Doctors like this creep me out.

[Shockeye]

When Kegal Exercises Don't Do the Job - New Laser Surgery Can Mean Better Sex Life For Women
     


When Kegal exercises don’t do the job, women are contacting Dr. Joseph Berenholz, board-certified OB/GYN and director of the Laser Vaginal Rejuvenation Institute of Michigan who has brought the world’s newest, most advanced laser surgical techniques to the Midwest. Performing laser vaginal rejuvenation, Dr. Berenholz can tighten and reconstruct the muscles of the vagina. This can serve to increase sexual pleasure, plus it can deal with issues like incontinence (loss of bladder control) and other discomfort that can occur in women after giving birth. The results can be dramatic, often for both partners.

Southfield, MI (PRWEB) April 27, 2005 -- Dr. Joseph Berenholz, board-certified OB/GYN and director of the Laser Vaginal Rejuvenation Institute of Michigan in Southfield, has brought some of the newest, most advanced laser surgical techniques in the world to the Midwest.

“In the past, women who were unhappy with their bodies have literally changed their lives with surgical procedures like liposuction and breast augmentation,” said Dr. Berenholz. “At the same time, most women have been resigned to the idea that nothing could be done to improve their sexual function, self-image or pleasure.”

Gynecological surgeons have been using well-understood procedures for repairing vaginal defects, but only as a medical necessity. The revolutionary breakthrough here is in the use of lasers in these procedures. “Laser techniques have made vaginal rejuvenation and vaginoplasty faster, more precise, and have dramatically reduced pain, bleeding, and recovery time. For the first time, women can benefit from these procedures electively.” said Dr. Berenholz.

Performing laser vaginal rejuvenation® (LVR®), a surgeon can tighten and reconstruct the muscles of the vagina. This can serve to increase sexual pleasure, plus it can deal with issues like incontinence (loss of bladder control) and other discomfort that can occur in women after giving birth. The results can be dramatic, often for both partners. One LVR patient commented, “I know my husband loves me, but his dissatisfaction was obvious. Dr. Berenholz has given us a new lease on life.”

Another class of procedures, designer laser vaginoplasty® (DLV®), allows the surgeon to improve the appearance of the vagina according to the wishes of the patient. One of the most commonly requested modifications involves trimming oversized labia minora (inner vaginal lips) that extend past the labia majora (outer lips), a condition which these women find embarrassing and often uncomfortable. The DLV surgeon has a range of other options to offer, including hymenoplasty – reconstruction of the hymen. This is an often-requested surgery in various cultures.

Major national magazines like Vogue, Cosmopolitan, Playboy, Harper’s Bazaar, Elle, Playgirl, Marie Claire, Maxim, New Woman, Nerve, and Shine have all run articles discussing female sexual-enhancement surgery. These articles cite many women who are uncomfortable with their function and appearance “down there,” and who have found the solution in surgery. Some even tell of women bringing in photographs from men’s magazines and saying, “Make me look just like that.”

Dr. Berenholz is the only gynecological surgeon in the Midwest, and one of only a handful in the country, to have advanced training in these laser surgical techniques. He explained that the use of lasers makes the operation virtually bloodless and greatly reduces the risk of complications. Surgery is conducted on an out-patient basis, and most of the operations are completed in around an hour. Generally, patients are back to work in five to seven days, and can resume a normal sex life in as little as six weeks.

Dr. Berenholz is a member of a number of several major medical societies, including the American Academy of Cosmetic Surgery, Diplomate American College of Obstetrics and Gynecology, the American Society of Reproductive Medicine, the American Association of Gynecologic Laparoscopists, and the Society of Pelvic Reconstructive Surgery. He is on the active staff of Sinai Grace Hospital, Hutzel Hospital, Huron Valley Hospital, the Vivian Berry Surgical Center, St. John Healthcare System, and Providence Hospital. He is a clinical instructor and staff member of the Detroit Medical Center.

The Laser Vaginal Rejuvenation Center of Michigan is located at 30603 Southfield Road, in the Birmingham Cosmetic Center in Southfield. For more information, call (248) 593-8780 or visit: http://www.drberenholz.com

About Dr. Joseph Berenholz
Dr. Joseph Berenholz, board-certified OB/GYN and director of the Laser Vaginal Rejuvenation Institute of Michigan in Southfield, has made a career of bringing some of the newest, most advanced laser surgical techniques in the world to the Detroit area.

