Dr Siwar Ben Salem - Obstetrician-gynaecologist, Tunis

Intimate surgery and functional, aesthetic and regenerative gynaecology.

Medical expertise in the service of health, function and femininity.

Dr Siwar Ben Salem does not treat a catalogue of procedures: she looks first for why, before deciding what. Every course of care begins with what you are going through, with a single requirement, listening that fits who you are.

Pain, a drop in desire, difficulty reaching orgasm: these are reasons to consult, not subjects to keep to yourself. They have causes - hormonal, anatomical, drug-related, sometimes simply mechanical - and most of them can be looked into.

Hard to reach, or gone after a birth, surgery or a change of treatment. We start by looking for what has changed.

A lasting drop almost always has something underneath it: hormones, fatigue, contraception, pain anticipated. We look for it before correcting it.

Dyspareunia, vaginismus, dryness. Pain during intercourse is not something to be endured, and it can be treated.

Post-partum, menopause, cancer treated: the tissues change. Sexuality does not have to stop there.

What is said in consultation stays there.

Before any intervention, there is the follow-up: the consultation, screening, pregnancy, birth, contraception, fertility and menopause. It is the practice's foundation, and the same doctor from start to finish.

Consultation, pelvic ultrasound, smear test and HPV screening: the exam and its result in the same appointment.

From the positive test to term: monthly consultations and an obstetric ultrasound each trimester.

At the clinic, day and night. The doctor who followed the pregnancy is the one present at the birth.

Choosing or changing contraception, taking stock when a pregnancy is slow to come, going through menopause with support.

The same doctor, from start to finish.

Techniques

In theatre or in the consulting room, surgical or medical: every procedure is chosen for the indication it treats, prepared and explained, never offered by default.

• Vaginoplasty - Tightening of the vaginal walls, after childbirth or a loosening of the tissues.
• Perineoplasty - Repair of the perineum, on its own or following a vaginoplasty.
• Reconstructive vaginal surgery - Cystocele, rectocele and uterine prolapse repair, combined where needed with vaginoplasty and perineal repair.
• Cystocele repair - Anterior colporrhaphy: correcting the descent of the bladder towards the vaginal wall.
• Rectocele repair - Posterior colporrhaphy: correcting the bulging of the rectum towards the vaginal wall.
• Uterine prolapse treatment - Correcting the descent of the uterus or vaginal vault, by the vaginal or laparoscopic route.
• Labiaplasty - Reduction or reshaping of the labia minora, when the discomfort is daily: clothing, sport, intercourse.
• Clitoral hood reduction - Improves access to the clitoris and the quality of orgasm .
• Labia majora lift - Redefining the volume and the contour of the labia majora.
• Baby Shape - A package bringing together all the surgical procedures, for complete care in a single operation.
• Fat injection in the labia majora - Restoring the volume of the labia majora by lipofilling, from your own fat.
• Diamond Bikini - A package bringing together every surgical procedure except vaginoplasty and fat injection.
• Monsplasty - Correcting the contour of the mons pubis by liposuction and lifting, on its own or following significant weight loss.
• Hymenoplasty - Surgical reconstruction of the hymen.
• Laser hair removal - Permanent hair removal of the intimate area, in a few sessions.
• Labia majora filler - Restoring the volume of the labia majora with hyaluronic acid, without surgery.
• Hymenorrhaphy - A quick procedure that restores the hymen temporarily.
• Intimate lightening - Mesotherapy, PRF or peeling, to even out the pigmentation of the intimate area.
• G-shot - Augmentation of the G-spot, by lipofilling in theatre or with hyaluronic acid in the clinic.
• O-shot - An injection of PRF, a plasma drawn from your own blood, to improve the quality of orgasm.
• C-lift - Hyaluronic acid injected around the clitoris, to restore volume and sensitivity.
• Botox - An injection reducing pelvic floor hypertonia, as a last-line treatment for vaginismus.
• Vaginal dryness & atrophy - Topical and hormonal treatments, regenerative medicine, technologies and hyaluronic acid.
• Lightly cross-linked hyaluronic acid - Restoring the hydration of the intimate tissues, particularly after the menopause.
• Exosomes - An injection of exosomes to stimulate the regeneration of the intimate tissues.
• Device-based treatment for dryness - Laser, LED, vaginal LED or vulval LED: the technology is chosen according to the indication.
• CO2 laser - Stimulating collagen and improving the mucosa's quality, to restore hydration and intimate comfort.
• PRF injection - Regenerating the vaginal and vulvar mucosa with platelet-rich fibrin, prepared from your own blood.
• Lichen sclerosus - Management and follow-up of vulval lichen sclerosus.
• Genital warts - Topical treatments, surgery or CO₂ laser, whichever method is best suited.
• Hormone therapy - Hormonal support through the menopause and the perimenopause.
• Vulvovaginal nanofat - Injection of autologous fat prepared as nanofat, to improve the hydration and quality of vulvovaginal tissue.

