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The Vagina Epilogue

By Karen Asp
Posted On Jan 26, 2017
The Vagina Epilogue

Everyone’s favorite body part is getting lots of attention, as women explore new ways of correcting and enhancing their vaginas.
Here’s the 411 on vaginal rejuvenation and its sister surgeries.

When you want to change how you look,you diet and exercise—and maybe even go in for a little nip-and-tuck. When you experience relaxation, a surgery called vaginal rejuvenation comes into play. Through this procedure,the vagina and its surrounding structures are tightened. While it might sound slightly unnerving or over the top, women are more interested in this surgery than ever before. In 2012, more than 3,500 procedures were performed in the United States—up 64 percent from 2011, according to the American Society for Aesthetic Plastic Surgery (ASAPS).

Credit the increased demand in vaginal rejuvenation to women becoming more educated about how these procedures can change their lives. “Women want to take control of their bodies and sexuality,” says Nicole E. Williams,MD, board-certified gynecologic surgeon and founder of the Gynecology Institute of Chicago. “It’s all about feeling good about yourself from the top to the bottom—and this is the bottom.”

While many such procedures have come under controversy, they offer significant hope to women who have been too embarrassed to talk about these issues in the past. If this sounds like you, it’s a good time to see whether vaginal rejuvenation or similar surgeries that improve the aesthetics of the genitals are in your future.

Vaginal relaxation is a little-talked-about side effect of child birth, especially if a woman has delivered vaginally and has had several kids. “There’s nothing abnormal about vaginal relaxation, as every woman who goes through a vaginal delivery—even if you’ve had a C-section but were pushing for hours before it—experiences this,” says Wesley Anne Brady,MD, medical director of the Women’s Wellness Institute of Dallas in Texas.

Some women, however, experience it to a greater degree than others. The age at which you deliver, the number of children you have,and the size of your babies are two contributing factors. Exercises such as kegels, which involve the contraction and release of the pelvic floor muscles, can help restore some of that muscle tone. However, they do little to pull the muscles back into place.

The downside of vaginal relaxation, says Williams, is inadequate friction or sensation during intercourse, which can lead to a decrease in gratification for both partners.Some women develop medical issues such as urinary stress incontinence—meaning that they leak small amounts of urine when laughing,exercising, or coughing—or pelvic organ prolapse, where a pelvic organ like the bladder drops from its normal spot.

While childbearing is the primary cause of vaginal relaxation, age is also a contributing factor. The vagina is no different from other muscles like the triceps and quadriceps:“Normal aging can cause pelvic floor muscles to lose support, which makes them loosen,”Brady says. Genetics are likely another reason for this issue, especially in women who have never had children.

The Surgery Scoop

Vaginal rejuvenation, or vaginoplasty, is a procedure that can be performed surgically or via laser. Two main things happen: The vaginal muscles and their support tissues are brought back together, and excess skin is removed. “As a result, you increase vaginal tone, strength,and control,” says David Matlock, MD, president of the Laser Vaginal Rejuvenation Institute of Los Angeles, who pioneered the laser version of this procedure. 666_ny_celeb-web-post_flower-2-1140x650

This leads to more gratifying sexual experiences,and may correct medical issues such as urinary incontinence. It’s important to note that this surgery does not address libido or difficulty achieving orgasm. These conditions are better served by hormone replacement therapy.

This procedure generally leads to a boost in one’s self-esteem. “Our sense of self can be affected by our genital attractiveness,” says Denise Baker, MD, board-certified gynecologic surgeon in Bradenton, Florida. “The ability to enjoy our sexuality shouldn’t be limited to women who have perfect anatomies.”

Surgery, however, isn’t the only option. Fillers,can be used to plump up the vaginal area, even the G-spot (technically termed the GräfenbergSpot—a bean-shaped area known to be an erogenous zone). The best filler is actually a woman’s own fat, Baker says. Radiofrequency and infrared technology are two other alternatives—both of which stimulate the body’s production of supportive tissues like collagen and elastin.

