fashioned but still the most effective way.
The procedures that are performed with microwave device, ultrasound or
suction often show recurrence of the issue.Surgical procedure only works on the armpit and not on other body parts. It goes as follows:
marking on apocrine gland area
２－３cm mark in the middle for incision
after undermining or undercutting skin, glands are shaved or trimmed out
apocrine glands are located along hair follicles
Under local anesthesia mainly this surgery is performed, and , of course, general anesthesia also is possible. Needs 2 days of gauze tie-over and bandage compression for a week. Stitches are removed 1 week later. Tight compression is required inorder to avoid severe bleeding making a clot that might prolong recovery time. Even after stitch removal, sometimes wound recovery needs few more weeks to heal completely. Swelling and bruises might last for weeks.
Even this procedure is the most effective remedy for this problem, only obvious aprocrine sweat glands are removable, while tiny eccrine glands, which are also responsible for excess sweating, cannot be completely shaved, and postsurgically might still cause some residual thinner sweating. So this method is usually recommended for cases that are mainly concerned with the odor of sweating. If excessive sweating, and not smelly, is the main concern, other treatments mentioned below maybe are better options.
Pricing
| without tax | with tax | ||
| Axillary Osmidrosis Surgery | both sides | \240000 | \264000 |
Botulinum Toxin Treatment
Besides usage in expression wrinkle lines on face, Botox also treats hyperhidrosis(over-sweating). Less perspiration means less odor. Not only in armpits but also on hands and feet. Minutes of treatment can give you about half a year of comfort.
botulinum toxin injection before/after
downtime: puffy for few hours, if bruise observed, takes around 1wk. to subside
Botulinum toxin has plenty of brands worldwide, and the most famous one is the original Botox brand from Allergan company.
Other ４brands are approved by the FDA and one of them called Dysport is available in our clinic. It is more like a generic drug of Botox from Ipsen, a British company. While Botox own 50％of the share in the US, Dysport comes nearly 50％, according to recent statistics.
Botulinum treatment shows its effect at the earliest on the 2-3rd day, sometimes may take a week, and completes around a 2-week period. 3－4 months later effect may start fading and might completely go away around 6- 8th month.
Allergic reaction rarely seen might be observed partly on the area injected. Pregnant or expecting to be pregnant individuals are not good candidates for this treatment.
This treatment is mainly done on armpits, which treats both excessive sweating and odor, but if the smell is the main concern, permanent removal of sweat glands with surgery might be a better option.
Other parts treatable are palms, soles of feet, forehead、temple、scalp and groin parts.
Botulinum toxin usually shows effect after 2-3 days and be completed within 2 weeks, then lasts for 3-4 months, and sometimes longer 6 months up to 8 months. Better reinject before obvious lines come out again.
After treatment, be careful to watch for allergic reaction. Pregnant or any possibility of pregnancy may not be able to take this treatment.
Pricing
| Botox | Dysport | ||||
| without tax | with tax | without tax | with tax | ||
| Sweat Treatment | armpits | \80000 | \88000 | \50000 | \55000 |
| palms | \100000 | \110000 | \70000 | \77000 | |
| soles | \120000 | \132000 | \80000 | \88000 | |
| forehead | \60000 | \66000 | \40000 | \44000 | |
| temple | \60000 | \66000 | \40000 | \44000 | |
| scalp, etc10×10cm | \60000 | \66000 | \40000 | \44000 |
Aluminium Chloride AlCl3 Lotion
Aluminium chloride works as an anti-perspirant by blocking ducts of sweat glands.
palm AlCl3 treatment before/after
downtime: apply everyday or every 2to3 days, itchiness&redness might be observed
Effect is not permanent so daily use is required to gain continuous confort.
Actual lotion application goes as follows:
armpit At night, take about 1 cc of lotion on hand, then directly apply at armpits. Next day,
wash. If feeling severe itchiness and pain after few minute, wash it immediately to
avoid worsening. Even in this short period, effect might be observed. Continue in similar
manner for few days until good effect observed. Then once or twice a week of
applying enables you to maintain sweatlessness.
palms & soles Treat them similarly as armpit. Since skin is thicker, this might take you more.
If not seeing effect, try to wear cloth gloves or socks that soak easily the lotion
then cover it with saranwrap for 1 night to let substance penetrate easily.
other parts (same as armpit)
AlCl3 lotion might cause itchiness and skin rash that might turn into discoloration afterwards. In this case, try to lessen application or take rest for a while till they subside.
Pricing
| without tax | with tax | ||
| AlCl3 Lotion | 30㏄ | \1500 | \1650 |
| 100㏄ | \4500 | \4950 | |
Labia Minora Reduction
Enlarged or stretched A private care for a private matter in woman's
body. This is a procedure done to reduce the labia minor. Excessive skin
that causes discomfort and also cosmetic issue is removed.
