Vaginoplasty surgery is a corrective cosmetic procedure which improves the functionality and appearance of the vagina and the surrounding structures. The perfect candidate for this surgical intervention may desire the cosmetic as well as the corrective/functional outcome. Many obtain a greater degree in sexual satisfaction with this procedure. It may also improve vaginal sensation in this area because of tightening of the vaginal walls. Most women experience a significant anatomical changes secondary to childbirth, which results in increased laxity of the structures: the birth canal and the surrounding tissue. Not only the vaginal walls undergo an extensive stretching but also the tissue around the vaginal opening leading to a widening of this area and "gapping" appearance. Frequently, there is a sudden change in the way the organs feel due to increased laxity with regards to bladder, bowel and sexual function.
What is the cause of vaginal laxity?
Multiple vaginal deliveries may lead to tears and relaxation of pelvic muscles, stretching of pelvic muscles and vaginal mucosa, loss in vaginal rugae and ultimately to excessive widening of vaginal walls.
Other potential causes of vaginal/pelvic relaxation could be hormonal changes, aging, genetic predisposition, weight gain, heavy lifting, excessive cough and physical activity.
Ultimately, these factors may lead to stretching, laceration and/or change in elasticity in the vagina and surrounding tissue such as perineum. Increased laxity and stretched pelvic and perineal muscles loose their ability to function properly. Childbirth remains one of the most crucial predisposing factors since stretching during pregnancy and vaginal delivery may lead to major anatomical changes of vagina and perineum.
What is a vaginoplasty procedure?
Vaginoplasty procedure is a cosmetic gynecological procedure which involves restoration and transformation of anatomy and anatomical functionality of the vagina in order to achieve more desirable appearance of this area as well as better experience during sexual activity. During vaginoplasty procedure the diameter of the vaginal canal is adjusted according to patients needs. The procedure also restores, tightens and improves the overall tone of vaginal walls and may improve the anatomical functionality. Frequently, a perineoplasty is performed in combination with vaginoplasty surgery since both anatomical areas are usually affected by stretching.
The levator ani muscles indicated by green lines need to be restored during a vaginoplasty procedure.
What is Perineoplasty ?
Perineoplasty is surgical procedure, which entails restoration of the anatomy and function of perineum. It includes repair of all affected, by stretching and other factors, perineal muscles and connective tissue. In order to properly perform the surgery, a good knowledge of anatomy is required. The end result of the procedure is a well restored and functional perineal body ( the distance between the opening to the vagina an the anus).
Is it possible to combine Vaginoplasty and Perineoplasty ?
Yes, it is possible to perform both procedures during the same surgery since frequently both anatomical areas are damaged and require a thorough repair. In addition to vaginal tightening, the opening to the vagina should be narrowed as well by combining both procedures.
What is laser vaginal rejuvenation?
Laser vaginal rejuvenation is an additional procedure which is performed using a laser technology to create vaginal ridges (rugae) in the vaginal mucosa. In addition to transformation of the vaginal surface, it may also result in narrowing of the vaginal canal.
The healing process takes about 4-6 weeks and every patient responds differently to the effect of laser energy.
How long is the recovery after Vaginoplasty?
Laser vagina The length of the recovery process depends on multiple factors such as the extend of repair, the degree of laxity and stretching of pelvic muscles and connective tissue, the desired extend of correction. Usually, it takes up to 4 weeks to be able to exercise and 8 weeks to be able to engage in sexual activity. Occasionally, the diameter of the vagina is too tight initially, which can be corrected by using vaginal dilators and estrogen cream.
Can the vaginal tightness be corrected or adjusted ?
If there is any evidence of too loose vaginal walls after a vaginoplasty procedure, a second surgery can be performed within one year at no additional surgeon cost. Prior to any surgery, a detailed discussion is conducted in order to determine the desired outcome ( tightness and opening of vagina).
Perineal muscles (Bulbocavernosus and Superficial transverse perinei) undergo tear and stretching during childbirth which may result in weakening of perineal body ( the area between the opening of the vagina and the anus). Depending on the extend of the tear, the area may vary in strength and support of the perineum. Potential outcomes of perineal tears include difficulties with bowel function, decreased sexual safisfaction and urinary incontinence. The most advanced degree of perieneal tear is 4th degree which extends to the rectal area. In the illustration a 4th degree perineal laceration is presented.