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  3. Perineoplasty

Perineoplasty

A perineoplasty is a surgical procedure that reshapes and tightens the area between the vaginal opening and the anus. This procedure is typically done after a woman has experienced one or multiple vaginal childbirths and is uncomfortable with the appearance of the perineum. A widened or scarred perineum can also have a negative affect on sexual activity and future pregnancies.

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The Skinny

Perineoplasty
avg. recovery
3 weeks
permanence
Is permanent
application
Surgical Procedure
surgical
Yes
cost
$500 - $7100

About the Procedure

During childbirth, it is common for women to experience a tearing or purposeful cutting of the perineum which is the area between the vaginal opening and the anus for easier delivery. This tearing of the perineum can cause a widening of the perineum which some women find aesthetically unpleasing. A teared perineum can also cause scarring which can make subsequent deliveries difficult and make vaginal sex uncomfortable. For women who desire a tighter appearance to the perineum for either aesthetic or health reasons, a perineoplasty, also called a perineorrhaphy, can be performed. A perineoplasty typically only requires local anesthesia and is done on an outpatient basis. Patients may be prescribed a sedative for improved comfort throughout the procedure. The patient will be positioned on a table with the legs spread. The incisions done during a perineoplasty will vary depending on the needs of the patient and may include additional procedures such as a vaginoplasty or labiaplasty. The procedure may be performed with either a traditional scalpel or with lasers. Typically, incisions will be made in a V-shaped pattern within the vaginal mucosa. Excess skin and any scar tissue is excised. The vaginal levator muscles are tightened. Internal and external closure of the vaginal mucous and perineal muscles are performed to achieve a tighter appearance and function of the perineum. Results are noticeable immediately after the 30-45 minute procedure.

The goal of a perineoplasty is to repair tissue in the area from the vaginal opening to the anus, tightening muscle and skin to address vaginal laxity and be more aesthetically pleasing.

Last Updated: 01.14.2020

What to Expect

A perineoplasty is a surgical procedure that reshapes and tightens the area between the vaginal opening and the anus. Here is a quick guide for what to expect before, during, and after a perineoplasty procedure.

Before Treatment

  • Stop taking blood thinning medications 4 weeks before and after
  • Stop taking diet pills and herbal medications
  • Diabetic medications should not be taken the day of surgery
  • Antibiotics may be prescribed

During Treatment

  • Local anesthesia with sedation
  • Incisions for a perineoplasty will vary depending on the needs of the patient
  • Typically, incisions made in a V-shaped pattern within the vaginal mucosa
  • Excess skin and any scar tissue excised
  • Vaginal levator muscles are tightened
  • Internal and external closure of the vaginal mucous and perineal muscles
  • Procedure complete in 30-45 minute procedure

Recovery Notes

Following a perineoplasty most patients are able to return to work within 1 week postoperatively. Spot bleeding is common in the first few days after surgery. Incisions should be kept clean and dry. Stitches typically dissolve within 2 weeks. To avoid constipation, drink lots of water and increase fiber intake. All normal activities can be resumed after 4 weeks however penetrative sexual intercourse should be avoided for 6 weeks.

Ideal Candidate

The ideal candidate for a perineoplasty has given birth vaginally and is experiencing vaginal looseness or itching, decreased sexual sensation, or changes in bowel habits. Patients who are suffering from similar symptoms caused by being overweight are also good candidates for perineoplasty.

Not Recommended For

Perineoplasty is not recommended for patients who are looking to treat dyspareunia, which is painful or difficult sexual intercourse.

Side Effects

Side effects of a perineoplasty may include over-tightening of the vaginal opening requiring dilation tools, infection, abscess, or formation of a fistula requiring a subsequent surgery.

Pros

  • tighten skin
  • tighten muscle
  • remove scar tissue
  • improved look

Cons

  • potential unsatisfactory results
  • results affected by future pregnancies

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