People may assume that vaginal rejuvenation surgery, such as labiaplasty, is purely cosmetic. However, these procedures can improve not only the appearance but also the sexual function of the vagina and vulva.
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“The majority of women seek this for sexual reasons — the function is not what it should be. Appearance is secondary,” says Marie Fidela Paraiso, MD, Section Head of Urogynecology and Reconstructive Pelvic Surgery.
She has counseled hundreds of women who sometimes bring photographs of their body to their appointment to help explain the problems they are encountering.
Why do women seek vaginal rejuvenation?
Women may seek vaginal rejuvenation, such as labiaplasty and vaginal reconstruction, because of:
- Sexual problems after childbirth. Vaginal rejuvenation can help address genital scarring or lost muscle tone, which can happen after childbirth and make sex uncomfortable or unsatisfying.
- Congenital concerns. Some women are concerned about the shape and appearance of their labia (the external portion of their genitalia).
- Changes after menopause. Post-menopausal women may have lost muscle tone in their vagina, which may limit sexual pleasure for both themselves and their partners.
- Desire to boost their self-image. Some women seek vaginal rejuvenation to enhance their self-confidence.
What happens during vaginal rejuvenation surgery?
After an initial consultation, Dr. Paraiso typically prescribes physical therapy with or without biofeedback or function electrical stimulation to see if exercises can remedy a woman’s concerns. For example, Kegel exercises, also called pelvic floor exercises, can help strengthen vaginal muscles and improve sexual pleasure by increasing pelvic floor tone.
If physical therapy does not help, she discusses what type of procedure might best treat a patient’s particular problem.
She performs vaginal rejuvenation with either a laser or through plastic surgery, or both. It typically is done in one procedure. As it is an elective cosmetic procedure, insurance does not typically cover it, she says.
What do critics say about vaginal rejuvenation?
Vaginal rejuvenation is controversial in the United States and elsewhere, Dr. Paraiso says.
“Some people feel that women seeking the procedure are succumbing to outside pressures. But in my experience, 90-95 percent of the time, the patient desires it for herself. Her decision is not based on her partner or husband,” she says.
Less controversial is vaginal laser therapy. The vaginal laser treatment performed at the Cleveland Clinic, MonaLisa Touch, was approved by the U.S. Food and Drug Administration for gynecologic use in 2014.
It uses laser technology to help treat:
- Vaginal atrophy
- Vaginal pain during intercourse (dyspareunia)
- Potentially urinary incontinence and urinary urgency (often related to estrogen declining after menopause)
This procedure has been successful for the majority of patients, Dr. Paraiso says.