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Female genital mutilation or cutting (FGM/C) reconstructive surgery is a reconstructive procedure that may increase sexual function and appearance of the female genital on patients who have been injured by FGM/C.

The reconstructive surgery was developed by Ivona Percec, MD, PhD, a leading plastic surgeon and Associate Director of Cosmetic Surgery at Penn Medicine.

What is Female Genital Mutilation or Cutting (FGM/C)?

Female genital mutilation or cutting (FGM/C) is the practice of totally or partially removing the female genitalia or causing other injury to the female genitals, without medical indication.

Often misleadingly described as female circumcision, FGM/C is most commonly performed on young babies, girls and women for a variety of culturally ingrained reasons that pre-date modern religion and span several continents. The motivations for such practices are often cited as tradition; a passing into womanhood; a preservation of virginity, chastity, and family honor; and a protection against sexual assault. In some cases, women consent, but in most others, it is imposed upon them without consent.

According to UNICEF, “It is estimated that 200 million women worldwide are affected by FGM, with 3 million at risk annually, and a significant portion of these women is believed to reside in underdeveloped areas internationally.”

Despite the prevalence of these cultural beliefs in some areas, these practices are of no medical benefit, present extensive, profound and persistent morbidity, and are internationally classified as a violation of human rights.

What is the Goal of FGM/C Reconstructive Surgery?

The goal of reconstruction is entirely based on discussion between the patient and the physician. Many times, a patient’s goal is to help the anatomy look and feel more “normal” and for the individual to “feel more whole.”

“Plastic surgeons have a crucial role to play in this recovery, and it’s important for physicians to be informed and prepared to address the surgical and emotional needs of women who seek care for this,” Dr. Percec said. “Our procedure is simple yet effective and can help victims restore their physical and psychological sense of well-being.”

It’s important to have a thorough discussion with your doctor regarding your specific goals and have a thorough history including medical/physical, psychological, sexual and social history. Every woman’s anatomy is different and not every patient’s ideal goals may be achieved with surgery.

What to Expect from FGM/C Reconstructive Surgery

Pre-Surgery Consultation

During your consultation, you will meet with one of our surgeons to discuss your medical history and expectations as well as undergo a physical examination to determine which surgery plan is best for you, based on your cutting type. Pre-operative photos may be taken during your visit with your consent.

Once you have scheduled your surgery, you will return for a pre-operative history and physical examination appointment.

Before surgery, your care team will give you pre-op and post-operative instructions, as well as prescription medication for after surgery.

The Day of Surgery

At Penn Medicine, FGM/C reconstructive surgeries are typically scheduled at our Penn Medicine Rittenhouse location at the Tuttleman Center.

The surgery takes about two-to-three hours in the operating room. It is performed under general anesthesia, and you will go home the same day of the operation.

You will need to arrange for someone to drive you home after surgery and provide assistance for a few days. Plan to be at the outpatient surgical center for about four-to-six hours’ total, including operation time and time before and after the procedure.

After Surgery

Two weeks after vaginal surgery, you will see your nurse practitioner for a post-operative check-up. The nurse will check for surgical site wounds, infection and any pain, and that everything is healing correctly.

The restoration of pigmentation, sensation, sexual function and psychological healing will vary; it may take months to a year or more for a full recovery.

Risk and Outcomes from FGM/C Reconstructive Surgery

Every type of surgery has risks. You can help reduce complications by carefully following all pre- and post-surgery instructions.

Dr. Percec and the nurse practitioner will review all the potential risks and side effects specific to you and your surgery.

Cost of FGM/C Reconstructive Surgery

The surgery is generally covered if the patient meets the criteria for female genital mutilation and if the hospital takes your insurance. This will be determined after your initial evaluation and physical exam in the office with the doctor. After your consultation, we submit the information to the insurance company to request approval for surgery. It typically takes four-to-six weeks to receive a response from insurance.

If you do not have insurance or do not wish to go through insurance to cover the costs, an estimate for the out-of-pocket costs of the procedure will be given at the consultation visit.

Traveling to Penn Plastic Surgery

Many of our FGM/C patients travel to Philadelphia from out of town or far away. It is often best to coordinate to stay overnight in a hotel nearby the day before and/or after the procedure with a guardian or family member. We are available to answer any questions you may have about accommodations and traveling to Penn Medicine.

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