Have you ever heard of Perineoplasty? Possibly not. But you might have heard of Designer Vagina, an umbrella term to cover a number of procedures to tidy up the most intimate of areas. It's easy to mock vaginal aesthetics as the latest celebrity trend, but women no longer need to tolerate discomfort or loss of sensitivity during sex, or look at her vagina in the same way again.

What is Perineoplasty?

Perineoplasty is a simple surgical procedure that tightens up loose muscles around the opening of the vagina. It's usually combined with vaginoplasty (which tightens the muscles inside the vaginal) following child birth. (Don't forget about labiaplasty...read Labiaplasty: Why Women Care (Plus Pro Tips For Quick Labiaplasty Recovery).)

Vaginal rejuvenation procedures have become fashionable recently due to celebrity endorsement and perineoplasty is now increasingly performed alone to improve both the appearance of the perineum and loss of sensitivity.

Where is My Perineum?

You might not have even heard of your perineum, which is the area between the anus and vaginal opening. The perineal muscles determine the tightness of the entrance of the vagina and provide essential pelvic floor support.

What are the Benefits of Perineoplasty?

Almost 80% of women have experienced loss of sensitivity due to loss of muscle tone. Yet, tightening procedures such as vaginoplasty concentrated on tightening and repairing the muscles inside the vagina following childbirth, rather than tightening the opening. Women suffered in silence when loose muscles left their vagina gaping open which affected sensitivity during sex. This self consciousness can damage or even prevent intimate relationships.

However, vaginal aesthetics is no longer a taboo subject. Despite controversy, this procedure has both health and psychological benefits. It can provide relief from discomfort and pain and help women look and feel attractive again. (Read The Vajacial: An Intimate Treatment You Never Knew You Needed.)

What Causes Perineum Damage?

Muscles around the entrance of the vagina loose elasticity and start to sag for various reasons.

Childbirth

During a vaginal delivery the perineal muscles stretch from a smooth V shape to a U shape. If they don't snap back into shape after the delivery, the perineum gapes open, which can lead to stress incontinence and infections. Tampons can even fall out!

Episiotomy scarring

Sometimes the perineum is torn or needs to be cut during childbirth. (Known as an episiotomy). Poor stitching can lead to lumpy episiotomy scarring which can cause pain and discomfort during sex.

Obesity

Excess weight can stretch the perineal muslces until they loose elasticity.

Extreme weight loss

Perineal muscles droops permanently despite weight loss.

Dyspareunia/vaginismus

Perineoplasty is an effective for treatment of dyspareunia (painful sexual intercourse) and vaginismus (involuntary muscle contractions which prevent sex). The muscles are loosened instead of tightened.

Aging

Overtime the perineal muscles lose elasticity leading to a loss of sensitivity during sex.

What Are the Alternatives to Perineoplasty?

Pelvic floor exercises can help improve bladder control and loss of sensitivity during sex, but they need to be started before giving birth. Once the muscles have separated during labor, only surgery can repair them.

What Should I Consider Before and After Perineoplasty?

Make sure that your surgeon specializes in loss of sensitivity as well as tightening. Bear in mind that vaginoplasty surgeons tend to focus more on medical repairs rather than aesthetics.

What are the Risks?

Perineoplasty is considered safe and successful with a minor complication rate of just under 20%.

Minor risks

  • Bleeding.
  • Infection: treat with either antibiotics and/or drainage.
  • Inflammation/swelling.
  • Constipation.

Rare complications

  • Nerve damage.
  • Tissue adhesions.
  • Vaginal discharge with a foul smell.
  • Unsatisfactory results: not tight enough.
  • Unsatisfactory results: too tight so sex is painful. A stitch may need to be removed or special dilators used to stretch the vagina for several weeks.

Who Qualifies for Perineoplasty?

This procedure is not just popular with new mothers. Other candidates include people who have experienced vaginismus, loss of bladder control or loss of sensation during sex.

Are there Perineoplasty Myths and Misconceptions?

Please be aware that female genitalia varies enormously. Try not to compare yourself to images in the media which may well have been doctored.

Understanding the Perineoplasty Procedure

During the consultation your surgeon will conduct an internal exam to assess the perineal muscles and the width of the vaginal opening. This simple outpatient procedure takes between 30-45 minutes under local anaesthetic with mild sedation. Remember not to book your surgery during your menstrual cycle.

The surgeon starts by making a V shaped incision to the back wall of vagina and then peels back the opening of the vagina. Any lumpy episitomy scarring or excess skin is removed. The muscles are tightened and the edges of skin carefully stitched back together then the incision is closed with dissolvable stitches. Some surgeons use laser technology instead of a scalpel for improved precision.

Downtime

After a short recovery in hospital, you will be given painkillers and antibiotics and sent home to rest for a few days. While there is little discomfort, expect minor bleeding so you may need sanitary pads. The stitches will dissolve after two weeks and it is very important to keep area clean and dry to avoid infection.

  • Consume lots of liquid and fiber to avoid constipation.
  • No heavy lifting or exercising for four weeks.
  • No sex for four weeks or the incision may reopen.
  • Wear loose clothing and loose underwear for six weeks.
  • No tampons for four weeks.

What are the Best Recovery Tips Following Perineoplasty?

An experienced surgeon will recommend pelvic floor exercises one month before surgery and for 6-8 weeks following surgery to strengthen the re-attached muscles.

Non-surgical Vagina Face-lift.

Not ready for surgery? A non-surgical option for the time-poor is the Vagina Laser, a non-invasive procedure with much less downtime. A small wand is inserted into the vagina which delivers either radiofrequency or ultrasound laser energy to gently heat up the collagen.

Over the next three months the vaginal tissue gradually tightens up. A course of three is recommended, at least one week apart and results can last up to two years.