Enlarged or stretched labia minora is the subject of this procedure that is popular among women in their 30s thru early senior years. Expanded labia can cause discomfort or pain while wearing fit pants or jeans and sometimes turns into a pigmented part that is noticeably not appealing cosmetically for some, so reduction of labia minora by removing unwanted excess extremities is the main method of the procedure. Overgrowth of the labia commonly occurs from labor, aging, and other unknown causes.
Usually performed under local anecthesia and it goes as follows:
extended labia minora incised, then sutured
subextension on upper part also removed to even out
dissolvable stitches used, so no need of removal
compression with napkin for about 2 days needed
Bleeding is carefully cauterized to avoid severe swelling, but bruises might be sometimes observed for 1－2-week period. Sexual intercourse and other strong stimulation need to wait for 3－4-week period.
Pricing
Enlarged or saggy labia majora is reduced to gain a tight and younger appearance. Overgrown labia sometimes causes friction pain with fit underwear, and might present unpleasant odor by accumulatimg dirt at groin area.
Actual method goes as follows:
expanded labia majora incised to remove excess skin and tissue.
stitches done to reduce size
This part is prone to bleeding so operation must be well taken care of, and postsurgical compression with gauze and napkin is also required. Swelling might be observed for 2 weeks. Stitches are dissolvable, so no removal afterwards. Sexual intercourse and other strong force that might damage wounds must be forbidden for 3-4-week period.
Pricing
Labia Majora Hyaluronic Acid(HA)Injection
This might not be popular in Asian countries,but in Western States, loose or saggy labia majora caused by aging is a subject of HA filler injection to obtain tighteness. In Asian countries where tininess is more favored, filler injection is kind of as a remedy going in wrong direction.
Labia majora needs around 1cc or more of HA to tighten up both sides.
saggy labia majora
puffy labia majora after filler injection
HA filler has 2 major brands:
Labia Majora Fat Transfer
Labia majora fat transfer has similar goal as HA filler injection to tighten up the part, which is more like a Westernized idea rather than an Asian concept in which smaller labia is praised. Aging or labor can cause loosening of labia majora.
While fat grafting has many advantages, a list of disadvantages also does exist. Let's see first some of its ADVANTAGES:
・not artificial, self-derived autologous fats are safe
・more natural in shape and touch
・permanently remain in the tissue
・liposuction can be performed together
There might be some more, but these 4 are the main factors in the list.
Next are the DISADVANTAGES:
・most injected fats are resorbed, survival rate as bad as 20％ up to 50％
・need treatments to achieve desired volume
・every session needs liposuction procedure
・non-surviving dead fat mass may turn into calcification or infection if not resorbed
About same number of cons as pros is the reality of this method, however, tactics have been developed to cope with these issues. Firstly, injected fats must be rich in fat stem cells(adipose stem cells ASC). Harvested fats is purified to highten ASC's density inside the graft, anticipating stem cells to grow and multiply into mature fat cells inorder to compensate for the resorbed portion of the graft.
Then, actual injection must be done in scattering manner by injecting fats in smaller strips along a layer and the same way at the other levels of the subcutis tussues, fat layers, and muscles, if necessary, to avoid creating a bulk.
Tissue layer condition also affects survival rate of the fats. Specifically, loose spacious layers embrace more of the graft than the dense and firm ones. Body parts with loose layers and saggy excessive skin that has more room usually adopt well to the injected fats about 2 or 3 times of its desired capacity, which is necessary to gain the desired goal. Injecting further more than these might cause low survival rate and undesirable side effects. Only body parts that have extra room for fats can tolerate the adequate enormous graft volume.
Fat graft is purified by the following process:
Liposuction or Mini Lipo by Syringe Method is used for harvesting fats.
Then syringes are centrifuged.
Impurities are separated from purified fats.
Directly inject fats or subdivide them to smaller syringes.
Fat transfer with harvesting through mini lipo can be done usually with local anesthesia. Injection of fats is performed with lidocaine blockage which numbs parts during the procedure. The patient is able to go home by oneself under this method like what is normally done in dental clinics. Of course, general anesthesia also is available.
Labia majora's fat transfer needs around 6cc on both sides. Fats can be harvested through mini lipo. Small areas such as this labia need only few cc's of fats, and they might not be desirable for this procedure which needs liposuctioning in every session. Usually they are good with hyalunic acid filler such as Juvederm or Restylane, which is the main method done in the clinic. Hyaluronic acid might be absorbed later but lasts longer compared to fat graft that reduces into half within months.
Fat injected area does not need any compression or covering but mini lipo area does. It requires few months of simple compression and stitch removal a week later.
Pricing
Pricing is only for 1 treatment session.
2nd treatment and beyond are 50% OFF.
Liposuction fee is required in every session. Refer to Liposuction page for pricing details.
