What is vaginal rejuvenation?

Vaginal rejuvenation — also called posterior colporrhaphy or female genital surgery — refers to cosmetic surgery to change the appearance and improve function of the vagina and surrounding organs and tissues. Vaginal rejuvenation is a highly individualized treatment. Your plastic surgeon may treat one or more areas in one surgery. Depending on your personal goals, vaginal rejuvenation surgery can offer cosmetic improvements and enhanced sensation, as well as practical, medical and functional improvements.

Plastic surgeons can treat a wide range of intimate problems such as weak vaginal muscles, excess fatty or elongated skin folds and related discomfort. Vaginal rejuvenation can include vaginoplasty, which tightens loose vaginal muscles, and labiaplasty, which removes skin flaps or folds outside the vagina.

At The Ohio State University Wexner Medical Center in Columbus, our board certified plastic surgeons perform vaginal rejuvenation alone or in combination with other cosmetic surgery procedures such as liposuction and nonsurgical skin rejuvenation.

Why is vaginal rejuvenation done?

Normal, age-related loss of muscle tone, skin elasticity and contours affect vaginal areas, too. For some women, pregnancy, natural childbirth and hormonal changes have undesirable effects. Loose skin, fatty or drooping tissues and weak muscles can lead to frustrating complications. Even inherited traits, traumatic injuries, congenital defects or tears during childbirth may also need corrections. 

Women with an enlarged vaginal canal may no longer be able to wear tampons. Others may feel less confident with excessive, deflated or malformed and hanging skin in or around genital organs. Related problems include painful tugging sensations while riding a bike, avoidance of fitted lingerie and swimwear and changes in intimate sexual experiences.

During vaginal rejuvenation, doctors may perform one or more procedures focused on treating specific internal or external problems.

Common vaginal rejuvenation procedures include:

Labiaplasty – This surgery reduces oversized folds of skin called labia minora (inner lips) and labia majora (outer lips). It sometimes includes clitoral hood reduction and removal of excess folds of skin over or surrounding the clitoris.

Monsplasty – Vaginal rejuvenation may include monsplasty, which can raise or remove loose, excess or bulging skin and tissues over the genitals (mons pubis). The surgeon can also reduce the mons pubis in width or height.

Perineoplasty — This procedure restores skin and repairs defects between the vaginal opening and anus. Doctors treat natural or age-related problems as well as tissues torn during childbirth or resulting from an injury. In addition to repairing torn tissues, perineoplasty can reduce the size of the vaginal opening. 

Vaginoplasty – Surgeons use this procedure to tighten muscles of the vagina and correct any defects of the vaginal wall and vaginal opening. It sometimes includes the removal of excess skin and changing the size of the vaginal opening. 

Discuss vaginal rejuvenation with your Ohio State plastic surgeon. You might be a good candidate for female genital surgery if you meet these and other conditions:

  • You’re a nonsmoker
  • You don’t abuse drugs and alcohol
  • You don’t feel pressured by anyone else
  • You don’t have any medical conditions that affect healing
  • You’re in good overall health
  • You have realistic expectations

How to prepare for vaginal rejuvenation

When you schedule a consultation with an Ohio State plastic surgeon, you’ll have a chance to discuss your treatment goals, ask questions and learn more about vaginal rejuvenation procedures and any other cosmetic surgery options you’re considering.

During your office visit, you’ll learn about steps to take before and after your surgery. Preparation before your surgery may include:

  • Discussion of your surgery, including anesthesia and types of incisions
  • Directions about when to stop eating and drinking before surgery
  • Evaluation of your health and health history
  • Examination of treatment areas
  • Guidance about pre- and postoperative steps of your procedure
  • Instructions about medications and supplements to avoid before surgery
  • Questions about medications, supplements and drug allergies
  • Questions about alcohol and tobacco use

Before the day of surgery, you’ll receive additional individualized instruction, including:

  • Checklist for what to do and where to go the day of your procedure
  • Details about what type of results you can expect
  • Information about recovery and follow-up care

What to expect if you have vaginal rejuvenation

Vaginal rejuvenation procedures may be done under local or general anesthesia, and depending on the treatment, you may receive sedation to help you relax in addition to anesthesia. Your doctor may schedule the surgery in a hospital or Ohio State’s outpatient surgery center in Columbus or surrounding locations.

