Vagionoplasty or vaginal tightening procedures are becoming more common and popular with patients.B It is part of the what is aesthetic genital surgery.
Patients that desire a vaginoplasty usually experience decreased vaginal sensation most commonly with the feeling of having more vaginal laxity usually due to childbirth.B They complain they are not as tight as they used to be.
It is thought that this decreased sensation is due to pelvic relaxation which in turn results in less friction durning sexual intercourse.
The goal of the surgery is to tighten the lower third of the vagina which includes the introitus or opening, hence the diameter of the vagina is reduced.B The perineal body is also built up; this is the area between the vaginal opening and the rectum.B This will result in more tone and improved sexual function.
My procedure of choice for vaginal tightening is to remove a small amount of tissue in the perineum and vaginal which enables meB to re-approximate the levator ani muscles which I feel is the key to providing more tone, and a smaller caliber vaginal width which producesB long lasting results.B Care must be taken to not tighten too much as this will result in painful intercourse and sexual dysfunction.
Other procedures reported in the literature for vaginal tightening include removing a strip of vaginal mucosa laterally.B I donbt feel this will hold up as well over time as the fore mentionedB procedure where the levator ani muscles are re-approximated.
There have been non surgical procedures described in the literature for vaginal tightening.B These include injections of ones own fat and fillers like hyaluronic acid.B Permanent fillers have also been injected, but long term studies as to their effect is lacking.B There have been reports of pulmonary emboli from these fillers causing death.
There was a study from Korea that used a 2940 nm Erbium:YAG laser to induce vaginal tightening. In their study of 30 women, they found that all patients had more vaginal tightening based on perineometer values at 2 months compared to baseline. The perineometer measures vaginal tone. The patientbs responses noted that 76.6% felt there was more vaginal tightening and 70% felt more sexual satisfaction.
1B Complications were minimal in the study.
Goodman et al. 2B did a cross-sectional study that includes 258 women with 341 different procedures performed by 12 different surgeons from 10 centers and 8 states.B B The procedures included labioplasties, clitoral hood reductions, combinations of the previous mentioned two,B vaginoplasties and other combination procedures.B In doing the retrospective analysis and following these patients 6-42 months, they found 92% of the patients were statisfied with the results of their surgery.B B There was a significant subjective enhancement in sexual function by both the women and their sexual partners.B This was statistically significant to the (p=0.0078) especially in the vaginal tightening group.B The complications sere minor andB acceptable to the patients.
Goodman3 did another study the following year to see if he could validate his previous findings.B He did a literature search on genital aesthetic surgery. He found the same results as in the previous study.B Here the patient satisfaction rate was 90-95% and sexual satisfaction was 80-85%. Hence, his conclusion was thatB female genital aesthetic surgery seems to fulfill theB patientbs wishes for functional and cosmetic improvement along with improved sexual gratification.B B Unfortunately, all the results in the literature were retrospective.
In conclusion, most patients were very satisfied with the outcome of their surgeries and the majority of patients who undergo a vagioplasty procedure report improved sexual satisfaction.