Vaginal Tightening
Child birth and aging might stretch out vaginal wall and opening, leaving it so loose that might need correction mainly with a surgical technique. Specifically, muscles of the wall are the ones that are loosened through these events.
Recently, various nonsurgical devices are invented for treatment of this issue but mostly unsuccessful. So surgery is still the best remedy.
This procedure is possible to perform under local anesthesia, but usually general anesthesia is recommended. Actual method goes as follows:
from vaginal opening into 3-cm inner membrane flap removed
muscle, then membrane tucked together with sutures to tighten
remaining 2-finger breadth opening
This surgery might show blood oozing to some extent, so compression with gauze tampon is needed for 2 days. Dissolvable stitches are used so no need of removal. Swelling and bruises might be observed for around 2 weeks. In a phase of a month or so, discharge tainted with blood might sometimes be observed, so sexual intercourse is not advisable during this period.
Pricing
general anesthesia fee \50000(with tax \55000)
Vaginal Tightening with Hyaluronic Acid Filler
If surgery is not the choice, filling in with filler to narrow the vaginal cavity is an option, by thickening the wall with an injectable.
Vaginal HA injection needs around 4㏄ or more amount of the substance:
HA filler filling in the loose opening up to inner area
HA filler has 2 famous brands, which are mentioned in detail above at Labia Majora HA injection section.
Effect is not permanent, for about half a year or more than a year depending on the brand. Surgical procedure might be a better choice. Filler maybe an option when time for surgery is not available.
Clitoral Hood Reduction
Removal of clitoral hood or prepuce to expose the clitoris is the goal of this procedure. Hood covering the clitoris might disturb feeling sensation and also gather dirt around the area that might cause unpleasant smell.
Actual procedure is to remove not entirely but just part of the prepuce to let the clitoris surface out from hiding:
marking of hood to be removed
clitoral hood or prepuce removed the sutured
This procedure is performed usually under local anesthesia. Since it is just in a limited tiny area, bleeding should be securely taken care of, compression with gauze and napkin for few days. Dissolving stitches are used, few months of wound redness might be observed. Few days later, showering is already okay, but swimming and bathtubing should be avoided for 2 weeks. Sexual intercourse should be avoided for about 2 weeks.
Circumcision(Phimosis Correction)
This procedure is to remove prepuce(foreskin) covering or strangling the penis. Foreskin might be hindrance for the feeling, may constrict the neck of glans causing inflammation around it, and, what is worse, often gathers fatty secretion called smegma around the penis glans that produces unpleasant odor. These are just some reasons to remove or loosen the prepuce.
3 techniques are available in correcting this issue; complete removal of prepuce by circularly incising around the glans neck which is the basic circumcision method(or sleeve method), making a slit cut on dorsal side of the penis to release strangulation which is called dorsal slit method, and removal of skin at penile base root to draw in skin in an atempt to expose the glans, the method that may be named root incision method.
Basic Circumcision Method is one mainly performed for all 3 types of phimosis called complete phimosis (nonretractile), retractile phimosis, and strangulated phimosis.
excess prepuce marked red
after prepuce removal, glans penis is exposed, wound is sutured just nearest place of the glans neck to hide it
Dorsal Slit Method is not new, traditionally done to release strangled phimosis in emergency setting. By relaxing the foreskin, it sometimes retracts naturally by itself that might consequently improve phimosis symptom. Applying this method to complete nonretractile phimosis is not advisable but might work for retractile phimosis. If preservation of foreskin or penile volume is the choice, this method might be a help, however, if complete removal of somewhat disturbing foreskin is the desire, basic circumcision is the method to choose.
a slit is made from prefuce distal end vertically
slit is sutured horizontally to relax tension
Base Root Incision Method is formulated to hide wound scar into pubic hairs but not applicable to nonretactile and strangulated phimosis, usually performed only on retractile ones. However, since prepuce is sometimes not that retractable, recurrence might happen.
base root marked red for skin removal
after skin removal, skin drawed in then sutured
Local anesthesia is the usual routine , but general anesthesia is also available. 30-60-minute surgery time needed, stitches are done with dissolvable ones so no need of removal. Bleeding might occur at home so compression with bandage is necessary, which is easy to be changed by oneself daily for around 5 days. Swelling and bruises might be observed for around 2 weeks. Sexual intercourse and other wound-damaging actions must be forbidden for at least 3 weeks.
general anesthesia fee \50000(with tax \55000)
Penile Fat Transfer
Penile Enlargement is often performed through fat transfer method. To enhance the girth and firmness, fat harvested from the belly or thigh is injected into penile subcutis.
While fat grafting has many advantages, a list of disadvantages also does exist. Let's see first some of its ADVANTAGES:
・not artificial, self-derived autologous fats are safe
・more natural in shape and touch
・permanently remain in the tissue
・liposuction can be performed together
There might be some more, but these 4 are the main factors in the list.
