In each edition, Modern Aesthetics® asks top cosmetic doctors about the newest devices in their practices. This month, Grant Stevens, MD, founder and Medical Director of Marina Plastic Surgery and The Institute, a medical spa in Marina Del Rey, CA, and medical director for Body by OrangeTwist aesthetic centers, talks about Geneveve by Viveve for nonsurgical vaginal rejuvenation. Dr. Stevens serves as chairman of the Viveve's Aesthetic Advisory Board. He is also the president-elect of the American Society of Aesthetic Plastic Surgery (ASAPS).

What is Geneveve by Viveve?

“Geneveve by Viveve uses cryogen-cooled monopolar radiofrequency to uniformly deliver gentle volumetric heating while cooling surface tissue. This device tightens the vagina; increasing moisture and improving urinary incontinence in women. It works largely by stimulating the body's natural collagen formation process.”

What makes it different than other devices in this growing category?

“I presently own several of the devices used for non-surgical vaginal rejuvenation. I think Geneveve works the best. I have had the device since late 2016 and have treated close to 80 women. The other devices only penetrate 1/2 to 3/4 millimeters (mm) deep by design, but Geneveve penetrates 3-5mm deep where it targets and tightens the muscular and submuscosal tissues. This is also the ideal depth for generating new collagen. Moreover, Geneveve is just one 20-minute procedure where the wand is rotated clockwise. Other devices require three or four treatment sessions to achieve the same results we see after one Geneveve session. It is a more palatable treatment for patient and provider alike, but more importantly, it is highly effective and the results last longer.”

Who is an ideal patient for Geneveve?

“I used to think only peri- and postmenopausal women and women who gave birth vaginally would be candidates for this type of treatment. I was totally wrong. I didn't realize the magnitude of the problem. So many women can and do benefit from Geneveve. I have treated women who used to get up three times a night to urinate and now can get through whole night without going to the bathroom. There are moms who can now sit through nine innings of their child's baseball games without having to go to the bathroom thanks to Geneveve.

“A patient of mine with multiple sclerosis used to wear adult diapers when she exercised because of incontinence. Not anymore. Women no longer leak urine when they laugh, sneeze, cough or work out. This is huge. Some menopausal women can't take systemic estrogen replacement therapy for health reasons and until now, these women needed to use estrogen cream to treat severe vaginal atrophy. This treatment has such a dramatic improvement on women's quality of life.”

Is there a Geneveve treatment protocol?

“I have two physician assistants and one nurse practitioner who perform Geneveve. The standard protocol comprises 110 pulses with the wand rotated clockwise, but we are now doing a study where we are increasing it to 220 pulses to see if we can achieve even better stress urinary incontinence outcomes. Women see results after one treatment, and I recommend they come back in one year for a maintenance treatment. There is no downtime and no risk associated with Geneveve. Women get off of the table and can go back to work or home.”

Have a new device that you are thrilled with? Are your patients raving about the results? Let us know. We would love to feature your experience in this column. Drop us a line at