New Minimally Invasive Procedure with No Pain or Downtime… From Dr. Michael Goodman, Caring For Women Wellness Center

• Laser Vaginal Tightening for Improved Sexual Pleasure and Relief from Minimal Urinary Incontinence
• Laser Vaginal Therapy for reversing Vaginal Atrophy (Good also for Breast Cancer Survivors with Vaginal Atrophy)

What is FemiLift?

A non-surgical, painless 15-minute office procedure utilizing reliable third-generation CO2 fractional Laser Pixel technology delivered into the vagina via a vaginal-shaped probe. The procedure consists of 3 treatments over 12 weeks, with a “touchup” one year later. The results are a noticeable tightening of the entire vaginal barrel for increased friction and pleasure during sexual intimacy. If utilized in a different power mode, FemiLift is also quite effective in reversing the atrophic effects of aging in the vagina.

What does FemiLift accomplish (for vaginal tightening)?

FemiLift works via pulses of laser energy into the collagen layer of the vaginal mucosa, where concentrated thermal heating leads to collagen and elastin “shrinkage” and secondary regeneration, producing an increased resiliency of vaginal skin for about 12-18 months. The initial shrinkage and secondary regeneration may temporarily increase intra-vaginal friction and G-spot pressure. Tightening also occurs along the base of the overlying bladder, with evidence shows that it also improves the pesky problem of minor urinary incontinence.

What does FemiLift accomplish (for vaginal atrophic changes)?

By altering and rearranging collagen fibers, enabling the formation of elastin and better collagen formation, FemiLift can provide long-term reversal of the atrophic effects of aging on the vaginal walls.

How does FemiLift work?

A laser generator produces safe pulses of patterned pixel-screen laser energy delivered via a tube-shaped intra-vaginal device. These pulses generate laser beams in a grid less than ½ mm apart and 0.6 mm deep via a microscopic laser-produced opening at intervals of several millimeters into the collagen under the dermis (the layer just underneath the vaginal skin). This causes a 360° symmetrical micro-contracture of the entire vaginal barrel, leading to overall tightening in the case of laxity, including tightening of the upper vagina, producing added support for the base of the bladder. In a different power mode, FemiLIft may be utilized solely to stimulate collagen and elastin formation to enable better “stretchability” of the vaginal tissues.

Who is a good candidate for this procedure? Who is not?

Candidates: Women with minimal to moderate vaginal looseness or laxity not severe enough to need a complete surgical repair (“Vaginoplasty”), but bothersome enough (less “grip,” too much “droop”) to diminish sexual pleasure and sometimes lead to modest urinary incontinence. Perfect candidates are:

1. Women who have not yet had a child but either feel themselves “wide” inside or have a partner with a smaller-sized penis.
2. Women with laxity after childbirth who plan on another child/children and need “temporary” tightening until their final childbirth, after which they may undergo a permanent surgical tightening procedure if the problem persists.
3. Women who will undergo a Vaginoplasty (surgical tightening procedure) of the outer (lower) half of the vagina/vaginal floor, but also have noticeable widening in the far inner (upper) vagina (where a surgical pelvic floor tightening procedure traditionally cannot reach), which frequently occurs with a coexisting problem of occasional involuntary loss of urine, and who wish to avoid an in-hospital general anesthesia, which is sometimes risky for upper-vaginal repair.
4. Women with mild urinary incontinence.
5. Women with only modest vaginal laxity and decent musculature, who wish to avoid a surgical procedure.
6. Post-menopausal women with dry, atrophic vaginal tissues.

Not Candidates:

1. Women with a significant pelvic floor vaginal laxity involving significant widening and muscular separation; these women need a surgical repair and will be disappointed with a solely laser procedure.
2. Women with significant urinary incontinence and/or prolapse; these women need a surgical repair/“sling” or “tape” procedure.
3. Women with very tightened, atrophic vaginas; these women will first need to undergo re-estrogenization and mild mechanical dilation in order to physically accommodate the treatment probe.

