Vaginal rejuvenation procedures or cosmetic surgery of the female genitalia includes:
- Labiaplasty (reduction of the skin folds around the vagina)
- Monsplasty contouring the pubic mound
- Clitoral hood reduction (reducing excess tissue of the hood of the clitoris)
- Vaginoplasty (usually to tighten the vagina)
- G-spot enhancement (to increase sexual responsiveness and pleasure)
Women choose genital cosmetic surgery to improve the appearance of their genitals, alleviate symptoms, or enhance sexual pleasure. There is a very high rate of satisfaction with the results of these procedures.
Labiaplasty is a plastic surgical procedure to change the shape or size of the labia minora or labia majora.
Enlarged labia can cause pain due to friction with activities and sexual intercourse, as well as self-consciousness and inhibition during sexual intimacy. Enlarged labia may also cause self-consciousness in tight fitting clothing and swimsuits (“camel toe”). The psychological and physical benefits of plastic surgery of the female genitals can be quite substantial in improving self-esteem and decreasing discomfort.
The labia majora are the outer skin folds surrounding the vagina; the labia minora are the inner skin folds. The female external genitals are called the vulva and include the labia, clitoris, clitoral hood, urethra (urinary opening) and the vagina. The labia minora surround the urethra and vagina and extend from the clitoral hood to the posterior border of the vagina. The labia majora extend from the mons pubis (pubic mound) to the perineum (the area between the vagina and the anus).
The size, shape, and color of the labia minora normally varies considerably among women, and it is not unusual to see considerable asymmetry (differences between the two sides): one of the labia minora is normally larger than the other. The labia minora may be hidden by the labia majora or protrude beyond the labia majora. The labia minora often enlarge during sexual arousal.
The labia minora may change in size due to genetics, hormonal effects (pregnancy), or as a result of mechanical effects, such as piercing, sexual intercourse, or activities like bicycling or horseback riding.
The labia majora and mons pubis may change as a result of pregnancy, aging, weight gain or loss.
- Edge Resection: Surgical trimming of the outer edge of the labia minora to reduce its size. This is the simplest surgical technique, leaving a less wrinkled and pinker edge to the labia minora.
- Wedge Resection: This surgical technique reduces the size of the labia minora by removing a pie slice-like wedge from the labia minora and stitching the remaining edges back together. This technique preserves the wrinkled edge and pigment of the labia minora.
- De-Epithelialization: Removes just the top layer of skin from the middle portion of the labia and stitches over the area to shrink the labia. This also preserves a wrinkled edge to the labia minora, but is useful for only limited reductions and recurrence is more likely than other techniques.
- Clitoral Hood Reduction: Surgical trimming of excess thickness or amount of tissue of the clitoral hood. Too much reduction is to be avoided to prevent overexposure hypersensitivity of the clitoris.
- Laser Labiaplasty: Usually involves the de-epithelialization technique. Studies show little or no advantage to using the laser, despite claims of quicker healing, which appear to be more a marketing ploy. There are reports of increased incidence of cysts forming after laser labiaplasty.
The labia majora procedures include:
- Reduction: This can sometimes be done with liposuction, rather than surgical cutting of tissue.
- Augmentation: if the labia majora have become deflated, fat grafting can restore volume and shape.
Vaginoplasty is performed to reduce (or widen) the vagina to enhance sexual intercourse. Surgical or laser reduction can be done to tighten the vaginal canal, if Kegel exercises to tone and strengthen vaginal muscles are not producing adequate results.
Surgical labioplasty and vaginoplasty procedures are normally done as an out-patient procedure, with either oral sedation and local anesthetic, or with intra-venous sedation.
Dissolving sutures are used. Patients will apply antibiotic ointment and wear a pad for 5-7 days. Most sports, vigorous exercise, tight clothing, insertion of tampons, and sexual intercourse must be avoided for a minimum of 4 weeks, to allow for adequate healing of these delicate tissues. Patients may shower immediately, but avoid soaking in a bath (or pool) for 1 week. Most patients will use some amount of pain medication for a day or two, post-op.
Potential complications are infrequent, but may include:
- Suture line separation
- Pain with intercourse
- Unsatisfactory appearance (under-correction, over-correction, or asymmetry).
Costs for these procedures vary, and are seldom covered by insurance, because they are usually elective cosmetic procedures, rather than medically necessary.