Next are the DISADVANTAGES:
・most injected fats are resorbed, survival rate as bad as 20％ up to 50％
・need treatments to achieve desired volume
・every session needs liposuction procedure
・non-surviving dead fat mass may turn into calcification or infection if not resorbed
About same number of cons as pros is the reality of this method, however, tactics have been developed to cope with these issues. Firstly, injected fats must be rich in fat stem cells(adipose stem cells ASC). Harvested fats is purified to highten ASC's density inside the graft, anticipating stem cells to grow and multiply into mature fat cells inorder to compensate for the resorbed portion of the graft.
Then, actual injection must be done in scattering manner by injecting fats in smaller strips along a layer and the same way at the other levels of the subcutis tissues, fat layers, and muscles, if necessary, to avoid creating a bulk.
Tissue layer condition also affects survival rate of the fats. Specifically, loose spacious layers embrace more of the graft than the dense and firm ones. Body parts with loose layers and saggy excessive skin that have more room usually adopt well to the injected fats about 2 or 3 times of its desired capacity, which is necessary to gain the desired goal. Injecting further more than these might cause low survival rate and undesirable side effects. Only body parts that have extra room for fats can tolerate the adequate enormous graft volume.
Fat graft is purified by the following process:
Liposuction or Mini Lipo by Syringe Method is used for harvesting fats.
Then syringes are centrifuged.
Impurities are separated from purified fats.
Directly inject fats or subdivide them to smaller syringes.
Fat transfer with harvesting through mini lipo can be done usually with local anesthesia. Injection of fats is performed with lidocaine blockage which numb parts during the procedure. The patient is able to go home by oneself under this method like what is normally done in dental clinics. Of course, general anesthesia also is available.
Penile fat transfer needs around 20cc of fats. Fat gratf can be harvested through mini lipo. Injection is mainly performed into penis shaft, some are transfered into glans penis but not so much since glans tissue has not much room to hold fat graft:
Injection area marked red
after procedure
Fat injected area does not need any compression or covering but mini lipo area does. It requires few months of simple compression and stitch removal a week later.
Injected area swelling subsides after few days or a week, but active stimulations such as sexual intercourse should better be stopped until 2 weeks.
Pricing
Pricing is only for 1 treatment session.
2nd fat injection and beyond are 50% OFF.
Liposuction fee is required in every session. Refer to Liposuction page for pricing details.
Penile Hyaluronic Acid(HA) Filler Injection
Penile filler injection is an alternative of fat transfer. Fillers might be convenient since they are ready-to-use injectables but last only for around a year or so.
The penis needs around 6㏄ of fillers. Of course, this changes accordingly to the desired size, but there is a limit.
While penile shaft might be a better candidate for fat transfer, glans part might be easier to perform filler injection because its tissue holds finer particles better. But firmness of the glans shows limit also in filler injection.
HA filler has 2 major brands:
Enlarged or stretched labia minora is the subject of this procedure that is popular among women in their 30s thru early senior years. Expanded labia can cause discomfort or pain while wearing fit pants or jeans and sometimes turns into a pigmented part that is noticeably not appealing cosmetically for some, so reduction of labia minora by removing unwanted excess extremities is the main method of the procedure. Overgrowth of the labia commonly occurs from labor, aging, and other unknown causes.
Usually performed under local anecthesia and it goes as follows:
extended labia minora incised, then sutured
subextension on upper part also removed to even out
dissolvable stitches used, so no need of removal
compression with napkin for about 2 days needed
Bleeding is carefully cauterized to avoid severe swelling, but bruises might be sometimes observed for 1－2-week period. Sexual intercourse and other strong stimulation need to wait for 3－4-week period.
Pricing
| without tax | with tax | ||
| Labia Minora Reduction | both sides | \250000 | \275000 |
Labia Majora Reduction/Lift
Enlarged or saggy labia majora is reduced to gain a tight and younger appearance. Overgrown labia sometimes causes friction pain with fit underwear, and might present unpleasant odor by accumulatimg dirt at groin area.
Actual method goes as follows:
expanded labia majora incised to remove excess skin and tissue.
stitches done to reduce size
This part is prone to bleeding so operation must be well taken care of, and postsurgical compression with gauze and napkin is also required. Swelling might be observed for 2 weeks. Stitches are dissolvable, so no removal afterwards. Sexual intercourse and other strong force that might damage wounds must be forbidden for 3-4-week period.
Pricing
| without tax | with tax | ||
| Labia Majora Reduction | both sides | \250000 | \275000 |
Labia Majora Hyaluronic Acid(HA)Injection
This might not be popular in Asian countries,but in Western States, loose or saggy labia majora caused by aging is a subject of HA filler injection to obtain tighteness. In Asian countries where tininess is more favored, filler injection is kind of as a remedy going in wrong direction.