Shaping Up

While vaginoplasty helps women to regain sexual gratification and correct medical issues, other surgeries go a step further and offer women the opportunity to “reshape” their vagina. These have been dubbed “designer vagina surgeries,” and for good reason: “For 99 percent of women who request these surgeries, it’s all about aesthetics,” Matlock says.

Some women, for instance, undergo labiaplastyto correct long or uneven labia, the lips of a woman’s genitals. Other procedures include perineoplasty to improve the perineum, the visible area between the vagina and rectum, and clitoral hood reduction, which can increase orgasm potential. Many women have these procedures while undergoing vaginal rejuvenation.

Don’t be fooled, thinking these are simply women who are unhappy with their bodies. For the majority of women, changing this part of their anatomy will significantly improve their self-confidence and the overall quality of their lives. “I have patients who are embarrassed to be in bathing suits, who have never been seen nude by their husbands because of how their genitals look, and who have quit extracurricular activities like sports because of their anatomy,”says Baker. Wearing a bathing suit, for example, may reveal a larger-than-expected genital area, while exercising or playing sports can be downright uncomfortable. “These women need to know that there’s no ‘normal’when it comes to how the female genitals should look,” Baker continues, “and that there are things they can do to increase their confidence and enjoy an active lifestyle again.”

Baker recalls one particular patient who underwent labiaplasty. This woman, whom Baker describes as gorgeous, had been happily married for more than a decade and had a vibrant sexual relationship with her husband.  However, her self-confidence was fractured by the “extra stuff.” Even though she had an amazing figure, she didn’t feel comfortable wearing a bathing suit and was often distracted during sex. After surgery, everything changed. “Even her husband was amazed by the increase in herself-confidence,” Baker says.

The Full Picture

Vaginal rejuvenation and related procedures don’t come without controversy regarding their success and efficacy. In 2007, the American College of Obstetricians and Gynecologists (ACOG) issued a statement advising against cosmetic vaginal procedures, noting that these procedures “are not medically indicated, nor is there documentation of their safety and effectiveness.”

In addition, the ACOG statement lists infection, altered sensation, pain, adhesions, and scarring as potential complications that may result from these procedures. It also recommends that women who are seeking to improve sexual response be examined for sexual dysfunction and then consider nonsurgical options like counseling before going under the knife. Medical experts who practice vaginal rejuvenation procedures don’t deny the risks involved.“Every surgery, no matter what it’s for, comes with risks,” Williams says.

That’s why you need to vet your physician carefully and choose a board-certified surgeon who’s had training in vaginal surgery. Look for individuals from ACOG, the National Society of Cosmetic Physicians, the American Urogynecologic Society, the American Academy of Cosmetic Gynecologists, the International Society of Cosmetogynecology, or the American Society of Plastic Surgeons. Ask for “before and after” photos, too, as well as testimonials. The chance to chat with former patients is a great way to learn about their physician experience.

Brady agrees with ACOG’s position that these aren’t actually medically necessary vaginal rejuvenation procedures. “They’re elective,and no more necessary than a face lift,” she says. She also concurs that there isn’t good data to prove their efficacy. “We don’t have long term studies yet, although some new research is showing promising results.”

A review published in The Journal of Sexual Medicine says that among women who have completed vaginal aesthetic and functional plastic surgeries, complications were minor and patient satisfaction was high—generally in the 90 to 95 percent range. Sexual satisfaction was also over 80 to 85 percent.

Not that Brady or any of these experts needs science to tell them that these procedures work. As Williams says, “In the right hands,these procedures can be life-altering.”

just the facts, ma’am

Here’s a quick snapshot of
what you can expect when you
undergo vaginal rejuvenation:

Average cost:
$2,342, according to 2011 statistics from
ASAPS. Unless it’s being done for medical
issues, insurance doesn’t cover it.

Length of surgery:
one to two hours

Recovery time:
Approximately six weeks

Restrictions when recovering:
No activity during the first three
weeks, and then only light activity like
walking for the next three weeks. No
lifting anything heavier than 10 pounds
for the first six weeks. No intercourse
for at least six weeks.