(The video below contains graphic medical images and nudity)
If you're feeling brave, you can watch Dr. Oppenheimer perform a vaginoplasty and perineoplasty. Childbirth can cause trauma to the vaginal area, causing symptoms of looseness and a loss of sexual satisfaction. Dr. Oppenheimer goes through the pertinent anatomy and the key steps to the procedure. This patient is asleep under anesthesia and had nerve blocks performed. The recovery is about 6 weeks, at which point the patient can resume intercourse. You can see before and afters HERE and see the postop instructions HERE.
I don't love the term "vaginal rejuvenation" because it's kinda vague. It would be like calling Botox "facial rejuvenation". It's not wrong, per se, it just doesn't tell the story.
So instead, I like to call each vaginal procedure just what it is. With the photo progression below you'll get my point. On the left is the preop view in a woman who had 3 vaginal deliveries and a history of several perineal tears during childbirth. She was unhappy with intercourse and the feeling of being "loose" as well as displeased with the appearance of her labia being "messy".
So the left is PRE, the middle is AFTER TIGHTENING and the right is AFTER LABIAPLASTY. Taken right in the OR so the appearance will evolve as she heals over the next 4-6 weeks.
Is this vaginal rejuvenation? Definitely! Is that vague? Yes! Is it easier to say than perineoplasty/vaginoplasty followed by labiaplasty? For sure. But knowledge is power so we might as well use our doctor words, shall we?
Tightening = vaginoplasty/perineoplasty
Labia minora reduction = labiaplasty
Vaginal childbirth, aging, and intercourse can often result in a "loose vagina." This is because the vaginal canal and muscles become stretched over time.
Vaginal tightening is a surgical procedure that makes the vagina tighter and more youthful. This fixes the appearance AND improves sexual satisfaction for a woman and her partner.
If penile implants are covered by insurance--and if Viagra is covered for that matter--then vaginal tightening should be too. Maybe when I'm the surgeon general.
85% of all women experience a perineal tear during vaginal childbirth, with half of those being "severe": involving the pelvic floor muscles. Half. Of. All. Women. Studies suggest that most of these women are asymptomatic, but the reality is that many women suffer from:
• a lack of mutual satisfaction during intercourse because of vaginal looseness,
• painful scarring from tears that cause dyspareunia (pain during sex), and
• insecurity about the appearance of a wide introitus (large opening)
It's not time to start the conversation. It's actually long overdue.
This is is a before picture of a 35 year old mom of three who had vaginal deliveries for each child. Her main complaints were all three of the above. When I asked her if she had any history of birth trauma (perineal tears or lacerations during childbirth) she said no, yet when I examined her she had moderate scarring of the posterior vaginal canal and a very short perineum with an obvious history of injury, and in addition she had a wide introitus (opening). As you might assume, women don't want anything inside to be visible from the outside, and that was another of her main concerns.
While physical therapy can help with some of these issues, a vaginoplasty or perineoplasty is a small procedure that actually resolves them. Here is our same patient immediately after a perineoplasty.
We're entering an era where taboo topics are vanishing, being replaced by empowered conversation and shared medical decision making. If you're experiencing symptoms related to vaginal childbirth, find a doctor who can help you put words to them. Vaginal looseness is common after vaginal delivery, but it isn't "normal" unless we allow it to be. Erectile dysfunction is common too, but in our society men deemed it unacceptable. It's time (long overdue) for women to do the same with vaginal laxity.