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Through the years a woman’s body will evolve as a result of child birth, hormonal transformations, and aging. Previously, there were limited options available to address the issues that can occur as a result of these life changes. New technologies are now available to provide women with broader alternatives to address these changes safely, comfortably, and effectively.

Plus 90 (formerly known as Votiva) for women is our newest treatment for labial and vaginal tightening.

It is comfortable and easy, and performed using only a simple topical numbing cream. It is a highly effective and relatively simple, non-surgical treatment for the management of many vulvovaginal issues. At Awad Medical Aesthetics & Wellness, Cathy Awad, Nurse Practitioner is excited to offer this new treatment to women suffering from a variety of vulvovaginal issues, including vaginal laxity, vulvar laxity, and stress incontinence.

Women wanting to improve their quality of life through our Plus 90 treatments will undergo a confidential personal consultation with Nurse Practitioner Cathy where she will gladly answer your questions. 

How Does It Work?

Plus 90 (formerly known as Votiva) treatments use radiofrequency (RF) energy to gently heat tissue and rejuvenate collagen with minimal discomfort or downtime. Using this RF energy, we are able to tighten external and internal vulvovaginal tissue via a temperature-controlled tip.

Plus 90 uses advanced technologies to address internal and external areas of concern.

What Does Plus 90 Treat?

  • Vaginal laxity: Plus 90 tightens the vagina at the opening and the full length of the vagina

  • Vulvar laxity: Plus 90 tightens the labial tissues and reduces sagging. It often results in softer and smoother skin that is very noticeable

  • Vaginal Dryness: Plus 90 can add softer and thicker skin and more moisture both internally and externally to make daily life and sexual intercourse more comfortable

  • Stress incontinence: Plus 90 can reduce leakage and may reduce urge symptoms

  • Orgasmic dysfunction: Plus 90 may give you increased sensitivity, as well as more coordinated and stronger muscular contractions


Is Plus 90 Right For You? Who Is A Candidate?

There are many women who are good candidates for this procedure. Childbirth, aging, and weight loss all contribute to poorly supported vaginal structures, characterized by laxity, sagging, and discomfort. as well as decreased sensation, dryness, and pain.

Every year many women seek treatment for the uncomfortable and sometimes embarrassing symptoms associated with weakened vaginal muscles. Symptoms like reduced sexual satisfaction and problems with urinary incontinence, as well as loose skin and vaginal protrusions can all have a negative effect on self-esteem and physical comfort.

Vaginal rejuvenation strengthens and tightens the walls of the vagina, restoring contour, enhancing muscle tone, and improving the physical appearance of the entire vaginal area, as well as the labia minora and majora.

What Can I Expect During Treatment?

A numbing cream is first applied to the treatment area before treating the areas with RF energy that stimulate tissue remodeling. Two different handpieces are usually used during your first session–one to cause shrinkage and tightening of the internal muscles and the labia, the other to improve wrinkles and skin tone. Patients can expect to feel a warm sensation during treatment with little to no discomfort during and after treatment. Some patients may have slight discomfort during and immediately after treatment. There is very little downtime from this treatment for most people.

How Does This Treatment Different From Other Treatments?

Surgical procedures such as vaginoplasty or labioplasty require incisions and injectable anesthesia, and therefore carry additional risks. Plus 90 is non-surgical and is based on radiofrequency (RF) heat. Surgery is often reserved for more severe cases, while Plus 90 is recommended for women who have mild to moderate anatomical changes or other symptoms such as decreased lubrication or painful intercourse. By actually rejuvenating the tissue both internally and externally, Plus 90 is also capable of achieving more than just tightening and reduction achieved with surgery.

How Many Treatments Are Required?

The majority of patients require two to three sessions about 3-4 weeks apart, and most patients notice a difference after only one treatment. Many of our patients tell us they see results immediately, with continued results over the following weeks. Patients may require maintenance treatments once a year.

Vaginal Rejuvenation with Plus 90 is not just an aesthetic procedure – it is a functional procedure. After vaginal birth of their children or due to normal aging, many women will notice some loosening of the vagina. Frequently the vaginal muscles will become “stretched” and women may experience a reduced sensation of intimacy and/or orgasmic dysfunction. As well, stress urinary incontinence, such as involuntary loss of urine when laughing, sneezing, coughing, and/or exercising becomes a concern as they lose muscle tone, strength, and control.

Do you have another question that wasn’t addressed here? Please feel free to contact us with any questions or concerns you may have!





The O Shot

What is an O-shot?