As board certified Obstetrician/Gynecologist in the Detroit area since 1982, Dr. Joseph Berenholz has delivered thousands of healthy infants. However, his real calling has been gynecologic surgery, with a specific passion for urogynecologic and pelvic reconstructive surgery. He has performed nearly four thousand surgeries over the lifetime of his career. During this time, he has been a leader in learning and adopting the latest innovations in gynecologic surgical technique, and introducing them to his colleagues.

In the 1970’s, laser was first brought to southeast Michigan for gynecologic surgery by Drs’ Milton Goldrath and Alf Sherman. Dr. Berenholz was trained by these two pioneers in the application of CO2 laser therapy for a precancerous condition of the cervix called “cervical dysplasia.” After this experience Dr. Berenholz continued his search for innovative therapies in women’s healthcare.

At approximately the same time, Dr. Kurt Semm, the “father of laparoscopic surgery,” was developing laparoscopic techniques for gynecological surgery never performed before in Michigan. Dr. Berenholz corresponded with Dr. Semm and eventually spent time with him in California learning these methods. Dr. Berenholz returned to Detroit and encouraged his department to make the necessary instrument purchases for the advanced surgical techniques.

Next, Dr. Berenholz sought out Dr. Jacques Hamou, the world’s leading pioneer and authority in hysteroscopic surgery. This type of surgery is performed through a woman’s vagina and into a woman’s uterus, allowing the physician to correct many bleeding problems within the uterus without resorting to abdominal surgery and subsequent hysterectomy. Thanks to Dr. Berenholz’s training with Dr Hamou, hundreds of women have been spared such radical surgery. Dr. Berenholz was one of the first physicians in the area to begin doing “Endometrial Ablations” of the uterus, with the result that he has one of the lowest hysterectomy rates among his colleagues at both the St. John healthcare system and the Detroit Medical Center.

In the arena of urogynecology, Dr. Berenholz remains a leader among his fellow physicians. He was the first Ob/Gyn at Providence hospital to perform the “Trans Obturator Urethral Sling” procedure, allowing women to be cured of their urinary stress incontinence on an out patient basis. Prior to that, women traditionally had surgery requiring 2-3 days of hospital care.

Now, after nearly 20 years of practice, Dr. Berenholz once again finds himself leading the way in women’s healthcare. Over the years, patients have confided with Dr. Berenholz regarding “vaginal looseness” and loss of sexual sensation after childbearing. The standard gynecologist’s answer – that this was all just a “natural part of motherhood,” left both Dr. Berenholz and his patients very dissatisfied. Seeking a surgical solution, Dr. Berenholz encountered Dr. David Matlock of Beverly Hills, California.

Dr. Matlock was the first physician to develop Laser Vaginal Rejuvenation seven years ago. Dr Berenholz immediately flew out to California to meet with Dr. Matlock. Today, Dr. Berenholz is one of only approximately one dozen physicians worldwide trained in this procedure, and is currently the only physician in the Midwest using the laser to address women’s needs in this area.

In addition to his accomplishments as a surgeon, Dr. Berenholz has been sought out by the pharmaceutical industry to be a spokesperson to both physicians and women groups. He addresses issues such as “Osteoporosis” for the Lilly Corporation, “Hormone Replacement Therapy” for Wyeth-Ayerst Pharmaceuticals and “Treatment of Genital Herpes” for Glaxo Smith Kline Pharmaceuticals.

Dr. Berenholz has recently become a member of the American Academy of Anti Aging, and now lectures on the “Role of Inflammation in Aging and Chronic Disease.” He is also a Diplomate of the American College of Obstetrics and Gynecology, a member of the American Academy of Cosmetic Surgery, the American Society of Reproductive Medicine, the American Association of Gynecologic Laparoscopists, and the Society of Pelvic Reconstructive Surgery. He is on the active staff of Sinai Grace Hospital, Hutzel Hospital, Huron Valley Hospital, the Vivian Berry Surgical Center, St. John Healthcare System, and Providence Hospital. He is a clinical instructor and staff member of the Detroit Medical Center.

