What is Surgical Vaginal Rejuvenation?

The fastest growing segment of cosmetic surgery for the past decade has been female cosmetic genital surgery.  Originally, “vaginoplasty” was the term used for the surgical repair of the vagina for both functional and aesthetic reasons.  Vaginal tightening surgery was called “vaginoplasty” by surgeons.  Many phrases have been used to describe what is surgically done and the catchall phrase lay people have seen is “vaginal rejuvenation.”  The term has been used to refer to both labiaplasty (labial reduction) and vaginoplasty (vaginal tightening).  The branded name “Laser Vaginal Rejuvenation” has even gained national attention.  The term is owned by David Matlock, M.D., and is a marketing term not found in traditional medical textbooks.  It has gained worldwide exposure and is sometimes mentioned now in more academic writings.

Genetic reasons, birth trauma, stretched tissues, and improper episiotomy and surgical healing are the usual reasons for requesting consultations.  Surgery entails a modification of a standard procedure called “posterior repair” or rectocele repair or levatorplasty.  This procedure was traditionally performed for prolapsed rectum, or rectocele.  Rectocele is a bulge of rectum going into the vagina akin to a vaginal wall herniation.  A similar appearing bulge is an enterocele. It is a bulge of small bowel going into the vagina.  Repairs by lasers have no advantage over other modalities and can be more destructive than radiofrequency surgical devices.

In recent years reconstructive vulvovaginal surgeons have popularized these aesthetic and functional genital procedures and have helped provide legitimacy worldwide glucophage xr koupit.  It was only several years ago when many medical practitioners attacked cosmetic vaginal surgery as barbaric, unnecessary, and frivolous. Baby boomers wanting a renewal of their genital conditions drove the acceptance of these procedures and fueled the growth of this subspecialty.  Women did not want to live with unflattering, sagging, and large labias, nor did they want to live with gaping vaginas and decreased sensation when sexually active. Young women wanting a pleasing appearance of their genitals and older women wanting to repair the ravages of childbirth and time forged into the forefront to look and feel 21 again. Southern California became the birthplace of this movement.  Both labial repairs and vaginal tightening surgeries blossomed in California and spread worldwide.

Gynecologists, Urologists, Colorectal Surgeons, Urogynecologists are the specialists with the most advanced training in these types of advanced repairs.  Urogynecologists have years of additional training working specifically on the pelvic floor.  Plastic surgeons have the years of training on face/body and more recently have included external genital surgery as part of their field of expertise.  Plastic surgeons and cosmetic surgeons rarely have the training required for deep vaginal surgery required for vaginoplasty surgery but can be very adept at perineoplasty surgery for improving the external look of the vaginal opening and providing tightness specifically at the entry into the vagina.  Vaginoplasty typically takes about 60 to 90 minutes to complete depending on if other pelvic reconstruction procedures are needed.  It is often accompanied by slings for incontinence and bladder repairs for fallen bladders.  Very few surgeons are able to do this in an office setting.  Specialized protocols for in-office vaginoplasty surgery can save thousands of dollars, improves safety, and decreases risks.

There has been great controversy whether vaginal rejuvenation can improve the pleasure of intercourse. There are no randomized controlled studies showing that narrowing the vaginal canal improves orgasms or dramatically alters a woman’s sex life. However, more and more studies have come out in the past few years to show the improved sexual satisfaction patients report after posterior repairs, pelvic reconstruction, and vaginoplasty surgery.  Reports of improved sexual sensation from increased friction are by anecdotal experience and less scientific surveys. However, many couples do report more satisfying lovemaking, more tightness, and a belief that surgery has helped their sex lives.

There are only a handful of surgeons who perform these surgeries in adequate numbers to be proficient. Technical skill is of paramount importance but having an artist’s eye is of equal value. The cost of a vaginoplasty is approximately $7,500, perineoplasty is about $4,500, and labiaplasty at $6,500. Insurance companies do not typically cover these surgeries. However, repair of cystocele, rectocele, enterocele, fallen uterus, and slings for incontinence are covered. Vaginal rejuvenation can be combined with pelvic prolapse repair. Some women even have their tummy tucks and breast augmentations done concomitantly as part of their “extreme makeover.” Plastic surgeons and gynecologic surgeons have improved their working relationships by learning a great deal from each other’s specialties.