women’s genital surgery

Women's Genital SurgerySydney plastic surgeon Dr Laith Barnouti explains the fundamentals of vaginal tightening and labial reduction surgery.

It is widely accepted these days for a woman to elect to have antiwrinkle injections to erase wrinkles, or surgery to refine her nose and enlarge her breasts. It is no longer shameful or embarrassing to want or to undergo cosmetic surgery to correct areas of the body causing concern or to improve the wrinkles that come with ageing.

Likewise, more women than ever are concerned with the appearance of their genitals or a lack of sexual gratification. Women are much more aware of the function and aesthetics of their vagina. There is an obvious, direct connection between a woman’s comfort level with her genitals and her sexual enjoyment. A large number of women who would like to improve the appearance of their genitals or enhance their sexual satisfaction are seeking cosmetic surgery procedures such as labioplasty or vaginoplasty.

Vaginal rejuvenation is cosmetic plastic surgery of both the vagina and the labia to improve their appearance and to tighten and tone the pelvic floor muscles. This restorative surgery can be performed simultaneously to beautify the vaginal area, enhance vaginal tone, improve muscle strength, increase voluntary control of the vagina and strengthen the tissue of the perineal body between the vagina and the anus. It can be a direct means of enhancing one’s sexual life once again.

Causes of outstretched vagina

Vaginal dilatation can be an unwanted result of childbirth, ageing, muscular deconditioning or a combination. The muscles are relaxed and have poor tone, strength and lack control. The internal and external diameters of the vagina increase, and the muscles of the perineum may be weak and poorly supported.

Many women find that while the experience of childbirth may be the most rewarding of their lives, sometimes the after-effects for both their sexual partner and themselves is not as satisfying as it once was. Under these circumstances, the vagina is no longer at its optimum physiological state. As a result, sexual gratification is diminished. Some of the causes of outstretched vagina include:

  • Childbirth If a woman has had multiple births, this problem can worsen each time she experiences childbirth and the muscles usually do not return to their pre-pregnancy size.
  • Trauma during delivery
  • Developmental disorders Some women have a loose vagina even if they have never had children.
  • Ageing process This can lead to loss of substance and elasticity in the vagina and vulvar structure.
  • Epiostomy Some women elect to have vaginoplasty surgery to repair a badly healed incision from episiotomy during childbirth at the perineum between the vagina and the anus.

All of these factors can result in increased vaginal laxity. The increased size of the vagina means there is usually a lack of friction during sexual intercourse, therefore reducing the likelihood of sexual satisfaction and reaching orgasm. It can also has a negative impact on self-esteem.

Careful assessment of signs and symptoms and a thorough clinical examination will precede the surgical decision. Any co-existing vaginal disease or infection will be diagnosed and treated before embarking on surgery.

Alternatives such as Kegel exercises and medical therapies will also have to be taken into account.

Vaginal tightening procedure (vaginoplasty)

Vaginoplasty is primarily a reconstructive procedure. It is performed to rejuvenate and tighten a women’s vagina by decreasing the diameter of the vaginal walls, resulting in increased friction during intercourse. By removing excess lining, repairing the soft tissues and reconstructing the perineal/pelvic floor muscles, this procedure returns the vagina to a more ‘youthful’ state.

It also creates greater contraction, strength and tone, which can permit greater sensation during sex for the woman and her partner and make the vagina more appealing aesthetically. Couples report an overall improvement in their quality of life after a vaginal tightening procedure.

Women's Genital SurgeryVaginal tightening procedures are performed under local anaesthesia and some sedation (twilight sleep) on an outpatient basis. The patient can typically go home the same day and can return to work after around three to five days. After surgery, women may experience some mild discomfort and swelling, which usually disappears after around one to two weeks. Sexual activities cannot be resumed for four to six weeks to ensure the vaginal area is completely healed.

Most women are very happy after vaginal tightening surgery and they often wish they had undergone the surgery much earlier. Their regained vaginal muscle tone can significantly improve their quality of life. Generally, anyone in average physical condition and good health can be a candidate for vaginoplasty surgery.

Labial reduction (labioplasty)

Some women are born with an irregularly shaped or large labia that is embarrassing for them when they wear tight clothing such as a bathing suit or pants as their labia is very visible. Others develop misshapen labia after childbirth because it has been stretched during delivery and often doesn’t return to its normal size.

Others may feel unattractive or wish to enhance their sexual experiences by removing some of the skin that covers the clitoris. The purpose of a labioplasty is to better define the inner labia.

Labioplasty reduces and reshapes the labia minora (outside small lips) so it is more aesthetically pleasing. It also enables the patient to wear tight-fitting clothing without constant labial irritation. This procedure is designed to produce a more symmetrical appearance.

During the procedure, a wedge-shaped piece of tissue is removed and re-attaches the labia in a new position so that the inner lips no longer protrude beyond the outer lips.

Labial surgery is usually performed as day surgery, normally under local anaesthetic with or without twilight sedation. Patients can typically return home the same day and recovery is generally relatively quick. A burning or unpleasant feeling may be present but in general there is no need for painkillers.

After surgery, there is no normally no need for bandages. The area should be washed thoroughly with a hand-held shower head twice a day – personal hygiene is extremely important to promote rapid healing. Labioplasty surgery can be performed alone or in combination with a vaginal tightening procedure.

There is some controversy concerning the social acceptance and need for vaginal rejuvenation surgery. The decision to have the treatment is a highly personal one that not everyone will understand. What is important is how the individual patient feels about it. If they’ve achieved their personal goals and wishes through genital surgery, their treatment has been a success.