Labia majora needs around 1cc or more of HA to tighten up both sides.
saggy labia majora
puffy labia majora after filler injection
HA filler has 2 major brands:
Juvederm
Juvederm is the most common name now among dozens of HA brands that exist because of its tactics in selling its products to the public. It is produced by the company called Allergan which is famous of its Botox brand.
Juvederm VOLUMA is the thickest in concentration among the line-up of the brand, then Juvederm VOLBELLA and comes Juvederm VOLIFT (named in the States as VOLLURE) as the thinnest of them all. These 3 are the newest generation of Juvederm, older one includes Juvederm Ultra & Ultra plus.
These new ones last longer than the old generation, reported to show effect for 1 to 1.5 years, though might vary in the amount injected.
Effect lasting period might be around a year but the actual HA substance stays in the tissue for around 5 years, while it is gradually excreted from the body. It is designed not to cause severe reactions to human body, but there are rare allergic reactions observed within this period of time. Reactions such as obvious lumps and redness of the injected area are the common symptoms. This can be dissolved and subsided by injecting HA dissolving solution called hyaluronidase.
Besides allergic reaction, skin and other tissue necrosis (death) are also the concerns of HA injection. When injected, HA rarely gets inside a blood vessel that may clog it and cause the problem. To avoid this, injection of the filler with blunt cannula is the best prevention available. If this side effect occur, a remedy using hyaluronidase is done to revive the damaged tissue.
Restylane
Restylane brand is the original producer of HA filler. Around 25 years ago, a Swedish company started the brand and, after that, has been taken over by an American firm. It is kind of being left behind by the famous Juvederm but still in vast use around the globe. It is reported to have a shorter effect duration than Juvederm, from 6 months to a year.
Restylane injection, same as Juvederm brand, needs careful observation of allergic reaction and tissue damage.
Juvederm is the most common name now among dozens of HA brands that exist because of its tactics in selling its products to the public. It is produced by the company called Allergan which is famous of its Botox brand.
Juvederm VOLUMA is the thickest in concentration among the line-up of the brand, then Juvederm VOLBELLA and comes Juvederm VOLIFT (named in the States as VOLLURE) as the thinnest of them all. These 3 are the newest generation of Juvederm, older one includes Juvederm Ultra & Ultra plus.
These new ones last longer than the old generation, reported to show effect for 1 to 1.5 years, though might vary in the amount injected.
Effect lasting period might be around a year but the actual HA substance stays in the tissue for around 5 years, while it is gradually excreted from the body. It is designed not to cause severe reactions to human body, but there are rare allergic reactions observed within this period of time. Reactions such as obvious lumps and redness of the injected area are the common symptoms. This can be dissolved and subsided by injecting HA dissolving solution called hyaluronidase.
Besides allergic reaction, skin and other tissue necrosis (death) are also the concerns of HA injection. When injected, HA rarely gets inside a blood vessel that may clog it and cause the problem. To avoid this, injection of the filler with blunt cannula is the best prevention available. If this side effect occur, a remedy using hyaluronidase is done to revive the damaged tissue.
Restylane
Restylane brand is the original producer of HA filler. Around 25 years ago, a Swedish company started the brand and, after that, has been taken over by an American firm. It is kind of being left behind by the famous Juvederm but still in vast use around the globe. It is reported to have a shorter effect duration than Juvederm, from 6 months to a year.
Restylane injection, same as Juvederm brand, needs careful observation of allergic reaction and tissue damage.
Pricing
| without tax | with tax | ||
| Juvederm | VOLUMA 1syringe1.0cc | \60000 | \66000 |
| VOLIFT 1.0cc | \60000 | \66000 | |
| Restylane | 1.0cc | \40000 | \44000 |
| 0.5cc | \30000 | \33000 |
Labia Majora Fat Transfer
Labia majora fat transfer has similar goal as HA filler injection to tighten up the part, which is more like a Westernized idea rather than an Asian concept in which smaller labia is praised. Aging or labor can cause loosening of labia majora.
While fat grafting has many advantages, a list of disadvantages also does exist. Let's see first some of its ADVANTAGES:
・not artificial, self-derived autologous fats are safe
・more natural in shape and touch
・permanently remain in the tissue
・liposuction can be performed together
There might be some more, but these 4 are the main factors in the list.
Next are the DISADVANTAGES:
・most injected fats are resorbed, survival rate as bad as 20％ up to 50％
・need treatments to achieve desired volume
・every session needs liposuction procedure
・non-surviving dead fat mass may turn into calcification or infection if not resorbed
About same number of cons as pros is the reality of this method, however, tactics have been developed to cope with these issues. Firstly, injected fats must be rich in fat stem cells(adipose stem cells ASC). Harvested fats is purified to highten ASC's density inside the graft, anticipating stem cells to grow and multiply into mature fat cells inorder to compensate for the resorbed portion of the graft.
