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The Hoodectomy procedure is fairly common in that its objective is to unhood the clitoris. But, how do you specifically perform the procedure?

Well, this varies from surgeon to surgeon, as you might expect. My technique has varied somewhat in the 150 procedures I’ve done over the last several years. I’ve now gained significant experience dealing with varying body types and anatomies to assure a good result.

The way I begin is by first determining the extent of the sensory perimeter of the clitoris. By this, I mean I actually test the region around the clitoris, when the patient is fully conscious, using hot and cold swabs. This tells me two things. First, it tells me if the woman has a hormonal issue, or one of sensitivity. If it’s a sensitivity problem, this testing gives me an understanding about how far out the nervous tissue from the clitoris extends. Now, don’t get me wrong . . . normally the innervation of the clitoris is localized to the immediate area, and few people know that sometimes there will be more sensitivity to one side of the clitoris, versus the other. This is extremely important in ascertaining the extent of the procedure. Next, I use the experience I’ve gained from studying the natural folds and muscular action of the genital area and mark what I believe will be the best areas to remove. As I said, it’s very important to realize that there are no two vulvas that are the same. A good result can ONLY come from doing many, many procedures. The size of the clitoris determines the extent of the Hoodectomy.

Once I’ve established a perimeter, and marked the area accordingly, I apply a topical benzocaine anesthesia ointment to numb the immediate area. After waiting for this numbing action to occur, about twenty minutes, I further infiltrate the area with a more concentrated anesthetic, usually one combined with epinephrine to reduce fluid loss. From there, I retract the clitoral node from the Prepuce (clitoral hood) allowing sufficient space for a surgical incision. Generally, I use a very small curved incision made roughly 270 degrees in an arc, around the clitoral hood. In most instances the incision is approximately 1⁄4” long. Never, at any time, is the clitoris node near enough to the incision area to risk any injury to the nervous tissue, because it is retracted far enough to prevent accidental damage. At all times the patient is awake. The area remains numb for approximately 60-90 minutes, which is more than enough time to finish the Hoodectomy procedure. The small incision is closed with a few sutures that dissolve in about seven days. Also, I used some special instruments that I’ve designed that allow for a nice accommodation of the artistic arc that’s needed to assure natural tissue movement after the surgery is finished. I also use some graft techniques that enhance healing and improve the results. I specifically don’t talk about these because of the years it’s taken me to develop them. But the bottom line is that my graft technique cuts down on pain, swelling and scarring.

How long does the procedure take?
In virtually every case, the surgical part of the procedure I do, takes less than an hour. Now that’s not the entire process, needless to say, because I do some sensitivity testing beforehand.

What are the complications you’ve seen?
I’ve never had any notable complications. However, as with any surgical procedure, complications can occur. Usually they are few. Inflammation is an example of something that can occur, not so much from the anesthetics, but from a histamine reaction to the suture material. Sometimes there is some irritation from the separation of the tissues. Infection is usually never an issue because patients are given antibiotics a few days prior to the procedure—and a week after, which virtually eliminates any chance of infection happening. If any infection does occur, it is usually treated with topical antibiotic creams and/or ointments. Actually, there is something rather beneficial from having a Hoodectomy done. It’s rarely talked about but it’s well known that for some women who have frequent urinary tract infections and frequent vaginitis, those conditions seem to resolve after a Hoodectomy. The theory behind it of course is that if one has a considerable amount of excess tissue in this area; this excess tissue can cause a problem with excess bacterial build up, thus increasing the possibility of these feminine infections.

How painful is the procedure?
Most patients are able to return to normal activities within 36 hours, many in less time. In every instance, they’ll never feel pain during the procedure. Ice packs are provided as well and sometimes, for those women who are particular sensitive, we’ll provide a mild pain reliever, usually an oral med. I have many women who’ll fly in, have the procedure done, and head right out to the airport to head home. No problems whatsoever.

What are the main reasons a woman would want to have a Clitoral Unhooding done? 
I’ve discovered that in most cases, the main reason is always the same. The woman wants to have the procedure done to help her reach orgasm faster, or to have a much stronger climax. Another reason given frequently is that the woman wants to improve her potential for having multiple climaxes. There’s been some data that says that roughly 15% of the population is capable of multiple climaxes and that number improves significantly with a Clitoral Unhooding. But, the real benefit for women, and for men to a large extent, is that if a woman can achieve climax faster and with greater intensity, she naturally wants to have sex more often . . . so generally, her mate would benefit as well. Sex becomes real enjoyable, for both people, again. That’s a huge benefit for a few thousand bucks.

