Vaginoplasty is a procedure that aims to "tighten up" a vagina that's become slack or loose from vaginal childbirth or aging.
After childbirth, women may complain of vaginal laxity, resulting from stretching of tissues and separating of muscles, sometimes to the point that a tampon falls out, and this lack of tone can contribute to $eksual dysfunction.
A vaginoplasty brings the separated muscles together, and the extra mucosa skin from the back side of the vagina is removed. The external skin can also be removed for a more aesthetic appearance.
A labiaplasty is a surgical procedure done to reshape a woman's labia minora—the inner "lips" of the vulva.
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The vagina lift also called vaginoplasty or posterior colpoperineorrhaphy, is intended to restore the anatomy of the vagina and perineum and is intended for all women who want to correct a sagging and distension of their vagina which has lost its tone after childbirth or from menopause. The intervention will strengthen the musculature of the perineum and allow the patient to regain sexuality "as before".
The vagina is a virtual cavity with important elastic properties. It can open and expand during sex and childbirth. Its tone is ensured in its lower half by the muscles of the perineum which form a very powerful muscular strap, mainly by the levator muscles.
Childbirth is a trauma to the vagina and perineum. During childbirth, even normal, they are often injured, and in the event of an episiotomy, which by definition cuts these muscles, the repair made on the spot does not always allow the perfect reconstitution of the musculature. It is often during the first childbirth that the damage is to be deplored, especially as the baby has too much weight for the size of the mother's pelvis. Even during an emergency cesarean section during a difficult childbirth, the perineum is also sometimes damaged. Despite a well-conducted perineal rehabilitation, the anatomical damage to the perineum is such that the vagina has distended and has become lifeless. However, the perivaginal musculature has a fundamental role during sexual intercourse, hence the major problems encountered, both in women and in their partners.
The woman “no longer feels anything” while her partner painfully observes the change as well and says “float”…
The difficulties encountered are not always expressed and are still experienced as a taboo subject. These women don't always get the listening they deserve.
Other disorders can also be associated, such as stress urinary incontinence which results in an involuntary loss of urine and the inability to hold back during various circumstances such as physical exertion, sport, laughter, etc. coughing, sneezing. These are urine leaks without the urge to urinate. This incontinence is a very disabling pathology in both everyday and sexual life and it sometimes severely compromises physical activity and social relationships. This pathology must be taken care of.
Posterior myography consists of tightening the vagina by reducing its diameter and restoring its tone in order to allow the woman to recover sensations during intercourse.
It is a question of reconstituting the muscular strap in the form of a sling which ensures the tone of the vagina and its contractility during sexual intercourse, especially during orgasm.
Perineum surgery is for all women who present with sexual disorders related to vaginal distension and sagging perineum following dilapidated childbirth.
This intervention can be performed after a period of 6 months after childbirth; this period will have been used for perineal rehabilitation (10 sessions). However, when the lesions are significant, rehabilitation is ineffective and it is useless to continue in the event of no improvement after about fifteen sessions.
The surgical tightening of the vagina can perfectly be done in a woman who still wishes to have children. If a new pregnancy is planned within a year, the procedure will be postponed until after the birth. On the other hand if this project is more distant, we will be able to practice the lifting of the vagina knowing that it will be necessary to discuss the indication of a classic childbirth or a cesarean according to among others the weight of the baby.
Reconstruction of the perineum can also be performed much later in women after menopause, the consequent hormonal deficiency revealing latent disorders.
If the muscular gesture is the most important, we can also make a gesture on the vaginal mucosa and a cutaneous gesture on the vulva.
Finally, stress urinary incontinence will be treated by minimally invasive surgery (placement of a suburethral band).
The clinical examination is at the same time gynecological, sexological and urological.
The questioning makes it possible to specify the discomfort felt, loss of sexual pleasure, the partner's feeling of floating. We will also learn about urinary disorders sometimes associated with a type of stress urinary incontinence (involuntary loss of urine during restraint efforts, running or laughing).
The questioning specifies the parity (number of children), their weight, the modalities of childbirth (episiotomy, forceps, epidural, tear and its method of repair).
The examination allows to note the anatomical state of the vulva (episiotomy scars), perineum and vagina (vaginal open bite). The vaginal examination tests voluntary contractions and makes it possible to assess its loss of tone. A complete gynecological examination looks for a possible associated lesion.
In postmenopausal women, we will find out about taking hormone replacement therapy which may be recommended in order to improve the trophicity of the perineum.
At the end of this assessment, Doctor Sylvie ABRAHAM, female cosmetic surgeon and sexologist, will tell you, depending on the nature of your lesions, the importance of the surgical procedures to be performed, muscular, mucous, skin and fatty. A suburethral sling may also be recommended.
All the information you need to understand your treatment will be provided to you during this consultation. Documents will be given to you so that you can read at home the essential elements for your decision and be able to ask additional questions during the next consultation, which will be free.