Obstetric gynaecology

Consultation, screening, pregnancy, contraception, menopause and fertility: the underlying care, the kind that depends on no procedure at all.

• Gynaecological consultation - The basic appointment: what you come to say, a clinical examination if needed, and clear answers.
• Pelvic ultrasound - Uterus, ovaries and endometrium examined at the clinic, during the same consultation.
• Cervical smear & HPV screening - Screening for cervical cancer: a few seconds of examination, a result that counts.
• Antenatal care - From the positive test to the birth, the same doctor from start to finish.
• Obstetric ultrasound - The three scans of pregnancy, plus any others a check warrants.
• Childbirth - Vaginal birth or caesarean: what was prepared with you, not decided without you.
• Contraception - Pill, IUD, implant: the one that fits your life, not the default one.
• Menopause assessment - Understanding what is changing before deciding what to do - or to do nothing.
• Fertility work-up - A work-up for both partners, tests in the right order, and a clear referral if one is needed.
• Premarital check-up - Medical history, blood group, vaccination status and screening: taking stock before marriage and any future pregnancy.

what you feel, first.

• Vaginal or intimate dryness - Tightness, irritation, discomfort during intercourse: intimate dryness has identifiable causes, and a graduated range of answers.
• Atrophy of the labia majora - A gradual loss of volume, often linked to age or to weight loss, which changes both appearance and comfort.
• Intimate hyperpigmentation - A darkening of the skin in the intimate area, common and harmless, but which sometimes weighs on self-image.
• Vaginal laxity and widening - A loss of tone in the vaginal walls, most often after one or more vaginal deliveries.
• Urinary leakage - Leaking when you laugh, exert yourself or cough is not an inevitable part of age or motherhood: it can be assessed and treated.
• Genital prolapse - Pelvic heaviness, a sense of something dropping, urinary or bowel discomfort: pelvic organ prolapse is assessed precisely, and treated according to the organ involved.
• Vaginal pain during intercourse - Burning, tenderness on contact, pain during intercourse: the vulva is a sensitive area that deserves to be examined, not ignored.
• Orgasmic difficulty - Hard to reach, or gone after a delivery, surgery or a change of treatment: it can be investigated, and it can be worked on.
• Hypertrophy of the labia minora - A size or asymmetry of the labia minora that causes everyday discomfort - clothing, sport, intercourse - can be corrected simply.
• Clitoral hood hypertrophy - An overly prominent hood can limit access to the clitoris and the quality of sensation - a subject rarely raised, yet simple to treat.
• Hypertrophy and ptosis of the labia majora - An excess of volume or a sagging of the labia majora, often after significant weight loss or a pregnancy.
• Vaginismus - An involuntary contraction of the pelvic floor muscles that can make penetration painful, difficult or impossible: vaginismus can be treated, with gradual, tailored solutions.
• Female genital mutilation (circumcision) - Pain, scarring, urinary discomfort or sexual difficulties: a specialised consultation makes it possible to assess each situation and consider, where necessary, reconstructive surgery.
• Low libido - Hormonal, medical, psychological or relationship-related causes: a personalised assessment guides care, including hormone therapy where needed.

what we dare not say.

• Giving birth leaves no wound to your sense of self - Bringing a child into the world is a remarkable medical act, not something the body is simply stuck with. When a change persists, there are simple, precise surgical answers.
• These procedures affect neither virginity nor sensitivity - Hymenoplasty, hymenorrhaphy, clitoral hood reduction: precise procedures, chosen to preserve the integrity and the sensitivity of the tissues, never to compromise them.
• Pain during sex is not something you simply have to live with - Dryness, tightness, deep pain: these are medical symptoms like any others. They can be examined, they have causes, and they can be treated.
• Feeling good in your body also helps your intimate life - An intimate aesthetic concern often affects far more than appearance: ease during intercourse, pleasure, the quality of the relationship with a partner. The right care can change all of that.

To book an appointment, call +216 29 682 692.