Clitoris Anatomy Applied to Aesthetic, Reconstructive and Transgender Surgery: A Narrative Review

Area of Science:

• Anatomy
• Surgical Science
• Female Physiology

Background:

• The clitoris, a vital female organ, has been historically understudied.
• Recent understanding reveals it as a multi-planar structure with extensive innervation.
• Its anatomy is critical for female sexual function, particularly orgasm.

Purpose of the Study:

• To comprehensively review the clitoral anatomy, including internal structure, topography, and neurovascular supply.
• To highlight the clinical implications of clitoral anatomy in aesthetic, reconstructive, and transgender surgery.
• To synthesize current knowledge on the clitoral complex's integration, surgical techniques, and functional importance.

Main Methods:

• A narrative review of papers published over the last 70 years.
• Searches conducted in Pubmed, Embase, and Scielo databases.
• Exclusion of case reports, editorials, opinions, and studies lacking clear anatomical descriptions or full-text access in English, Portuguese, or Spanish.

Main Results:

• The clitoris is a complex, multi-planar organ with significant depth and innervation.
• Buck's fascia is identified as a key landmark in aesthetic and reconstructive clitoroplasty.
• The neurovascular bundle's location relative to Buck's fascia is critical for preserving blood supply and sensation.

Conclusions:

• Detailed knowledge of clitoral anatomy is fundamental for successful aesthetic and reconstructive surgery.
• Understanding the neurovascular supply is essential to prevent complications like glans necrosis and desensitization.
• The clitoral complex's anatomy and surgical techniques are relevant for the transgender population and gender-affirming surgeries.