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Surgery for a long time taboo which has experienced significant development in recent years under the influence of the United States (vaginal rejuvenation), vaginoplasty or reduction of the vagina is a specialized surgery which can give very good results provided that the operative indication is correct. posed and that the surgeon perfectly masters the technique.

The most frequent request concerns the narrowing of the vagina (tightening or strapping). The vagina is loose, wide, too soft, gaping, distended, dilated and the pleasure less intense. Often the request is made after multiple deliveries, but not always.

The basic principle of this surgery is to tighten the vagina. An injection at the G-spot can sometimes be associated as well as a nymphoplasty .

First of all, a careful clinical examination should be carried out so as not to make a mistake in the diagnosis and not to miss another problem (prolapse, descent of organs, fistula, incontinence, etc.). Once the vaginal open bite is confirmed, the patient's request should be carefully considered at the risk of disappointing her. An honest, clear and precise explanation should be the rule. We must not make false promises or have too much expectation, beyond what the surgery could bring.

Before considering surgery, it is often necessary to consider pelvi-perineal rehabilitation, as after childbirth. Sometimes this only solution can be effective provided it is followed well (at least 3 months or even 6). In case of failure of rehabilitation, one can consider a surgical intervention.

Several surgical techniques exist:

• Vaginoplasty Light: Lipofilling or hyaluronic acid

  Lipofilling: The intervention consists of taking the fat from a place where it is present in excess such as in a liposuction (stomach, sides, hips, thighs, knees ...) and after having centrifuged and purified it to inject it circumferentially under the vaginal mucosa. The fat applied in this way reduces the diameter of the vagina. It is a simple, painless solution that lasts over time. The anesthesia does not have to be general and the hospital or clinic stay is very short (outpatient surgery). The pain is moderate and it is possible to return to work the next day or two. The main risk is injury to the urethra during the injection. This technique is performed in moderate vaginal openings.The result is immediately visible but a resorption of 30% of the injected fat should be considered within 3 months after the operation. On the other hand, the 70% of fat that is taken will remain permanently. The prices and tariffs depend on the anesthesia chosen and the quantity of fat to be injected.
  Hyaluronic acid : Hyaluronic acid is a molecule naturally present in the body and absorbable. The principle is exactly the same as for lipofilling except that in this case there is no need for anesthesia other than local and the hyaluronic acid is absorbable, i.e. it will disappear over time ( on average 12 months). It is therefore necessary to redo the injections every year. The price depends on the amount of hyaluronic acid to be injected.

• Surgical vaginoplasty or vaginoperineoplasty

  Technique heavier than the first 2 and described more than 30 years ago, reserved for large forms of vulvar open bite. The principle is to remove all the excess mucosa in the vagina (vaginoplasty) and reattach the vagina to the levator muscles (perineoplasty). The simple act of removing the mucous membrane from the vagina without fixing or strapping the levator floor muscles does not give any result. The consequences are longer than in light vaginoplasty (hospitalization required at least one night, sometimes urinary catheter, pain 10 to 15 days, professional eviction 10 to 15 days. The main risk is injury to the urinary tract as well as recurrence. .