Urologist Karen Elizabeth Boyle, M.D., F.A.C.S., says she started her reconstructive and aesthetic practice under the umbrella and support of the 80-plus physician urology group, Chesapeake Urology Associates in response to patient demand and her love of microsurgery and reconstruction.
More than a decade later, Dr. Boyle, founder of Chesapeake Aesthetic Surgery, says aesthetics found her. It wasn’t something that she tried to introduce to her practice.
“It … organically occurred and fit into my area of expertise,” Dr. Boyle tells The Aesthetic Channel. “I do think there are challenges for general urologists to just decide that they want to start providing more elective reconstructive or aesthetic procedures. I think that’s actually very difficult to do.”
Dr. Boyle, who has fellowship specialty training in reproductive medicine, microsurgery and reconstruction, and whose specialties include infertility, microsurgery, sexual health, genital reconstruction and aesthetics, shares her experiences and advice for offering aesthetics in today’s urology practice.
The Aesthetic Channel: What types of aesthetic challenges do you address?
Dr. Boyle: For women, I perform procedures like labiaplasty; clitoral hood reduction; clitoropexy or clitoroplasty; vaginoplasty; perineoplasty; reconfiguring the labia majora; vulvar beauty after baby—those kinds of procedures. I also perform hymenoplasty, or hymen reconstruction, for women — usually for cultural reasons, [to repair] the hymen, so they can get married within their culture.
Among the male procedures, there are some that are purely aesthetic, or elective, like correction of penis scrotal webbing, scrotal lift or scrotal reduction; then, there are some that border reconstruction and are not necessarily elective aesthetics, including correction of hidden penis or trapped penis; pubic lift; open lipectomy or liposuction.
For procedures that involve the pubic area and the abdomen, I partner with a plastic surgeon.
As a urologist who performs genital aesthetics, it is essential to recognize where my expertise ends and where a dedicated partnership with plastic surgery begins. Even if I’m comfortable in the suprabpubic space, if the patient would benefit from an abdominoplasty or liposuction, I involve plastics.
The Aesthetic Channel: Did you transition into aesthetics, where you might have referred more patients early on than you do now because you have more experience? How does that work?
Dr. Boyle: I did not wake up one day and decide I was going to perform labiaplasties. I had specific surgical interests with a dedicated focus on genital reconstruction from my surgical training. I feel so fortunate to have had an extremely strong training in pediatric urology — utilizing skills from that training that I now use daily in my adult aesthetic practice. I had what I consider exceptional general surgery and urological surgical training at Johns Hopkins. I had a personal interest in reconstruction, microsurgery and plastics. After leaving Johns Hopkins, I went to Baylor College of Medicine and trained in reproductive medicine and microsurgery. After my fellowship at Johns Hopkins, I started doing more genital reconstruction as a faculty member. Also, I helped out with the now adult (former pediatric) urology patients who needed genital revision procedures. I then joined Chesapeake Urology Associates 10 years ago under the leadership of Dr. Sanford Siegel, who shared my vision of Chesapeake Aesthetic Surgery and has given unwavering support of this practice.
My first labiaplasty patient years ago had been seeing me for sexual health concerns. I referred her to plastics, but she came back and said: I really want a female physician, and I really want a doctor who is sensitive to my concerns about sexual health.
So, the first few labiaplasties I did, I worked with plastics. I did extra training with genital aesthetic surgeons in California and gained experience. Even though I had that experience from training, doing aesthetics is a very, very different practice type.
Clearly from my perspective, it’s just something that naturally fit in to my practice structure because I perform mostly elective surgeries. I perform microsurgical vasectomy reversals; I do vasectomies; I do sexual health. I don’t take care of prostate cancer, bladder cancer or incontinence. So, I already had a large self-pay population of patients. My practice was already set up for and comfortable with dealing with young, healthy patients who desired ‘unnecessary’ elective surgeries.