A 1974 graduate of the University of Michigan, Dr. Berenholz earned his Medical Doctorate in 1980 from the prestigious Autonomous University of Guadalajara, completing his internship at the St. Louis School of Medicine in St. Louis, MO in 1981. He served a surgical residency at Mount Carmel Mercy Hospital in Detroit and an OB/GYN residency at Providence Hospital in Southfield.

Dr. Berenholz has been married since 1972 to his beautiful wife Annette. She teaches “metalsmithing” at the college level and is a well recognized artist in her own right. They have three very accomplished children, Leah, Dan, Lisa and their black toy poodle “Lucky.”

The Laser Vaginal Rejuvenation Center of Michigan is located at 30603 Southfield Road, in the Birmingham Cosmetic Center in Southfield. For more information, call (248) 593-8780 or visit: http://www.drberenholz.com

His wife teaches "metalsmithing" and he gets to play with women's hoo-has all day. What a life.

[Paelos]

Now doctors can make your dingaling bigger and a woman's hoo-ha tighter. Sex will eventually become a physical impossibility.

[WayAbvPar]

Too much free time, obviously. Also-Laser Vaginal Rejuvenation Institute of Michigan? Homey needs to talk to a marketing expert.

[HaemishM]

What, are you kidding me? I want me a T-Shirt that says Laser Vaginal Rejuvenation Institute with an arrow pointing towards my crotch. I'd buy that T-Shirt.

[WayAbvPar]

What, are you kidding me? I want me a T-Shirt that says Laser Vaginal Rejuvenation Institute with an arrow pointing towards my crotch. I'd buy that T-Shirt.

I bow to your superior marketing instincts. I too would like a T-shirt like that.

[Sky]

After watching the Penn&Teller Bullshit! on circumcision, I think the practice either needs to be outlawed as cruel and inhumane and unecessary, or women should also be getting their clitties chopped. Fair's fair.

[Shockeye]

After watching the Penn&Teller Bullshit! on circumcision, I think the practice either needs to be outlawed as cruel and inhumane and unecessary, or women should also be getting their clitties chopped. Fair's fair.

Perhaps I'm in the minority here, but I much prefer looking at circumsized penises than uncut ones.

But then, that's just me.

Err... wait...

[HaemishM]

Chyna really did scar you for life, didn't she?

[tazelbain]

Dr. Drew is pro-circumcision, what more do you need to know?

[Shockeye]

Meet the Genitailor


Dr. Roy Jackson. Photo by Aleah Dunfield

What's that mean? Think, um, designer vaginas.
By Danielle Egan
Published: June 10, 2005

“Designer vaginal surgery is on the cutting edge in terms of cosmetic surgery trends, no pun intended,” says Dr. Roy Jackson, a Vancouver obstetrician and gynaecologist who specializes in vaginal and vulvar cosmetic augmentation procedures. Jackson is taking a lunch-break with me before his afternoon appointment at the False Creek Surgical Centre: a combined tummy tuck and “laser vaginal rejuvenation.”

According to The American Society of Plastic Surgeons, these surgeries have become the hottest trend in the field, thanks largely to Dr. David Matlock of the LA-based Laser Vaginal Rejuvenation Institute. He taught Jackson his techniques five years ago and is booked solid for the next six months “making things pretty.”

According to Matlock, the most popular surgeries are “liposculpting a mons pubis which is too fat,” laser-cutting “sagging or long labia majora,” injecting fat into the labia, tightening the vaginal passage to enhance a woman’s “sexual gratification” and even re-constructing hymens. It might sound like some kind of horror plot, but according to Matlock, “this is a no-brainer for women” who “want an overhaul.”

Porn ideals

For Matlock, it all started when a woman he treated for incontinence commented to him that after her surgery, her sex life was improved, so much so that her husband said it was “like being with a new woman.” Through word of mouth and an ad in a local paper in 1998, he became “inundated with calls” from women who didn’t have incontinence but wanted tighter vaginal passages.

Other women came in with porn mags, saying they wanted to look like the women in the pictures, and he developed other labial and pubic procedures to meet their needs.

