Times change. I would never have believed you if you told me twenty years ago that I would be performing vaginal and genital rejuvenation surgery as part of my plastic surgery practice. Not that it is a large part of my practice, but there is an increasing number of patients asking for this type of cosmetic plastic surgery, as women know that it exists and that there are plastic surgeons who can help them achieve the results they want.

There are four main procedures in vaginal rejuvenation. The procedures are intended to correct the deformities that usually occur either genetically or as a result of the hormonal changes that follow pregnancy and their effects on the peri-vaginal tissues. Reconstruction of the hymen obviously falls into a separate category.

All of these surgeries are usually performed as an office procedure under local anesthesia as an outpatient surgery.

Labia majora surgery

The labia majora consist of the outermost tissues of the female genital organs. With age or as a result of the effects of pregnancy, these areas either become loose or their volume decreases. The surgeries involved in labia majora rejuvenation include:

1. Fat injections – fat is removed via liposuction from one area of the body and injected into the labia majora
2. Excision of the skin around the labia majora

Labia minora surgery

The labia minora are the smaller inner flaps of tissue directly next to the vaginal opening. With pregnancy, they often become larger and darker, and their excision is one of the most common surgeries in this area. The excess tissue is cut and the edges of the labia are sutured together.


With vaginal birthing, the tissues of the vagina undergo an amazing amount of stretching and sometimes rupture. Episiotomies can lead to a controlled enlargement of the vaginal opening, but, nevertheless, in all three situations the vagina’s integrity is compromised to some degree.

Vaginoplasty is a procedure to tighten the lax vagina by decreasing the diameter of the vaginal opening through removal of excess mucosa and tightening of the muscles.

Reconstruction of the hymen, or hymenoplasty

In some cultures, an intact hymen is an absolute prerequisite for marriage. The hymen, which is a small flap of circumferential tissue about 2 cm inside the vaginal opening, is frequently torn with the more active lifestyles of women these days. Riding a horse, for example, will rupture the hymen, and you will no longer be considered a virgin! Be that as it may, reconstruction involves freshening the edges of the tissues or the elevation of new flaps of mucosa and reconstruction.

Common risks of genital surgery

1. Infection – low risk, but antibiotics must be taken
2. Bleeding – very common to have spotting for several weeks after surgery; the tissues in these areas are very friable, and they swell and bleed easily; the bleeding is usually self-limited and stops with pressure
3. Wound disruption – very common, again because of the type of tissue; wounds may need to be re-sutured or, in some cases, left to close on their own secondarily
4. No sexual relations for at least six weeks after surgery until healing has occurred

Correction of physical deformities or changes in the vaginal area are possible, and the results are gratifying for patients who may have had years of feeling self-conscious about their bodies in this area.


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