Deciding to go under the knife or needle for any reason is, needless to say, a big decision. What’s the best way to make a big decision? Arm yourself with as much information as possible. In this series, Ask AEDIT, we break down the best questions to ask before choosing to undergo aesthetic treatments and procedures with expert insight from the providers that perform them.
First things first, the most important thing to know about vaginoplasty is that it doesn’t actually refer to one specific surgery so much as it’s an umbrella term for a number of cosmetic gynecology procedures. “It can range from surgically removing skin and improving the appearance of the outer part of the vagina all the way to internal surgery to improve the bladder, pelvis, or areas related to sexual gratification,” explains Jason Emer, MD, a board certified cosmetic dermatologist in West Hollywood. As a result, women seek vaginoplasty to address both functional and aesthetic concerns.
Regardless of your motivation for considering the procedure, we’ve tapped top providers to answer the most frequently asked questions about vaginoplasty.
1. How Should I Choose a Provider to Perform Vaginoplasty?
As with any procedure — but especially a procedure in such a sensitive area — doing your homework is critical. Consider factors including a doctor’s experience and training (make sure they are board certified), how often they perform the procedure, and how comfortable you feel with them and their practice. Feel free to ask for patient testimonials and to see before and after photos.
2. What Are the Benefits of Vaginoplasty After Pregnancy?
It should come as no surprise that vaginoplasty is often a part of a so-called mommy makeover. “Among pregnant women, more than 70 percent will have a vaginal delivery,” explains Falguni Patel, MD, a board certified gynecologist and vaginal rejuvenation specialist in Matawan, New Jersey. “The trauma that the pelvic floor endures in that process is sometimes not recovered. As a result, the most common complaint is that sex isn’t the same anymore.” Vaginoplasty can, to a certain extent, “restore sexual youth,” she says, and that is a primary reason women want these surgeries. “The vaginal muscles are tightened in layers and excess tissue is removed,” she explains, which brings the vagina to a place more similar to where it was pre-pregnancy.
3. Who Is a Good Candidate for Vaginoplasty?
As mentioned, there are a number of factors (both physiological and aesthetic) that lead women to pursue vaginoplasty. “Anyone who is unhappy with the outer apperance of their vagina (perhaps there is loose skin or sagging), anyone who has desire to improve their sex life, or anyone who wishes to tighten the vagina” is a good candidate, according to Dr. Emer. Those with symptoms of urinary incontinence or pelvic floor issues are also good candidates, though, he notes, they may need more complex treatments. In such cases, the patient can “have a cosmetic improvement performed at the same time as a medical functional treatment,” he says. When there are medical concerns, they should first be evaluated by a gynecologist.
On the flip side, you are not a good candidate for vaginoplasty if you are still planning to have children. “The layers of repair will most likely be injured with another delivery,” Dr. Patel says. She does, however, recommend vaginoplasty for “any woman who has completed childbirth and is seeking pleasure during intercourse again.”
4. How Do You Prepare for a Vaginoplasty?
“Prior to the surgery, I like to recommend to my patients that they start stool softeners to avoid straining post-surgery,” Dr. Patel says. “Even if they don’t suffer with constipation, some may have constipation from narcotic use for post pain management.” Additionally, essential preparation before any surgery involves smoking cessation (if applicable), as well as discontinuing the use NSAIDs and medications with anticoagulant properties, “including supplements and vitamins such as fish oil, garlic, turmeric, vitamin E, and red wine, for at least seven days prior to the surgery,” she explains.
5. What Are the Risks Associated With Vaginoplasty?
“As with all surgical procedures, there are inherent risks,” explains Douglas Monasebian, MD, a New York City-based plastic and reconstructive surgeon. “Bleeding and infection are always possible complications of surgery. Swelling and bruising is common after surgery but temporary.” In the case of all cosmetic gynecology procedures, there is the possibility of decreased sensation. “There is a risk for slightly sensory disturbance, but this is very minimal,” he says, adding the surgery is generally a “predictable” one.
6. Does Insurance Cover Vaginoplasty?
Most of the time, no, insurance does not cover vaginoplasty because it is considered cosmetic surgery. That said, there are some cases in which vaginoplasty is deemed medically necessary. Generally, this is the case when there are issues including “pain, function, or refractory infections around the vagina,” Dr. Monasebian explains. Before sure to consult with your provider and insurance company about whether your procedure qualifies.
7. How Does Vaginoplasty Impact Sexual Health?
Vaginoplasty can improve sexual health and sexual pleasure. In fact, Dr. Patel says more than 99 percent of her patients find it has a positive impact. Fertility is not impacted, but sex may become more pleasurable. If it was previously painful, that discomfort is often resolved.
8. What Is It Like to Recover from Vaginoplasty?
Discomfort is common in the initial 24 to 72 hours post-surgery, though it is typically managed with pain medications. Generally, patients are advised to avoid sex for at least a month. “I routinely put patients on antibiotics to prevent any infections in the post-operative period,” Dr. Monasebian notes. Three to six weeks of post-op recovery are required before exercise and sex are allowed.
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