Now, a whole spectrum of women from their teens to their 60s is opting for these surgeries: from waitresses to lawyers to stay-at-home-mothers. Jackson recently operated on a “high-profile supermodel” and Matlock recalls “a young nude dancer,” with “a beautiful genital structure, but excess skin like a raspberry.” So, he performed a labioplasty to “make the labia majora hug the labia minora, like a pencil.”

Sarah, a single 22-year-old Toronto university student and waitress, travelled to LA last year for her surgery with another designer vagina specialist, the appropriately named Dr. Gary Alter. Sarah had a labia reduction. “I felt uncomfortable with the way my vagina looked. I'd say I started noticing a difference between me and other girls and become more aware and embarrassed when I was, like, 13. It brought down my confidence and later made me not want any guy to see me naked.” Sarah is “totally satisfied with the results.”

‘Totally natural’

“You have to be realistic, right?” Sarah says. “He's not going to give you a totally different vagina, just take the extra skin off yours. There are actually barely any scars. It looks totally natural, and there is absolutely no loss of feeling. Now I don't have to hide anything. I rarely had sexual relationships before but now, it's a lot more fun! I feel totally free.”

Women often say they feel free, liberated, somehow more like their true selves after cosmetic surgery. These ideas surfaced when Kathy Davis wrote about cosmetic surgery recipients in the mid-90s and claimed that these women were empowered “cultural agents” of feminism, pursuing personal goals and re-claiming their bodies. Since then, cosmetic surgery numbers have been steadily increasing, with a new surgery targeting a different body part appearing virtually every year.

Feminists and bio-ethicists, however, wonder if recipients are more like “cultural dopes” and merely puppets of cultural forces fixated on physical perfection.

“We wanted to look at the reasoning involved with the ‘feminist agency’ idea that cosmetic surgery improves women’s circumstances,” says University of Washington philosophy professor Sara Goering, who has been studying recent cosmetic surgery recipients. She’s found that most of the women she’s polled feel “less autonomous and feel pressure to conform to social biases.” She’s also found that “all of the women had lower self-esteem” after surgery and in fact wanted more surgeries.

Feminist procedures?

“Even good feminists don’t want to undercut women’s choices, but I think we need to look at the larger moral implications,” says Goering. “The easier it becomes to do, the more the responsibility to look like this shifts and places a burden on the person who chooses not to augment.”

Back at the lunch table, Dr. Jackson thinks “women should be entitled to have their choice. I might see a patient who’s going to have a hysterectomy, right. I’ll be thinking to myself, geez, this is unbelievable what I’m seeing here. And she is not even aware of the fact that her labia are a problem for her. Then I’ll see a woman’s labia, which compared to other women might be reasonable, but to her it’s a huge thing. She’s doing this for herself, for her self-confidence. So I just ask what I can do to help.”

What about those social implications and the heavy stress on superficial aspects of self-esteem? “

Okay,” says Jackson, “Let’s assume that on a psychological level, a woman sees herself as 80 percent perfect, and feels some of her shortcomings are based on her physical appearance. We could build her confidence to 90% by taking care of the physical aspects and then maybe by working with her psychologically you can build her to 100 percent, or 98 percent. I spend a lot of time building up their psyches. I’m a very positive person and I want to ooze – you know, I want them to be passionate and appreciative of life and feel positive that the glass is half full, not half empty.”

Where are the men?

Jackson admits he can’t fix everyone and does turn away the odd patient. “The red flags are, first if you don’t quite develop that patient-doctor rapport,” says Jackson. “Or if I think the reason she wants to have surgery is the wrong reason: for example, a woman who has never had any children, and who wants a rejuvenation done because she thinks her vagina isn’t tight enough, and she’s hoping to have this unbelievable sexual experience – one I won’t be able to provide. I would tell her from the outset, your ability to have an orgasm has nothing to do with the surgery.”

Jackson recently refused a patient. “She wouldn’t leave me alone, phoning me every day: ‘why won’t you operate on me?!’” Dr. Matlock even had a patient threaten to “go outside with a razor blade and cut it off.” He had to call in security.

“Are we so programmatically masochistic that we not only accept but lust after these incredibly dangerous procedures?” wonders Virginia Blum, a University of Kentucky English professor, social theorist, and writer of the book Flesh Wounds: The Culture of Cosmetic Surgery. “Why not do these surgeries if they make you feel better? Because it participates in making people crazy. Cosmetic surgery is an incredibly addictive structure.”

