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What is the MonaLisa Touch?

What is the MonaLisa Touch?

The MonaLisa Touch is a fractional CO2 laser specifically designed to treat vaginal tissue. It creates controlled micro-injuries that trigger your body’s healing response, which boosts collagen and elastin production, thickens the tissues, and increases blood flow.

The MonaLisa Touch is used to treat atrophic vaginitis—the thinning, drying, and inflammation of the vaginal walls that often accompanies estrogen loss after menopause or other health changes. MonaLisa Touch treats symptoms like vaginal dryness, painful intercourse, and urinary incontinence.

Charlotte, North Carolina, urologist Dr. John Hettiarachchi says, “Many people have mistaken this treatment as a vaginal tightening treatment. Although patients will notice a tightening due to the changes in the thickness and texture of their vaginal tissue, the goal of this treatment is not to tighten. It is to change the underlying health of the tissue so that women in menopause can ‘feel normal’ again.”

While lasers and other energy-based devices have been approved to treat abnormal or precancerous cervical or vaginal tissue and warts, the FDA has not approved any to treat vaginal atrophy, urinary incontinence, or reduced sexual function. In fact, in 2018, the FDA warned several companies to stop marketing laser devices for “vaginal rejuvenation.”

New York City–based plastic surgeon and RealSelf chief medical editor Dr. Lara Devgan explains the situation this way: “While the laser and energy vaginal devices in question have not been FDA-approved for the claims that are frequently made about them, they do work well anecdotally and in clinical practice.”

Pros

  • MonaLisa Touch treatments can increase lubrication, thicken vaginal tissues, and increase blood flow, reducing pain during sex.
  • A reduction in urinary incontinence means many patients are able to stop using bladder medication and urinary pads.
  • Among RealSelf members 94% say it’s Worth It—one of the highest Worth It Ratings among many similar treatments.

Cons

  • Results aren’t permanent. You’ll need a maintenance treatment every 12 to 18 months.
  • MonaLisa Touch costs an average of $2,000 for the initial series of treatments, and it’s not covered by health insurance.
  • It doesn’t work for everyone. Some RealSelf reviewers say they experienced no improvement for painful intercourse.
  • If an inexperienced provider performs this treatment at an incorrect setting, burns are a potential risk. Lake Bluff, Illinois, OB-GYN Dr. Kelly London explains in a RealSelf Q&A that “The settings suggested for treatment were predetermined after rigorous clinical trials looking at the histologic changes in the tissue, and the unique stacking [DEKA-Pulse] technology prevents such side effects [as burns] from happening.” In other words, if your provider observes these recommended settings, this shouldn’t happen to you.

What happens during a MonaLisa Touch treatment

Your physician will begin with a thorough pelvic exam, to make sure you’re a good candidate for the procedure and don’t have any active infections. Then they’ll apply numbing cream to the vaginal opening and vulva, where the nerves are more sensitive.

Once you’re numb, you’ll recline on the exam table with your feet in stirrups as your physician places a sterile “insertion ring” (a circular device that allows the laser handpiece to be inserted and moved without rubbing against your labia) into your vaginal opening. Next, the wand-shaped laser delivers energy pulses to specific treatment areas, which patients say feels like bursts of vibrations.

The pulses are calculated to a specific depth and width, depending on the areas being treated—usually both the internal vaginal canal skin and outer vulva skin. (Researchers note that results are more significant when the vaginal opening is treated. A typical MonaLisa Touch treatment involves 5 to 10 minutes of active lasering.

What to expect after MonaLisa Touch treatment

The recovery phase is fairly simple. Your doctor will send you home with a gel ice pack to use if you experience any discomfort, but most women resume their normal routine.

Some patients have vaginal spotting or cramping for a few hours, and some may also have external itching for a few days. Avoid baths and hot tubs for the first four days and vaginal sex for the first week, to allow yourself to heal.

When you’ll see results and how long they’ll last

Women generally report feeling a difference within three to four weeks of the initial treatment, with better lubrication and more pleasurable sex—but most people need three to four sessions, spaced six weeks apart, for optimal results. The laser settings may be increased during each subsequent visit, depending on your response to the initial treatment.

“A booster or follow-up treatment is usually required about 12 to 18 months after the course of MonaLisa Touch laser treatment,” says Toronto OB-GYN Dr. Elin Raymond in a RealSelf Q&A. “This is because the low hormone state and the natural aging process continues acting on the vaginal tissues. Usually, only a booster is required if patients come back when they start to notice the return of symptoms and don’t allow the full effect of the treatment to diminish.”

How much MonaLisa Touch costs

RealSelf members report the average cost for MonaLisa Touch is about $2,000. Your cost will depend on the experience level of your provider and their practice location.

Though it’s not covered by insurance, you may be able to use your flexible spending account if the procedure is performed in a medical office by a doctor.

See more about the average cost of MonaLisa Touch

ABOUT AUTHOR

Dr. John Hettiarachchi, FACS FPMRS

Dr. John Hettiarachchi, FACS FPMRS

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