What should be the mission and vision of Aesthetic Gynecology (Aesthetic Gynecology) in terms of patient care and treatment approach?

Mission and Vision of Aesthetic Gynecology

The mission of aesthetic gynecology should prioritize patient autonomy, psychological well-being, and evidence-based practice while distinguishing legitimate functional concerns from purely cosmetic requests, with the vision of integrating trauma-informed care principles and rigorous outcome documentation to establish safety standards currently absent in this field.

Core Mission Elements

Patient-Centered Care and Autonomy

• Women seeking aesthetic gynecologic procedures must act autonomously without coercion from partners or surgeons with proprietary conflicts of interest 1
• Implement shared decision-making where decisions about clinical care are made in equal partnership, with the patient informed and in charge at all times 2, 3
• Respect patient empowerment through informed consent and choice, allowing patients to pause or stop procedures at any time for any reason 2

Psychological and Quality of Life Assessment

• Screen all patients for psychological conditions including depression, perfectionism, and obsessiveness before proceeding with aesthetic procedures 4, 1
• Assess trauma history using a trauma-informed approach, as past trauma can significantly impact patient experience and outcomes 2, 4
• Evaluate whether requests stem from body dysmorphia or external pressure rather than genuine functional concerns 1

Education and Realistic Expectations

• Educate women about the normal range and variation of labia widths and genital appearance before considering surgical intervention 1
• Provide accurate information about the uncertain value of aesthetic gynecologic procedures in improving sexual function, given the absence of quality outcome data 1
• Use therapeutic and empowering language throughout all patient interactions, avoiding triggering terminology 2

Vision for Practice Standards

Evidence-Based Medicine Integration

• Currently, no documentation exists on the safety and effectiveness of cosmetic-plastic gynecologic procedures in the scientific literature, preventing establishment of a standard of practice 5, 6
• Prioritize documentation of outcomes, complications, and long-term effects to build an evidence base 2, 1
• Distinguish between traditional gynecologic surgical procedures and cosmetic procedures, as mislabeling traditional procedures as cosmetic constitutes deceptive practice 5, 6

Functional vs. Aesthetic Distinction

• Evaluate all patients for true pelvic support disorders such as pelvic organ prolapse and stress urinary incontinence before attributing symptoms to aesthetic concerns 1
• Recognize that the line between cosmetic and medically indicated surgical procedures is blurred, requiring careful assessment 1
• Address legitimate female pelvic floor disorders separately from purely aesthetic conditions 1

Trauma-Informed Approach

• Train all staff (administrative, clinical support, and physicians) in trauma-informed care principles and therapeutic language 2
• Implement universal screening for trauma before pelvic exams or procedures 3
• Maintain open body language with clinician positioned lower than patient, allowing patient to see clinician at all times 2

Ethical Framework

Avoiding Conflicts of Interest

• Reject business models that attempt to control clinical-scientific knowledge dissemination through trademarking traditional gynecologic procedures 5, 6
• Avoid proprietary conflicts of interest that may pressure patients toward unnecessary procedures 1
• Ensure multidisciplinary consultation when procedures may affect other treatment needs 2

Quality of Life Prioritization

• Assess functional and aesthetic outcomes alongside consideration of possible side effects and patients' quality of life 2
• Recognize that aesthetic problems can significantly impact quality of life, but must be balanced against surgical risks 2
• Use validated quality of life questionnaires to assess outcomes rather than relying solely on subjective reports 2

Training and Competency Requirements

Multidisciplinary Expertise

• Require contributions from gynecologists and reconstructive pelvic surgeons in evaluating the appropriateness of aesthetic procedures 1
• Establish certification and preceptorship programs with standardized training protocols 7
• Develop residency and fellowship curricula that address aesthetic gynecology within an evidence-based framework 7

Team-Based Care Model

• Utilize a trained and competent team approach from first to last patient contact 2
• Train clinical support staff in recognizing patient discomfort and communicating concerns to the clinician 2
• Implement therapeutic alliance principles throughout the care continuum 2

Common Pitfalls to Avoid

• Never perform aesthetic procedures without first ruling out functional pelvic floor disorders that may be the true source of patient concerns 1
• Avoid proceeding with surgery when patients show signs of coercion from partners or unrealistic expectations 1
• Do not label traditional gynecologic surgical procedures as "cosmetic" or "aesthetic" when they address functional problems 5, 6
• Never establish proprietary control over surgical techniques through trademarking, as this constitutes unethical practice 5, 6