Then, actual injection must be done in scattering manner by injecting fats in smaller strips along a layer and the same way at the other levels of the subcutis tussues, fat layers, and muscles, if necessary, to avoid creating a bulk.
Tissue layer condition also affects survival rate of the fats. Specifically, loose spacious layers embrace more of the graft than the dense and firm ones. Body parts with loose layers and saggy excessive skin that has more room usually adopt well to the injected fats about 2 or 3 times of its desired capacity, which is necessary to gain the desired goal. Injecting further more than these might cause low survival rate and undesirable side effects. Only body parts that have extra room for fats can tolerate the adequate enormous graft volume.
Fat graft is purified by the following process:
Liposuction or Mini Lipo by Syringe Method is used for harvesting fats.
Then syringes are centrifuged.
Impurities are separated from purified fats.
Directly inject fats or subdivide them to smaller syringes.
Fat transfer with harvesting through mini lipo can be done usually with local anesthesia. Injection of fats is performed with lidocaine blockage which numbs parts during the procedure. The patient is able to go home by oneself under this method like what is normally done in dental clinics. Of course, general anesthesia also is available.
Labia majora's fat transfer needs around 6cc on both sides. Fats can be harvested through mini lipo. Small areas such as this labia need only few cc's of fats, and they might not be desirable for this procedure which needs liposuctioning in every session. Usually they are good with hyalunic acid filler such as Juvederm or Restylane, which is the main method done in the clinic. Hyaluronic acid might be absorbed later but lasts longer compared to fat graft that reduces into half within months.
Fat injected area does not need any compression or covering but mini lipo area does. It requires few months of simple compression and stitch removal a week later.
Pricing
| Fat Transfer | Labia Majora both sides | \120000(with tax\132000)＋mini lipo fee | |
2nd treatment and beyond are 50% OFF.
Liposuction fee is required in every session. Refer to Liposuction page for pricing details.
Vaginal Tightening
Child birth and aging might stretch out vaginal wall and opening, leaving it so loose that might need correction mainly with a surgical technique. Specifically, muscles of the wall are the ones that are loosened through these events.
Recently, various nonsurgical devices are invented for treatment of this issue but mostly unsuccessful. So surgery is still the best remedy.
This procedure is possible to perform under local anesthesia, but usually general anesthesia is recommended. Actual method goes as follows:
from vaginal opening into 3-cm inner membrane flap removed
muscle, then membrane tucked together with sutures to tighten
remaining 2-finger breadth opening
This surgery might show blood oozing to some extent, so compression with gauze tampon is needed for 2 days. Dissolvable stitches are used so no need of removal. Swelling and bruises might be observed for around 2 weeks. In a phase of a month or so, discharge tainted with blood might sometimes be observed, so sexual intercourse is not advisable during this period.
Pricing
| without tax | with tax | ||
| Vaginal Thightening | surgery | \300000 | \330000 |
Vaginal Tightening with Hyaluronic Acid Filler
If surgery is not the choice, filling in with filler to narrow the vaginal cavity is an option, by thickening the wall with an injectable.
Vaginal HA injection needs around 4㏄ or more amount of the substance:
HA filler filling in the loose opening up to inner area
HA filler has 2 famous brands, which are mentioned in detail above at Labia Majora HA injection section.
Effect is not permanent, for about half a year or more than a year depending on the brand. Surgical procedure might be a better choice. Filler maybe an option when time for surgery is not available.
Pricing
| without tax | with tax | ||
| Juvederm | VOLUMA 1syringe1.0cc | \60000 | \66000 |
| VOLIFT 1.0cc | \60000 | \66000 | |
| Restylane | 1.0cc | \40000 | \44000 |
| 0.5cc | \30000 | \33000 |
Clitoral Hood Reduction
Removal of clitoral hood or prepuce to expose the clitoris is the goal of this procedure. Hood covering the clitoris might disturb feeling sensation and also gather dirt around the area that might cause unpleasant smell.
Actual procedure is to remove not entirely but just part of the prepuce to let the clitoris surface out from hiding:
marking of hood to be removed
clitoral hood or prepuce removed the sutured
This procedure is performed usually under local anesthesia. Since it is just in a limited tiny area, bleeding should be securely taken care of, compression with gauze and napkin for few days. Dissolving stitches are used, few months of wound redness might be observed. Few days later, showering is already okay, but swimming and bathtubing should be avoided for 2 weeks. Sexual intercourse should be avoided for about 2 weeks.
Pricing
| without tax | with tax | ||
| Clitoral Hood Reduction | surgery | \80000 | \88000 |
Circumcision(Phimosis Correction)
This procedure is to remove prepuce(foreskin) covering or strangling the penis. Foreskin might be hindrance for the feeling, may constrict the neck of glans causing inflammation around it, and, what is worse, often gathers fatty secretion called smegma around the penis glans that produces unpleasant odor. These are just some reasons to remove or loosen the prepuce.
