The hymen is a remnant of vaginal development and is located at the inner margin of the vaginal opening; it has a thickness of approximately 2 mm. Because it may be lacerated during the first sexual intercourse to cause bleeding, the hymen is considered to be an indicator of virginity in traditional Oriental customs; however, it also indirectly poses psychological pressure to and shackles on many women. In recent years, due to the modern concept of Western culture and feminism, the role of the hymen in male and female relationships has changed. However, some patients with a traditional or conservative belief still regard it as the last barrier of faithful feelings and therefore seek plastic surgery for hymen restoration to present their most intact self to their beloved partner.
The technique of hymen restoration surgery is determined based on the hymen modality and ruptured period, which is not subject to fixed rules. Generally, if the reconstruction is conducted within 1–2 years after laceration, the remaining hymen segment peripheral to the vaginal opening can be used in most cases, and such remnant tissues can be stitched at the inner and outer layers like a jigsaw, which reconstructs 70–80% of the complete hymen. However, if the hymen has been lacerated a long time ago, it will be difficult to find hymen remnants peripheral to the vaginal opening, and the partial vaginal inner wall mucosa is utilized as the new hymen material. Surgery is conducted by detaching the mucosa adjacent to the vaginal opening from the inferior muscles, flipping over the regional flap, and drawing to the vaginal opening for reconstructing and stitching, which restores approximately 50% of the hymen. Regardless of the technique, Dr. Chuang recommends patients to undergo hymen reconstruction within 1 month prior to planned sexual intercourse because the new hymen is more prone to bleeding due to laceration; on the other hand, this avoids rupture of the repaired hymen caused by accidental compression or friction after waiting for a long time. In this way, the surgical objective of hymen hemorrhage at the first sexual intercourse is achieved.