Everything You Need To Know About Vaginal Rejuvenation

Over the course of a lifetime, no one is immune to change. When it comes to the vagina: puberty, childbearing, and menopause are all milestone events that have an effect on sexual function, laxity, and appearance. These changes can, in turn, have a powerful impact on sexual pleasure, physical comfort, and self-esteem. As genital cosmetic procedures have become more widely available, it is no surprise that more people are attempting to reclaim their sexual well-being through surgical solutions.

Vaginal Rejuvenation Is on the Rise

Statistics show that over the last five years, trends in genital cosmetic surgeries have increased in popularity. Labiaplasty, the reduction of the labia minora, reached peak popularity in the United States in 2016, according to the American Society of Plastic Surgeons. Vaginal rejuvenation, which describes a number of different procedures that enhance either the appearance or the function of the vagina, followed shortly after. Since 2016, vaginal rejuvenation procedures have seen a 22 percent increase globally – the largest increase of any cosmetic procedure over the past three years.

As genital surgeries soar in popularity, the advent of minimally-invasive treatments, including laser and radiofrequency tightening, have only expanded the ever-growing menu of vaginal rejuvenation options. As more people seek out vaginal rejuvenation, the need to define complex terms and reinforce clear medical information has become more important. Rejuvenation is a term that evokes a sense of well-being and restoration and plays a key role within the marketing strategy of rejuvenation procedures.

The Different Types of Vaginal Rejuvenation Is and Who It Is For

We spoke with Ryan Stanton, MD, a board certified plastic surgeon in Beverly Hills, to get to the bottom of the conversation.

The AEDITION: What is vaginal rejuvenation?

Dr. Stanton: Vaginal rejuvenation, sometimes referred to as Vaginal Reconstruction when done for functional medical reasons, can include a whole host of procedures – most commonly vaginoplasty and/or Perineoplasty.

Vaginoplasty surgery is specifically performed to tighten the vaginal canal. It is sometimes referred to as a colporrhaphy, when it is done for medical functional reasons to strengthen the vaginal walls. Once the amount of tightening to be done is determined, a pie-shape wedge is marked to delineate the extra skin to be removed from inside the vagina. Beneath the skin, the tissues are tightened with strong sutures. Once the vaginal canal has been tightened, the mucosal skin is sutured closed. If there is external skin that protrudes, this can be reduced as well for a more aesthetic result.

Perineoplasty, on the other hand, is a procedure to tighten and support the opening (not canal) of the vagina, especially as it relates to the supportive network. This area is frequently damaged either by an episiotomy cut or a tear during a difficult vaginal childbirth delivery. A perineoplasty procedure involves removing any scarred tissue from this area and suturing back together the connective tissue network to recreate a supportive and snug vaginal opening.

The AEDITION: Are non-surgical procedures as effective as surgery when it comes to vaginal rejuvenation?

Dr. Stanton: The various lasers or infrared devices marketed as new minimally-invasive procedures with no pain or downtime to tighten the vagina are somewhat effective to a mild degree and on a limited patient population. They usually require a series of treatments up front and ongoing interval treatments to maintain the results.

They work by pulsing energy into the collagen layer of the vaginal mucosa, where concentrated thermal heating leads to swelling and some degree of collagen 'shrinkage' and secondary regeneration, producing increased resiliency of the vaginal canal. Tightening may also occur along the base of the overlying bladder, with evidence showing that it may also improve minor urinary incontinence. This is all true with one important and common exception regarding patients seeking tightening and incontinence repair: if the vaginal canal and/or perineum tissues have been mechanically damaged by vaginal childbirth, then these minimally-invasive procedures will more than likely not do the trick and surgery is the only real solution.

The AEDITION: Who are the best candidates for non-surgical vaginal rejuvenation treatments?

Dr. Stanton: The best candidates for minimally invasive treatments include:

• Women who have never had a vaginal childbirth but still feel they may be abnormally large or "loose" inside or may have a partner with a smaller-sized penis.
• Women with laxity after vaginal childbirth who plan on having more children but don't want vaginal tightening until after their final childbirth, at which time they may elect to undergo a permanent surgical tightening procedure.
• Women with mild urinary incontinence.
• Women with only modest vaginal laxity who wish to avoid a surgical procedure.
• Post-menopausal women with dry vaginal tissues who have not responded adequately to hormone replacement therapy.

The AEDITION: Who are the best candidates for vaginal rejuvenation surgery?

Dr. Stanton: The best candidates for surgical options include:

• Women with significant pelvic floor vaginal laxity involving significant widening and muscular separation from multiple vaginal deliveries, a history of vaginal tear and/or an episiotomy during delivery.
• Women with significant urinary incontinence and/or prolapse of the bladder, rectum, or vagina. These women need a surgical repair and a bladder “sling” procedure for those with incontinence.

The AEDITION: How long after a vaginal rejuvenation procedure should a patient wait to resume work, exercise, and sexual activity?

Dr. Stanton: Patients may resume nearly all activities including sex as soon as a couple days following the minimally invasive procedures. However, patients will want to take at least a full week off of work, three to four weeks from exercise, and six weeks from sexual activity following the standard surgical interventions.

The AEDITION: Do you have any other pre/post-surgery advice for patients to help ensure a smooth rejuvenation process?

Dr. Stanton: Like any medical procedure or surgery, make sure you are going to a reputable physician who you can trust and have good chemistry with. One who explains all the pre-op and post-operative instructions as well as potential risks and complications. Also, it is imperative that the patient follow these instructions to the T.

The Cost of Vaginal Rejuvenation

In addition to the physical qualifications for each of the procedures detailed above, an important factor for vaginal rejuvenation candidates to consider is cost. Fortunately, vaginal rejuvenation spans a wide price spectrum. On average, vaginoplasty costs $5,475 and perineoplasty costs $4,150. As for minimally invasive treatments, vaginal rejuvenation with laser energy can cost anywhere between $1,500 to $4,500 and radiofrequency treatment can cost anywhere between $800 to $1,200 per treatment.

A Patient’s Perspective on Vaginal Rejuvenation

Stephanie* chose to pursue vaginal rejuvenation after she developed urinary urgency from entering perimenopause in her late forties. The condition made it difficult for Stephanie to exercise and led to uncomfortable intimate relations with her husband. Because of her active lifestyle, Stephanie decided that the non-surgical Ultra Femme 360 procedure, which uses radiofrequency energy, was the best way to gain the tightening benefits of vaginal rejuvenation without disrupting her workout routine. We asked Stephanie to tell us about her rejuvenation journey.

The AEDITION: Did the radiofrequency treatment meet your expectations?

Stephanie: It was unbelievable! I noticed a significant difference after the first treatment. I had less urgency and couldn’t wait to see how (the rest of) the series would help me. After the second treatment, I was able to comfortably be intimate with my husband once again. After a series of four treatments, my condition had alleviated and as an added bonus, I experienced less vaginal dryness.

The AEDITION: How long after the procedure did it take for you to return to your regular routine?

Stephanie: There was virtually no downtime. It is a twenty-minute treatment, and you can resume your day with no discomfort, absolutely none. Only positive results!

The AEDITION: Did you require any follow-up treatments or procedures?

Stephanie: Not yet! However, my doctor recommended an annual treatment to maintain results.

The AEDITION: How has your life changed since having the procedure?

Stephanie: My intimate life has been significantly refreshed and my lifestyle is back to normal. In essence, I regained my life and feel in control again.

*Patient's name has been changed