Blum has watched a few “brutal” cosmetic surgeries operations, including marathon all-day multiple procedures, and found it “really scary seeing these women treated like cars at the auto shop.” Cars are an appropriate analogy of the way we are increasingly objectifying ourselves to become marketable, palatable, shinier. “Cosmetic surgery is now a mainstream structure which proliferates the idea of consumption as empowerment and objectifying yourself as the best, quickest route to happiness,” says Blum. “But, why are so few men joining in?”

Indeed, while there was a 44 percent increase in US cosmetic procedures in 2004, including a 17 percent increase in surgeries, the surgery rates decreased 11 percent for men. Plus, most cosmetic surgeons are men. “They’re the darlings of the media,” says Blum, “And they’re getting more and more intrepid, walking an increasingly sharp ethical edge.”

A better product

While other surgeons invent new procedures, like Dr. Alter’s “pie-wedge” labioplasty, Jackson wants to add more psychology to his practice. “One of my mentors is Dennis Waitley. I just finished studying his work on the psychology of winning. Life is a game and we can win this game. In order to play the game right, you’ve gotta believe in yourself. If that means doing some surgery to contribute to building your belief in yourself, do it. If you don’t need it, don’t do it.”

“It’s part of the environment of taking the bar of civilization to the next level,” says Jackson. “We are producing some great people in the world today. At the end of the day, the human being should be a better product.

“I think life is fantastic. If my patient tells me that in the morning she just can’t wait to get out of bed, this is a happy person. If she tells me she loves Mondays, that’s a second indication. I’m totally against the phrase TGIF. Ah Monday, I love Monday. I try to instil in my children [aged 9 and 12] and the people I interact with that the next time someone says to you TGIF, say, you should rename it TGIM. Thank God it’s Monday. The week starts with opportunity. I hate Fridays. You know why I hate Fridays? Because it’s a weekend. I don’t like weekends.”

Others might welcome a chance to sail or hit Whistler’s slopes. “I’m a contrarian,” says the doctor. “I’m being a bit bizarre here but I’m giving you an example of what I really believe. If we enhance their happiness with the way they look, let’s do this. My goal is to at least get a smile out of them. We have a competition in our office. If I can get them to leave the office smiling or chuckling, I get a point. If they don’t leave with a smile, I lose a point. At the end of the day, we check the score and I win.”

Scoring against other doctors at the office? “No, myself. If I can make people feel better about themselves, then I’m winning. That’s what life is about. I want to win. I want people to feel good.

Danielle Egan is a freelance writer who has written for Vancouver magazine, Jane, Maisonneuve, Taddle Creek, Fashion, Salon and Seed. She lives in Vancouver.

[Merusk]

Memo to self:

After the scourge of Lawyers has been completed by the black beast Nglsek, the Plastic Surgeons are next.

[Shockeye]

Designer Vaginas

By JILL MAHONEY

Saturday, August 13, 2005 Updated at 12:53 AM EDT

From Saturday's Globe and Mail

Los Angeles — Women from around the world flock to David Matlock's marble waiting room carrying purses stuffed with porn. The magazines are revealed only in the privacy of his office, where doctor and patient debate the finer points of each glossy photo.

The enterprising gynecologist sees countless images of naked women, but none are more popular than Playboy's fresh-faced playmates. They represent, he says with a knowing smile, the perceived ideal.

“Some women will say, ‘Hey, you take this picture and hang it up in the operating room and refer back to it when you're sculpturing me,'” he said in an interview in his clinic overlooking hazy Los Angeles. “I say, ‘Okay, all right, fine.'”

Dr. Matlock is a colourful pioneer in a controversial — and growing — frontier of plastic surgery: nipping and tucking vaginas. Patients from the United States and more than 30 other countries pay thousands of dollars for his “designer vagina,” a purely esthetic procedure that includes shortening or plumping up the labia, or vaginal lips. He attracts even more women for an operation he claims improves sex by tightening, or “rejuvenating,” the vagina.

“There's a need for this,” he said. “Women are driving this. I didn't create this market, the market was there.”