Your Ohio State plastic surgeon will make the incisions discussed in earlier office visits. The location, number and type of incisions vary with each person’s treatment plan and procedure. Each procedure has different steps, including:

Labiaplasty — The surgeon removes a crescent-shaped section of skin from each side of the labia major (outer lips) or other excess tissue, in addition to any needed resculpting. For labia that’s asymmetrical or otherwise not the shape or size that you’re comfortable with, the doctor may use liposuction [link to https://wexnermedical.osu.edu/plastic-surgery/cosmetic-surgery/liposuction] to transfer a small amount of fat from another fatty area of the body. During a labiaplasty, the surgeon can reduce or reshape the skin surrounding the clitoris (clitoral hood reduction).

Monsplasty — The doctor removes skin and fatty tissues from the area above the genitals. The amount of skin and fatty tissue removed can vary depending on your condition and the treatment goals discussed with your surgeon. In some instances, the doctor may use liposuction [link to https://wexnermedical.osu.edu/plastic-surgery/cosmetic-surgery/liposuction] to remove excess fat or to reshape tissues. Surgeons can perform liposuction procedures through a single small incision, so you’ll have minimal scarring.

Perineoplasty – Surgical methods vary by procedure and condition. In most instances, the surgeon makes a diamond-shaped incision around the vaginal floor. The surgeon cuts and pulls back skin and muscle tissues. The doctor removes any torn tissue and scars caused by episiotomies or other injuries. The surgeon may correct any other skin deformities before reconnecting separated tissues and trimming excess skin.

Vaginoplasty — The surgeon pulls vaginal muscles closer together to narrow and tighten the vaginal canal. The doctor may remove excess skin from vaginal walls and other areas in and around the vagina, including the vaginal opening.

Depending on your unique areas of concern, your Ohio State plastic surgeon can treat other problems inside or outside the vagina. When surgical procedures are complete, your doctor will close incisions using surgical sutures or similar methods. Then, the surgeon covers the closes incisions with gauze or bandages.

After vaginal rejuvenation surgery

Your doctor will talk with you about what to expect during recovery, depending on your procedure. Scars will fade in time. Although scarring is permanent, scars are usually discreetly located and minimally visible.

After vaginal rejuvenation surgery, you may feel a deep aching sensation that should go away within a few days. Your doctor can recommend or prescribe medication to keep you more comfortable during recovery.

Downtime can range from one to two weeks. Healing times vary, but most people take five days to a week off before returning to work or other routine activities. Avoid rigorous activity during this time and avoid other activities as directed by your doctor. You should not use tampons or have intercourse for eight weeks to allow treated areas to heal. Depending on the amount of vaginal tightening, your surgeon may talk to you about gradually using dilators to stretch your vaginal tissue.

Before you return home, your doctor will provide personalized instructions about what to expect, including home care and recovery. For a month or longer after your surgery, you’ll have frequent follow-up appointments. If you had non-dissolvable sutures, they’ll be removed during a postoperative office visit.

Results of vaginal rejuvenation

After your vaginal rejuvenation, you should notice visible improvements as postoperative swelling subsides. In addition, you’ll see smoother contours and enhanced muscle tone. Improvements vary with each person and procedure.

After vaginal rejuvenation, women typically report increased confidence and self-esteem, and enhanced sexual experiences. Others are no longer bothered by problematic external skin folds or other defects. You may also appreciate practical benefits, such as easier tampon use and having more clothing choices.

Results vary, and vaginal-area muscles, skin and tissues will still reflect the typical effects of aging, gravity and time. You can keep your body in ideal form by taking good care of your health. Your plastic surgeon can recommend head-to-toe products and therapies to help keep your body looking and feeling younger.

Risks of vaginal rejuvenation

As with any surgery, there are some risks with vaginal rejuvenation. These vary depending on your condition and the type or extent of your procedure. Risks associated with having surgery include poor reaction to anesthesia, infection, bleeding and pain, and other potential complications.

If you’re considering vaginal rejuvenation surgery, your Ohio State plastic surgeon will talk with you about likely risks relative to your health, medical history, condition and treatment goals. In addition, your surgeon will explain other potential complications, such as:

  • Blood clots
  • Changes in skin sensation
  • Persistent swelling
  • Results not as expected
  • Unfavorable scarring

Choosing one of the experienced and skilled, board certified plastic surgeons from the Ohio State Wexner Medical Center can lower the likelihood of complications. Certain lifestyle changes, such as quitting smoking and practicing a healthy diet and exercise habits, will also help lower your risk of complications from any surgery. 

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