How would you describe the typical woman who is having this procedure done?
Well, there is no real stereotype. I’ve done procedures on women in their early twenties and even on some women in their sixties. Some are married, some divorced, some single. In many cases, a woman will come to see me for a Labiaplasty problem, and she’ll also have the Clitoral Unhooding done at the same time. The reason is because the Prepuce, or Clitoral Hood is actually an extension of the labia. She might mention to me that she’s had a difficult time with reaching climax or does so very infrequently. She might say something like, “my friend says she’s reaching orgasm with this guy in minutes and how great it is, and she’s not achieving climax at all.” She’ll tell me that sometimes she thinks it’s a mental problem, which is really sad. I usually offer to give her a sensitivity examination and testing, and in some of these cases, I’ll usually find the problem to be with excessive Prepuce tissue. But at least half the time women come to me solely to have a Hoodectomy done. As far as being a married woman or being a single woman, well, the numbers are about even.

Are your patients usually willing to give their perspectives on Hoodectomy postoperatively?
I’ve done numerous patients who are willing to discuss their cases with prospective patients. And, in fact, we have a few of them on this web site. I’ve never had a patient who’s been unhappy with the results.

What have you heard about the main objections from women to having this procedure done?
The main objection I’ve heard is largely from bad information that they’ve heard or read about loss of sensitivity. Also, the procedure is confused with Clitoridectomy, which is nothing more than Female Genital Mutilation. But, let’s talk about the issue of loss of sensitivity. Some people claim it can lead to loss of sensitivity . . . comparing it to a male circumcision where it’s been documented that a man loses sensitivity from the removal of the foreskin. To some extent, in the male this is true . . . because part of the loss of sensitivity for a male is when he loses the protective sheathing—the foreskin. The male foreskin has a certain amount of innervation in the tissue itself. So, in men, removing this tissue can actually result in a loss of feeling.

What people are talking about with Clitoral Unhooding is usually a claim that involves loss of sensitivity over time, because of chronic exposure. There are no studies that support this view. During a Hoodectomy, there is no loss of sensitivity because if the surgeon has the experience to not overexpose the clitoris and properly lets the clitoris seat in its protective sheathing—meaning they have an aesthetic understanding of each woman’s particular anatomy—there will not be any chance of loss of sensation because the clitoris will still have its protective hood. The concept isn't to completely remove the hood . . . the concept of a successful Hoodectomy is to remove the problematic tissue that is inhibiting the clitoris from protruding, thus keeping it from receiving the proper amount of stimulation. That’s what this is all about.

Let’s be honest here . . . does this procedure really work to help increase stimulation?
Absolutely. There’s no doubt about it. The clitoris is the end of the G-Spot. It's a long bundle of nervous tissue. Once I remove that excess hood tissue there’s more of the highly innervated surface of the clitoral node exposed, allowing more sensation and helping the woman achieve a faster, stronger climax.

Are the results immediate?
I tell my patients that they should avoid sex for at least a few weeks, to allow the area to heal properly. But, I will say that I've had women call me after the first week, and tell me they couldn't resist, telling me how wonderful the sexual climaxes can be. Now, I'm not recommending this, but sometimes I hear about it. The results, however, are immediate.

What should a patient look for selecting a surgeon?
It’s like of like the real estate line. You know, the one that says, “location, location, location?” Well, the same thing is true of this procedure . . . only the saying is “experience, experience, experience”. That's because experience is the key to assuring that you’ll get a good result. A surgeon that has performed hundreds of Clitoral Unhoodings, like I have, understands the aesthetic architecture of the female genitalia and can allow for natural movement of the tissues before, and afterward. How the exposure of the clitoral node appears after the surgery is what's important. This is perhaps the most important aspect of the procedure—to assure that the clitoral node won’t be exposed too much, which can result in over stimulation and possibly pain. You should only consider using a surgeon who has a huge number of procedures to their credit.

How many procedures must surgeons do to consider themselves "experienced" in it?
It's important to realize that there are fine differences between body types, depending on race, weight, anatomical proportion and other issues. ONLY an experienced surgeon that has performed a successful number of Hoodectomies can appreciate this fine detail. A surgeon doing this procedure usually gains the necessary experience after performing at least 35 procedures. I'd say that’s the minimum number.

What is the best time for someone to get this procedure done?
There’s nothing special about timing. The best answer to that question is, whenever she feels it’s appropriate for her. One would think that young women would want this procedure done more than older women, but it’s exactly the opposite that is true. The reason is that as women get older, they often feel more insecure about the problem during sex. Younger women haven't usually discovered the problem yet.



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