3 techniques are available in correcting this issue; complete removal of prepuce by circularly incising around the glans neck which is the basic circumcision method(or sleeve method), making a slit cut on dorsal side of the penis to release strangulation which is called dorsal slit method, and removal of skin at penile base root to draw in skin in an atempt to expose the glans, the method that may be named root incision method.
Basic Circumcision Method is one mainly performed for all 3 types of phimosis called complete phimosis (nonretractile), retractile phimosis, and strangulated phimosis.
excess prepuce marked red
after prepuce removal, glans penis is exposed, wound is sutured just nearest place of the glans neck to hide it
Dorsal Slit Method is not new, traditionally done to release strangled phimosis in emergency setting. By relaxing the foreskin, it sometimes retracts naturally by itself that might consequently improve phimosis symptom. Applying this method to complete nonretractile phimosis is not advisable but might work for retractile phimosis. If preservation of foreskin or penile volume is the choice, this method might be a help, however, if complete removal of somewhat disturbing foreskin is the desire, basic circumcision is the method to choose.
a slit is made from prefuce distal end vertically
slit is sutured horizontally to relax tension
Base Root Incision Method is formulated to hide wound scar into pubic hairs but not applicable to nonretactile and strangulated phimosis, usually performed only on retractile ones. However, since prepuce is sometimes not that retractable, recurrence might happen.
base root marked red for skin removal
after skin removal, skin drawed in then sutured
Local anesthesia is the usual routine , but general anesthesia is also available. 30-60-minute surgery time needed, stitches are done with dissolvable ones so no need of removal. Bleeding might occur at home so compression with bandage is necessary, which is easy to be changed by oneself daily for around 5 days. Swelling and bruises might be observed for around 2 weeks. Sexual intercourse and other wound-damaging actions must be forbidden for at least 3 weeks.
Pricing
| without tax | with tax | ||
| Phimosis Correction | circumcision method | \80000 | \88000 |
| dorsal slit method | \40000 | \44000 | |
Penile Fat Transfer
Penile Enlargement is often performed through fat transfer method. To enhance the girth and firmness, fat harvested from the belly or thigh is injected into penile subcutis.
While fat grafting has many advantages, a list of disadvantages also does exist. Let's see first some of its ADVANTAGES:
・not artificial, self-derived autologous fats are safe
・more natural in shape and touch
・permanently remain in the tissue
・liposuction can be performed together
There might be some more, but these 4 are the main factors in the list.
Next are the DISADVANTAGES:
・most injected fats are resorbed, survival rate as bad as 20％ up to 50％
・need treatments to achieve desired volume
・every session needs liposuction procedure
・non-surviving dead fat mass may turn into calcification or infection if not resorbed
About same number of cons as pros is the reality of this method, however, tactics have been developed to cope with these issues. Firstly, injected fats must be rich in fat stem cells(adipose stem cells ASC). Harvested fats is purified to highten ASC's density inside the graft, anticipating stem cells to grow and multiply into mature fat cells inorder to compensate for the resorbed portion of the graft.
Then, actual injection must be done in scattering manner by injecting fats in smaller strips along a layer and the same way at the other levels of the subcutis tissues, fat layers, and muscles, if necessary, to avoid creating a bulk.
Tissue layer condition also affects survival rate of the fats. Specifically, loose spacious layers embrace more of the graft than the dense and firm ones. Body parts with loose layers and saggy excessive skin that have more room usually adopt well to the injected fats about 2 or 3 times of its desired capacity, which is necessary to gain the desired goal. Injecting further more than these might cause low survival rate and undesirable side effects. Only body parts that have extra room for fats can tolerate the adequate enormous graft volume.
Fat graft is purified by the following process:
Liposuction or Mini Lipo by Syringe Method is used for harvesting fats.
Then syringes are centrifuged.
Impurities are separated from purified fats.
Directly inject fats or subdivide them to smaller syringes.
Fat transfer with harvesting through mini lipo can be done usually with local anesthesia. Injection of fats is performed with lidocaine blockage which numb parts during the procedure. The patient is able to go home by oneself under this method like what is normally done in dental clinics. Of course, general anesthesia also is available.
Penile fat transfer needs around 20cc of fats. Fat gratf can be harvested through mini lipo. Injection is mainly performed into penis shaft, some are transfered into glans penis but not so much since glans tissue has not much room to hold fat graft:
Injection area marked red
after procedure
Fat injected area does not need any compression or covering but mini lipo area does. It requires few months of simple compression and stitch removal a week later.
Injected area swelling subsides after few days or a week, but active stimulations such as sexual intercourse should better be stopped until 2 weeks.
Pricing
| Fat Transfer | penis shaft ＋glans | \120000(with tax\132000)＋mini lipo fee | |
2nd fat injection and beyond are 50% OFF.