While doctors have long known how to enhance women's genitals, demand for vaginal surgery has mushroomed in recent years because physicians — led by Dr. Matlock — market it as enhancing sexual satisfaction.

Doctors working in the field, including those in Canada, report higher caseloads and longer waiting lists. And the American Society of Plastic Surgeons says the increase is so great that it expects to soon start tracking volumes.

The trend has even reached girls as young as 15. In the past 18 months, the number of teens — and in one case an adolescent and her mother — who come to Dr. Matlock for designer vaginas has doubled.

“They're mature. Breasts, body, everything. I mean the clothing that they're wearing, the whole thing. These are not little girls. They're mature young ladies.”

Plastic surgery's spread to women's nether regions alarms those who see it as a manifestation of society's air-brushed standards of the female form that exploits women's deep-seated insecurities.

“I think it's appalling and frightening and one more way in which perfectly normal, beautiful women are terrorized by the possibility of being less than a perfect 10,” said Joy Davidson, a certified sex therapist and author in Seattle.

Michael Atkinson, a sociology professor at McMaster University in Hamilton, says the increasing popularity of cosmetic vaginal reconstruction is partly the outcome of the West's obsession with plastic surgery.

“This is essentially a cultural problem that we fix medically,” said Prof. Atkinson, who studies cosmetic surgery. “We have this notion the body's a problem to be worked and if you slightly deviate from a supposed norm you should do something about it, which is really a market logic. That's how we make a lot of money in our culture, to plant these cultural ideals in people's heads and then try to enforce them.”

However, women who have had their genitals surgically enhanced say it has transformed their lives. While some patients have genuine health problems, such as incontinence, many also ask their doctors to perform additional procedures while they are on the operating table. Others are solely driven by cosmetic or sexual reasons.

For the past 14 years, Julie Gause was troubled by the after-effects of an “extremely awful episiotomy,” which is an incision to facilitate childbirth, that she had while delivering her son. But “the No. 1” reason she sought the surgery was to “enhance” her sex life.

“It's definitely going to be worth it for the rest of my life,” the bubbly, tanned, 35-year-old Los Angeles resident said in an interview. “It takes you back to before children, for sure. It's an amazing difference. It's unbelievable.”

In June, she paid Dr. Matlock $16,000 (U.S.) for what she laughingly called “the full monty”: reconstruction of the after-effects of the episiotomy, reduction of her labia and tightening of her vaginal muscles.

Not all procedures are even surgical. On the recommendation of a friend, Katia Neves came to Dr. Matlock for the doctor's so-called G-shot, an $1,800 collagen-based injection in her G-spot that he says amplifies orgasms and lasts for about four months.

“It's a pretty expensive procedure for a short period of time,” said the 36-year-old cosmetologist, who was born in Brazil and now lives in L.A. “It does increase your pleasure. It makes a difference, even if you don't have problems you can feel the difference.”

Calgarian Sally Marshall turned to cosmetic surgery to fix something she first noticed at the age of 5: Her inner labia protruded beyond the outer lips, which made riding a bike and wearing a swimsuit or tight jeans an excruciating experience. She was also self-conscious about changing at the gym or having sex with a new partner.

Last year, Bruce Allan, a local obstetrician-gynecologist, trimmed her labia and tightened her vaginal walls for $3,700 (the price has since increased). The difference, she said, is “like night and day.”

“Oh my heavens, I'm [49] and sex has never been better!” she said. “Let me tell you, it does miracles for your husband, too. He loves it.” The question of why women seek plastic surgery for an area of their bodies that few people — including themselves — ever really see is hotly debated. Critics note that men benefit when their partners undergo vaginal tightening and say they, along with society at large, intentionally or otherwise steer women's interest in genital enhancement.

“Does anybody wake up in the morning and say, ‘I just really, really, really need to have my genitals reshaped because I just really want to do that because it's going to feel better'? “ Prof. Atkinson asked.

Pornography's drift into the mainstream and a growing candour about sexuality often lead to the thorny subject of anatomical comparisons, says Leroy Young, chairman of the American Society of Plastic Surgeons' emerging trends task force.