 

Which health care professionals should be doing the procedure? Which should not?

Laser vaginal tightening should ideally be performed only by a surgeon who also is trained and skilled in the performance of surgical Vaginoplasty and, hopefully, savvy in pelvic floor muscle physical therapy. A Board-Certified Gynecologist who is additionally skilled and certified in cosmetic and plastic vaginal pelvic floor work and savvy in the usage of lasers for vaginal tightening is ideal, as he/she is uniquely able to choose the right procedure for the right patient for the right reasons and is less inclined to (mis)use the laser in women who truly need only pelvic floor PT or in women who truly need surgery.

Laser treatment for vaginal atrophic changes should be performed only by a Board-Certified Gynecologist who is well-versed in the issues associated with, and the alternative treatment modalities for, menopause

What is the science behind this procedure?

The FemiLift laser utilizes pixel CO2 fractional pulsed light wave technology as a cutting, tightening or resurfacing tool. In this instance, non-ablative laser waves exiting the tube 360° at closely spaced intervals “drill” microscopic, closely spaced micro-punctures 0.6 mm (600 microns) into the dermis, producing a mini-defect in the collagen that contracts, producing shrinkage (in proper power settings) and stimulating the collagen and elastin to grow, thus bulking and “rejuvenating” this layer. This technology has been utilized in Europe and Asia for more than 5 years, and a wealth of data has accumulated verifying its effects and success.

How long does FemiLift last?

Present data suggest that, with 3 treatments over a 12-week time period and especially with a “touchup” after one year, the tightening and continence effects are experienced for up to 2 years.

Other uses of this technology

Co2 Pixelated Laser technology may also be used to:

1. Re-surface stretch marks and surgical scars.
2. “Bleach” darkened peri-vaginal and peri-anal skin.
3. Smooth out roughened labia majora skin.
4. As a new therapy to improve skin stretchability and diminish itching and burning for patients with later stage lichen sclerosis (evidence-based.)

**Ask Dr. Goodman’s staff about these possibilities!

How much does it cost? Are there any discounts available?

Full price for series of three intra-vaginal treatments is $2800. For individual pricing for other genital uses please contact office. For patients adding FemiLift to vaginal reconstruction to diminish urinary incontinence, the fee is reduced to $1500 for the series of 3 treatments.

Disclaimer:

This is new technology. Although it has been cleared by the FDA, FDA approval of “medical devices,” unlike medications, is a short and not necessarily exhaustive process. While it appears, from a limited number of studies, that both laser tightening and relief from vaginal atrophy accomplishes what it promises with little risk of harm, there really are no well-controlled long-term (over 2-3 years) studies like there are for surgical procedures. Surgery remains the “gold standard” for vaginal tightening, but laser treatment may offer benefits in certain situations (see above.) Vaginal estrogen therapy remains the “gold standard” for vaginal health rehabilitation, but there are situations where laser treatment may offer advantages.

References:

“Novel Minimally Invasive VSP Er:YAG Laser Treatments in Gynecology.” Vizintin, Rivera, Fistonic, Sercaglu, Guimares, et al. Journal of the Laser and Health Academy, 2012.

“A 12-Week Treatment with Fractional CO2 Laser for Vulvovaginal Atrophy: A Pilot Study.” Salcatore, Nappi, Zerbinati, Calligaro, Ferrero, et al. Climateric, 2014
“Histological Study on the Effects of Microablative Fractional CO2 Laser on Atrophic Vaginal Tissue: An Ex Vivo Study.” Salvatore, Maggiore, Athanasiou, Origoni, Candiani, et al. Menopause, 2015

“Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90° and 360° Scanning Scopes: A Pilot Study & Short-term Results.” Lee. Laser Therapy, 2014

“Vulvo-Vaginal Atrophy: A New Treatment Modality Using Thermo-Abative Factional CO2 Lser.” Perino, Calligaro, Forlani, Tiberio, Cucinella, et al. Maturitas, 2015.