The O-shot (a.k.a. orgasm shot) is a cosmetic procedure to enhance female sexual wellness. Platelet rich plasma is a substance derived from a patient's own blood containing stem cells and growth factors. Injections of PRP around the clitoris and within the vaginal walls can promote blood flow and cell growth to increase sensitivity, sexual desire, and enhance sexual sensation.

What cosmetic concerns does an O-shot procedure treat?

  1. Feminine Sexual Wellness: Injections of PRP into erogenous zones, like the clitoral area, vulva, and vaginal walls, stimulates blood flow and new tissue growth to enhance sensitivity.

  2. Mommy Makeover: An O-shot can help women experiencing changes in sexual function following a pregnancy.

Who is the ideal candidate for an O-shot procedure?

The ideal candidate for an O-shot procedure is a woman experiencing difficulty achieving orgasm and/or those with urinary incontinence. An O-Shot is not recommended for those seeking treatment for certain sexual dysfunctions like dyspareunia.

What is the average recovery associated with an O-shot procedure?

There is little to not downtime associated with an O-shot procedure. Patients may feel a sense of fullness in the vaginal area, experience an altered urinary stream, or notice swelling for a few days. All normal activities, however, including sex, may be resumed the same day.


What are the potential side effects of an O-shot procedure?

Possible side effects from an O-shot procedure include bleeding, consistent discomfort at the injection site, persistent arousal, constant vaginal wetness, altered vaginal sensations, hypersexuality, hematuria, or inconsistent results.

What can someone expect from the results of an O-shot procedure?

The results of an O-shot procedure will be immediately noticeable, and typically last six to 12 months at which time maintenance treatments will be needed. Results vary widely among individuals.

What is the average cost of an O-shot procedure?


An O-shot procedure can cost anywhere from $500+. This can be combined with other treatments and price may vary when used to compliment another treatment. 

FYI: We offer this treatment for men too, known at the 'P Shot'. 

BHRT: Bioidentical Hormone Replacement Therapy


The body has many different types of hormones. Some of the more known hormones are estrogen, progesterone, testosterone, cortisol, DHEA, and thyroid hormone. They work together to control body functions. Keeping them balanced is important for good health.

As aging occurs, hormone levels can change, and while some hormones may increase, others may decline. These changes can create a state of hormone imbalance. Many age-related diseases and health challenges are commonly associated with hormone imbalance, and Bioidentical Hormone Replacement Therapy can help a number of these syndromes caused from hormonal imbalances.


  • Menopause

  • Perimenopause

  • Andropause

  • Adrenal Fatigue

  • Chronic Fatigue

  • Hypothyroidism

  • Hyperthyroidism

  • Fibromyalgia

The symptoms of hormone imbalances are many, and may include fatigue, weight gain, loss of muscle strength, anxiety, depression, mood swings, brain fog, irritability, PMS, menstrual irregularities, hot flashes, infertility, sexual dysfunction, thinning or loss of hair, swelling, headache, insomnia, dizziness upon standing, hypoglycemia, and sensitivity to weather changes or smells.

Combining a complete history and evaluation of signs and symptoms with the hormonal test results, such as saliva or blood testing, our Bioidentical Hormone Replacement Treatment Specialist will work with patients to jointly create a health care plan to address individual health concerns.

Our BHRT specialist can help clients decide if Bioidentical Hormone Replacement Therapy is an appropriate option for them to consider. Other treatment options may also be recommended, such as lifestyle changes, diet modifications, supplements, or other therapies. Through Bioidentical Hormone Replacement Therapy clients have an alternative path back to health and wellness. Please follow the link to see Linda, our BHRT NP virtually to start your journey. 


The Femi-Lift

A woman’s vaginal area contributes to her sense of femininity. Any issues that affect this most private area can either give her confidence in intimate situations or make her feel quite uncomfortable. Labial rejuvenation helps with the common problems that women face today.

For women who wish to obtain labioplasty while avoiding surgery, we offer the Femi-Lift. The Femi-Lift is a safe and comfortable way to treat the labia and surrounding area, for enlarged labia and laxity of the surrounding skin tissue. Using our new, state of the art radiofrequency device, get the results of traditional labioplasty, without the risks of surgery and associated downtime.  

Catherine Awad, Nurse Practitioner is our expert who will perform this procedure. She is experienced in women’s health from a primary care perspective, which makes her an excellent choice for anyone interested in this procedure. She will do a full consultation and discuss your options for treatment.  

Please contact the clinic or use the online portal to book your free consultation. 

Our Nurse Practitioner is certified in Primary Health Care, and offers fee for service care for accepted clients. Clients must be screened prior to being accepted.  Services are not covered by OHIP, yet receipts are provided and may be claimed on some third party insurance benefits. 

Plus 90 Information Brochure
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