Post-operative advice and prescriptions are summarized in a personalized sheet.
Restorative intervention, posterior levator colpomyorrhaphy or vaginal tightening may benefit from partial coverage by health insurance. An estimate for the additional fees will be submitted to you. These fees may be covered, in whole or in part, by your complementary mutual.
The price of reconstructive surgery of the vagina and perineum therefore depends on your clinical case which determines the importance of the actions to be performed: muscular and / or mucous and / or skin and / or fatty.
A blood test is performed. A preoperative anesthetic consultation is scheduled at least 48 hours before your entry; the anesthetist will explain to you all the modalities of his gesture.
Quitting smoking is strongly recommended; any medication containing aspirin is prohibited. Trophic treatment via the vagina may be recommended as early as the preoperative phase. You will arrive in the clinic on an empty stomach for more than 6 hours.
The tracings of the incision are made in the operating room and photographs are taken.
The vagina lift is usually performed under general anesthesia.
Peri-dural anesthesia is also possible.
The final choice will be the result of a discussion between you, the surgeon and the anesthesiologist.
Doctor Sylvie ABRAHAM, female cosmetic surgeon in Paris and specialist in intimate surgery, adopts a technique which is specific to her and which she adapts to each case to obtain the best results. However, we can retain basic principles common to any vaginoplasty.
We describe here all the gestures; they are not systematically carried out, only according to your own lesions.
The incision is arcuate at the entrance to the vagina. The entire procedure is performed loosely which means that you will have no scar on your stomach, just a small invisible scar on the vulva.
The levator muscles of the perineum are dissected in the rectovaginal septum, then the ends are sutured together with absorbable thread in order to reconstitute the naturally present muscular strap. A vaginal mucosal plasty is sometimes associated. Finally, a cutaneous plasty of the vulva completes this intervention allowing to improve, if necessary, the episiotomy scar. The external scar is located on the midline between vagina and anus, about 3 cm long.
A possible lipomodelling (lipofilling or reinjection of fat) completes the procedure in order to pad the vaginal wall and ensure good trophicity. A fatty tulle is applied to the vulva as a bandage.
The duration of the operation is approximately 1 hour to 1 hour 30 minutes.
The stay in the clinic is one night with an exit the day after the operation.
-A nymphoplasty (reduction of the labia minora) is sometimes performed at the same time of operation.
-A amplification of the G-spot by lipomodelling (reinjection of fat) is possible, further improving the functional result.
-An episiotomy scar can be resected at the same time.
-Finally, a cure for stress urinary incontinence could advantageously be combined at the same time of operation with the placement of a suburethral band by the retropubic or transobturator route.
The immediate consequences are not really painful and the usual analgesics will ensure good comfort. Showers are authorized the next day. Local care is essential and you will be provided with strict instructions for personal hygiene.
Swelling (edema) of the vulva is usual.
It is recommended to sit on a special cushion called “perineum cushion” which makes the suites comfortable.
Minimal bleeding continues for the first days. The use of sanitary tampons is prohibited for 2 weeks. External healing is ensured in about ten days. If a suburethral tape is placed, urination is regularized in a few days.
A work stoppage of one week will be issued to you for your employer who will never know of its cause. You should refrain from any significant physical effort and from carrying heavy loads for 1 month. The resumption of sport is only possible at this time.
Sexual relations are possible after complete healing beyond the 3rd week. Their recovery will be gradual with the possible use of lubricants. The newly reconstructed vagina may feel a bit tight at first, and muscle repair gradually becomes more flexible with intercourse. Local trophic treatment may be advised.
The patient's compliance with the instructions given by the surgeon is essential
Doctor Sylvie ABRAHAM, female cosmetic surgeon, guarantees you a conscientious and considerate personalized follow-up. You can reach her at any time, 24 hours a day, for any post-operative question.
Post-operative consultations are included in the quote.
Surgical progress and current techniques for lifting the vagina now allow natural and aesthetic results to be obtained, while avoiding postoperative risks and complications as much as possible.
The results are assessed beyond the 3rd postoperative month. The vagina has regained a normal caliber and all its tone. This surgery allows the woman to recover a harmonious sex life and the couple to rebuild themselves. The reports become "as before" and the vagina recovers its tone which the woman and her partner perceive perfectly for their greatest pleasure. No scar is visible.
If a new pregnancy is planned, it will take 6 months to schedule it; a cesarean will be considered depending on the weight of the baby and the mother's perineum.
Doctor Sylvie ABRAHAM, specialist in intimate surgery, performs the procedure herself and provides post-operative follow-up; she will be able to accompany you throughout your project, before, during and after the operation.
In conclusion, vaginoplasty is a reliable procedure which, in the vast majority of cases, gives very good or excellent results in terms of functional, aesthetic and psychological benefits.