Liposuction fee is required in every session. Refer to Liposuction page for pricing details.
Penile Hyaluronic Acid(HA) Filler Injection
Penile filler injection is an alternative of fat transfer. Fillers might be convenient since they are ready-to-use injectables but last only for around a year or so.
The penis needs around 6㏄ of fillers. Of course, this changes accordingly to the desired size, but there is a limit.
While penile shaft might be a better candidate for fat transfer, glans part might be easier to perform filler injection because its tissue holds finer particles better. But firmness of the glans shows limit also in filler injection.
HA filler has 2 major brands:
Juvederm
Juvederm is the most common name now among dozens of HA brands that exist because of its tactics in selling its products to the public. It is produced by the company called Allergan which is famous of its Botox brand.
Juvederm VOLUMA is the thickest in concentration among the line-up of the brand, then Juvederm VOLBELLA and comes Juvederm VOLIFT (named in the States as VOLLURE) as the thinnest of them all. These 3 are the newest generation of Juvederm, older one includes Juvederm Ultra & Ultra plus.
These new ones last longer than the old generation, reported to show effect for 1 to 1.5 years, though might vary in the amount injected.
Effect lasting period might be around a year but the actual HA substance stays in the tissue for around 5 years, while it is gradually excreted from the body. It is designed not to cause severe reactions to human body, but there are rare allergic reactions observed within this period of time. Reactions such as obvious lumps and redness of the injected area are the common symptoms. This can be dissolved and subsided by injecting HA dissolving solution called hyaluronidase.
Besides allergic reaction, skin and other tissue necrosis (death) are also the concerns of HA injection. When injected, HA rarely gets inside a blood vessel that may clog it and cause the problem. To avoid this, injection of the filler with blunt cannula is the best prevention available. If this side effect occur, a remedy using hyaluronidase is done to revive the damaged tissue.
Restylane
Restylane brand is the original producer of HA filler. Around 25 years ago, a Swedish company started the brand and, after that, has been taken over by an American firm. It is kind of being left behind by the famous Juvederm but still in vast use around the globe. It is reported to have a shorter effect duration than Juvederm, from 6 months to a year.
Restylane injection, same as Juvederm brand, needs careful observation of allergic reaction and tissue damage.
Penile filler injection for enlargement shows better effect than other body areas. It has similarity with lips filler injection in which some individuals present sometimes longer swelling recovery due to sensitivity to needle wounds.
Juvederm is the most common name now among dozens of HA brands that exist because of its tactics in selling its products to the public. It is produced by the company called Allergan which is famous of its Botox brand.
Juvederm VOLUMA is the thickest in concentration among the line-up of the brand, then Juvederm VOLBELLA and comes Juvederm VOLIFT (named in the States as VOLLURE) as the thinnest of them all. These 3 are the newest generation of Juvederm, older one includes Juvederm Ultra & Ultra plus.
These new ones last longer than the old generation, reported to show effect for 1 to 1.5 years, though might vary in the amount injected.
Effect lasting period might be around a year but the actual HA substance stays in the tissue for around 5 years, while it is gradually excreted from the body. It is designed not to cause severe reactions to human body, but there are rare allergic reactions observed within this period of time. Reactions such as obvious lumps and redness of the injected area are the common symptoms. This can be dissolved and subsided by injecting HA dissolving solution called hyaluronidase.
Besides allergic reaction, skin and other tissue necrosis (death) are also the concerns of HA injection. When injected, HA rarely gets inside a blood vessel that may clog it and cause the problem. To avoid this, injection of the filler with blunt cannula is the best prevention available. If this side effect occur, a remedy using hyaluronidase is done to revive the damaged tissue.
Restylane
Restylane brand is the original producer of HA filler. Around 25 years ago, a Swedish company started the brand and, after that, has been taken over by an American firm. It is kind of being left behind by the famous Juvederm but still in vast use around the globe. It is reported to have a shorter effect duration than Juvederm, from 6 months to a year.
Restylane injection, same as Juvederm brand, needs careful observation of allergic reaction and tissue damage.
Penile filler injection for enlargement shows better effect than other body areas. It has similarity with lips filler injection in which some individuals present sometimes longer swelling recovery due to sensitivity to needle wounds.
Pricing
| without tax | with tax | ||
| Juvederm | VOLUMA 1syringe1.0cc | \60000 | \66000 |
| VOLIFT 1.0cc | \60000 | \66000 | |
| Restylane | 1.0cc | \40000 | \44000 |
| 0.5cc | \30000 | \33000 |
Miyagi Cosmetic Surgery宮城美容外科クリニック
〒900-0016
沖縄県那覇市前島２－２－１（３F)
2-2-1-3F Maejima, Naha City
Okinawa, Japan 900-0016
TEL 098-860-9120
FAX 098-860-9176
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e-mail info@miyagi-clinic.info
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