Vaginoplasty is a broad term that may be used to indicate several different types of surgery. It may be performed to address defects or pathologies such as pelvic organ prolapses, or as part of the transition process for transgender women, but in this article we will talk about the cosmetic colporrhaphy or cosmetic surgical tightening of the vagina. This is a common procedure in the category of designer vagina surgeries and treatments and is sometimes paired with a perineoplasty, the procedure that tightens the perineal muscles and the vaginal opening, in which case the combination of the two is called colpoperineoplasty.
During their life, up to 76% of women will experience decreased genital sensation, mainly described as a feeling of a wide vagina; this may be due to the physiologic aging process, weight gain and weight loss, pregnancy and childbirth. For this reason, there has been a rise in demand for surgeries to increase the sensation of the female genitalia which can result in improved sexual satisfaction both for the patients and for their partners. Moreover, the cosmetic vaginoplasty by tightening up the muscles may also alleviate stress urinary incontinence (SUI) which is the leakage of urine when coughing, sneezing, laughing or exercising but this may require the execution of a perineoplasty at the same time depending on the specific case.
Cosmetic vaginoplasty procedure
The cosmetic vaginoplasty can be performed both under local and general anesthesia, although most patients prefer the general anesthesia option; at the same time, a pudendal block is often performed: it is a type of local anesthesia that uses lidocaine to block signals from the pudendal nerves which innervate the pelvic region, thus relieving pain for 16-24h after surgery. Surgery lasts 1 to 2 hours and other designer vagina procedures may be performed at the same time. There are a few different surgical techniques: lateral vaginoplasty, anterior vaginoplasty, posterior vaginoplasty and laser vaginal rejuvenation (LVR).
Depending on the patient’s characteristics, symptoms and expectations and after consultation and careful examination the surgeon will advise the best technique; the surgeon’s knowledge and experience will influence the choice as well.
The different surgical procedures provide a slightly different outcome and have a slightly different risk profile.
In all surgical techniques, an incision on the vaginal mucosa is made and the tissues are dissected to reach the underlying fascia and muscles. After tightening up the muscles and the fascia with resorbable sutures, the excess vaginal mucosa is resected and the edges are stitched. For the superficial stitching non resorbable sutures may be used which will require removal after 8-14 days.
Laser Vaginal Rejuvenation (LVR)
Laser vaginal rejuvenation (LVR) is a trademarked term by Dr. Matlock a gynecologist in Beverly Hills, California, who in the 1990s marketed the colpoperineoplasty procedure for cosmetic purposes conducted with a laser cutting tool. In this case, laser does not indicate that is one of the nonsurgical options for vaginal rejuvenation, but that the tool used to cut is a laser which minimizes the bleeding. Depending on the surgeon, other surgical tools that may be used to cut are the scalpel and scissors, the electrocautery and the radiofrequency devices.
Cosmetic Vaginal Tightening Recovery
The cosmetic vaginoplasty may be carried out in an outpatient setting or may require a 1-night up to 3-nights inpatient stay, depending on the surgery.
After the procedure you should rest for about 1 week before resuming work and daily activities; during this time the area will need to be washed gently with soapy water and there may be some pain, but you’ll be prescribed a pain medication and antibiotics to cover that and to prevent infections.
You should refrain from activities such as lifting something heavy, strenuous exercising, riding bikes, motorbikes, or horses for 4-8 weeks as well as avoid penetrative intercourse for about 6 weeks. Tampons should also not be inserted for a few weeks, stick to your surgeon’s advice.
Vagina Tightening Contraindication
There are a few contraindications to the cosmetic vaginoplasty:
- Future pregnancy. If you are planning to get pregnant in the future, the vaginoplasty may not be indicated for you.
- Severe stress urinary incontinence. If you want this surgery to address severe stress urinary incontinence, this may not be your best option: talk with your gynecologist.
- Vaginal prolapse. If you suffer from vaginal prolapse or pelvic organ prolapse, this is not the right surgery for you, talk with your gynecologist.
- If upon physical examination there is no looseness of the vaginal mucosa and good muscle tone, you may not need this surgery at all, or you may want to check the noninvasive options for vagina rejuvenation.
- If you have active infections, you should get those treated before undergoing surgery.
Surgical Vagina Rejuvenation risks and complications
As any other medical or surgical procedure there are some risks involved when undergoing a cosmetic vaginoplasty.
Surgery will cause some swelling of the tissues for up to 4 weeks and for this reason may cause troubles in emptying the bladder; in this case, a catheter is placed for a few days.
Overcorrection may result in painful intercourse and will require the use of dilators.
Other risks of this surgery are the risk of localized infection, postoperative bleeding, wound breakdown, recurrent vaginal laxity or decreased sensation, vaginal pain, cystotomy, proctotomy, and fistulae.
Most patients don’t experience complications and are satisfied with the surgery; to reduce the risks, it is important to choose a skilled surgeon with extensive experience in vagina rejuvenation procedures.
Price of cosmetic vaginoplasty
The cost of the surgical vaginal rejuvenation varies depending on the chosen surgeon and clinic, on the type of vaginoplasty procedure performed (laser or traditional, anterior, posterior, etc.), nights spent in the hospital, and on the country where you are undergoing treatment.
On average, in the USA the price of the cosmetic vaginoplasty is 7,500-9,500 USD
In Australia, the price is 10,400-12,000 AUD (7,350-8,500 USD).
In the UK the price for cosmetic vaginoplasty starts at around 6,000 GBP (7,850 USD).
In Thailand, the average price of cosmetic vaginal tightening surgery is 38,000-116,000 THB (1,200-3,700 USD).
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L Triana – Springer, 2020
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MN Cohen, SR Thaller – Thieme, 2018
- Female Cosmetic Genital Surgery – Concepts, Classification, and Techniques.
C Hamori – Thieme, 2017
- American Society of Plastic Surgeons (ASPS)
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