Are Gillies’ Ten Commandments Just as Commanding Today?

Diver, Andrew J.

doi:10.1097/sap.0000000000001111

Cited by 5 publications

(3 citation statements)

References 1 publication

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“…Dy et al have previously presented their approach to vulvoplasty, noting the aesthetic goals of the procedure: (I) labia minora that are well-defined and three-dimensional; (II) labia minora that frame the introitus; (III) sufficient clitoral hooding; (IV) a patent introitus that appears closed at rest; and (V) prominent labia majora ( 8 ). Creating an aesthetic vulva employs many of the guiding principles upon which plastic surgery was founded—namely the judicious use of available tissues and replacing “like with like” ( 8 , 13 ). In this study, the authors note that each penile structure has an embryological homologue in the natal vulva.…”

Section: Resultsmentioning

confidence: 99%

Optimizing aesthetics in gender-affirming vaginoplasty and vulvoplasty: a narrative review and discussion based on over 600 cases of transfeminine vulvar construction

Peters,

Carboy,

Richards

et al. 2024

Transl Androl Urol

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Background and Objective The vulva is the external portion of a gender-affirming vaginoplasty or vulvoplasty procedure—the “visible” result of surgery. The vulvar appearance can play a major role in how individuals feel about their surgical results and new genital anatomy. Therefore, optimizing the aesthetics of the vulva is an important component of surgical care. Although there is no one “ideal” vulvar appearance, aesthetics are optimal when each major sub-unit of the vulva is reconstructed to create a proportional and cohesive vulvar unit. In this article we perform a narrative review of the literature and discuss clinical approaches to improve aesthetic satisfaction such as patient education, re-defining the “ideal” vulva, aesthetic surgery tenets and technical strategies based on our collective experience of over 630 gender-affirming vulvar constructions. Methods A narrative review of the literature was completed accessing PubMed, EMBASE, Google Scholar using search terms “Vaginoplasty OR Vulvoplasty”. Articles were removed if not pertaining to gender affirmation surgery, were not in English language, were not accessible or did not discuss aesthetics in the body of the text. Key Content and Findings A total of 1,042 articles were identified from initial search criteria. Of those, 905 were excluded as they did not involve gender affirmation as an indication. An additional 112 papers were excluded as they were not accessible, not in English, focused on non-vulvar outcomes or did not comment on vulvar aesthetics. Ultimately 25 articles were included for narrative review; 21 of these included technical descriptions of vulva and 13 had direct aesthetic discussion. The anatomy and aesthetics of the transfeminine vulva are reviewed according to the previously described principle of anatomic vulvar sub-units: the labia majora, labia minora, clitoris, urethra and the introitus. Conclusions Ultimately, creating the optimal vulva for each individual patient will demand flexible surgical decisions based on individual anatomy and available tissues. This narrative review provides an overview of current approaches to aesthetics in gender-affirming vulvar construction and technical insights based on our institutional experience of performing over 630 gender-affirming vaginoplasty and vulvoplasty procedures.

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Section: Resultsmentioning

confidence: 99%

Optimizing aesthetics in gender-affirming vaginoplasty and vulvoplasty: a narrative review and discussion based on over 600 cases of transfeminine vulvar construction

Peters,

Carboy,

Richards

et al. 2024

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…She also fills out many of Gillies' aphorisms ("Never do today what can be put off till tomorrow; provide a lifeboat; treat the primary defect before worrying about the secondary defect") with details of the experiences which led Gillies to formulate his commandments. 1 This book successfully portrays the drama of Gillies' achievements within the larger ghastly drama of war. Fitzharris also successfully describes how many of Gillies' legacies of analysis, planning, and technique became fundamental parts of the evolving specialty of plastic surgery.…”

mentioning

confidence: 99%

“…Fitzharris’ narrative includes the stories of many collaborators and patients who contributed to the achievements of Sidcup. She also fills out many of Gillies’ aphorisms (“Never do today what can be put off till tomorrow; provide a lifeboat; treat the primary defect before worrying about the secondary defect”) with details of the experiences which led Gillies to formulate his commandments 1 …”

mentioning

confidence: 99%