“[Women] get a comment from their spouse or boyfriend or whoever that, ‘Gee you don't look like whoever,' and a comment about a sensitive area like that, of course, is a huge emotional blow. So I think a lot of the women who pursue that are concerned about issues like, ‘How am I going to be perceived?'”

While Dr. Matlock acknowledges vaginal tightening benefits men, he insists his patients come to him because they want change.

“They say, ‘Look, I want to enjoy this. I want to have the best sexual experience possible. It's for me.' That's what they're doing. If a man was pushing a woman to come in, I'm not going to do it.”

Still, a husband of a woman with stress incontinence in the mid-1990s played a large role in Dr. Matlock's inadvertent realization of the demand for vaginal reconstruction, which builds on decades-old surgical techniques. Some physicians have long quietly added an extra stitch “for the husband” while repairing new mothers' episiotomies.

After he treated her, the woman reported that her sex life had dramatically improved. Then her husband telephoned to thank Dr. Matlock profusely, and the couple sent flowers. And one of the woman's friends — who had vaginal-relaxation, not bladder, problems — contacted him seeking the same procedure.

“Then what happened is there was all these women coming by word of mouth,” he said.

Soon Dr. Matlock, a trim, compact 45-year-old St. Louis, Mo., native with a throaty laugh, placed his first and only advertisement, which featured his then-girlfriend posing in a bikini.

The newspaper ad proclaimed the first sexual advance of the new millennium, saying: “You won't believe how good sex can be.” The response was so overwhelming that he pulled it and now largely relies on personal recommendations and his website, which depicts images of flowers and attractive women.

In the process, Dr. Matlock, who is seen as a key figure in the field, turned vaginal reconstruction into a lucrative business empire. He says one of his divisions grosses $200,000 a month, but refused to provide additional financial information. Dr. Matlock, who also has an MBA, has trained doctors in 10 countries, including Canada, in his techniques and charges them a monthly fee of $2,500 for support and for the use of his trademarked names, including Laser Vaginal Rejuvenation Institute.

Depending on the surgical procedure, the women who come to his fourth-floor West Hollywood clinic across from a Jaguar car dealership pay between $3,800 and $17,000. Celebrities who want complete privacy fork over $38,000. Patients, who include housewives and porn stars, are largely in their 20s, 30s and 40s. Most are American, though about one-quarter are foreign. About half are mothers. All, he says, have normal sexual function.

Using lasers instead of scalpels for the one-hour outpatient surgeries, Dr. Matlock performs a weekly average of 10 procedures — which he demonstrates with his Montblanc pen and a transparent plastic model of a vagina along with graphic before-and-after pictures of his patients — and claims a six-month waiting list.

He creates designer vaginas by surgically enhancing the external genitalia, including labia majora and minora, vaginal opening and perineum, which, his website says, creates a “youthful and aesthetically appealing vulva.” Trimming elongated or unequal labia is most common; some women get fat transplants to plump up their outer labia. (Some doctors also restore hymens for women, often from the Middle East, who want to appear to be virgins when they get married.) To tighten a woman's vagina, which Dr. Matlock calls laser vaginal rejuvenation, he decreases the vaginal opening by drawing muscles and support tissue together with an absorbable stitch. He also builds up the perineum, which is between the vagina and anus.

“It makes a tremendous difference for sexual gratification for the women. That's what the procedure is all about,” he said.

But gynecological experts say there is no proof that vaginal tightening improves sex and warn the procedure risks harmful side effects, including infection, hemorrhaging, loss of sensation, nerve injury, formation of scar tissue as well as becoming too tight. (Dr. Matlock says he has been reluctant to submit studies for publication in medical journals because he does not want to reveal his techniques.) “There are definite potential downsides to this,” said Dr. Young, adding that any possible benefits of tightening are not permanent.

There is no textbook outlining the ways and means that doctors can beautify the vagina. So Dr. Matlock, as he likes to say, gets all of his ideas by listening to women.

If they repeatedly make the same request, the man who has been called the Picasso of vaginas will attempt to turn wish into reality. He is currently developing what he calls a “lip tuck,” a facelift of sorts that would shrink sagging skin around the vulva and create a more “youthful appearance.”

He hones new techniques on animal parts — chicken thighs, turkey legs and pig's ears — until he is ready to work on women.

“It's basically all about art. I'm an artist.”