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Doing Repair 'Down There'

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woman in her underwear

Maggie Baumann, MA: According to the American Society of Plastic Surgeons, cosmetic (a.k.a. "aesthetic") surgery is still big business, despite our economic downturn. Some of the most popular cosmetic surgeries today include rhinoplasty (reshaping the nose), breast augmentation and liposuction. Minimally invasive cosmetic procedures (which are less costly) -- such as Botox, chemical peels and hyaluronic acid fillers -- have actually increased in number during this recession. Now there's a new hot cosmetic surgery: the vaginal facelift.

This can include vaginal rejuvenation/tightening, labia reduction (of either the labia minora or labia majora) and clitoral-hood reduction -- all of which can help you achieve a symmetrical, "less bulky" look. Yes, female genital surgery is one of the fastest-growing cosmetic surgeries out there.

Vaginal rejuvenation surgery"The procedure actually tightens the vaginal canal all the way up to near the top of the vagina," explains Dr. Red Alinsod of the Alinsod Institute for Aesthetic Vaginal Surgery in Laguna Beach, California. "It is for women who have had large babies or traumatic deliveries and whose vaginal opening is so wide it can prevent them from having enjoyable sex." According to Dr. Alinsod, widening of the vaginal canal can result in reduced friction (i.e., pleasure) for both partners; the goal is to reduce the diameter of the vagina by 50 percent or more, to create the sensation of tightness and help improve intimacy. Tightening surgery can be superficial and only involve the opening (a surgery called "perineoplasty"), or it can involve the full length of the vagina ("vaginoplasty"). Gynecologists and urogynecologists typically perform the deeper vaginal procedures; most plastic surgeons concentrate on external labial procedures only.

Labiaplasty, or labial reduction surgery"Torn or malformed labia minora can be caused by a trauma -- such as a biking accident or giving birth -- or, more commonly, by simple genetics, wherein one side of the labia is bigger than the other," says Dr. Alinsod. "Sometimes the labias are so large, both sides drop down to the inner thigh -- which can cause embarrassment to women in tightfitting or wet clothing. However, the majority of patients requesting labiaplasty do so to improve their physical appearance, even if they have normal-sized and -shaped labias. It is a personal choice to improve their self-confidence." Dr. Alinsod says that labia minora plasty is commonly requested by women in their 20s and 30s; he's even treated teens. Women in their 40s and 50s, on the other hand, tend to request labia majora plasty; they apparently feel that their labia majora are "saggy" due to aging, and therefore not pleasant to look at. (Some surgeons use the patient's own fat to plump up this area; in South America -- particularly in Brazil -- many surgeons use permanent fillers.) 

Dr. Alinsod prefers a formal surgical labia majora plasty -- a modification of a partial vulvectomy. He says that removal of the excess majora tissue results in a more youthful and tighter vulvar appearance, with "less sweating" (as compared to fat injections). Vaginoplasties and the like are considered elective aesthetic plastic surgeries (read: not covered by insurance) and are most often performed on an outpatient basis. (Dr. Alinsod performs his surgeries in his office, using local anesthesia.) If pelvic reconstruction and incontinence surgery is required, however, a one- or two-night hospital stay may be called for. "Many of my patients want to have their leaky and fallen bladders and fallen rectums repaired, then have the entire vaginal canal narrowed -- all in one hospital stay," notes Dr. Alinsod. "They also want to get a vulvovaginal facelift at the same time."

How safe is it? Well, blood loss from the surgery is common, but generally is not a safety issue. Nerve damage is extremely rare -- though pain with intercourse can be present early on, when things are quite tight. There's a small (about 1 percent) risk of damage to the bowels. It usually takes six weeks for the wound edges to close completely; softening of the scars from sutures may take an additional two to four weeks. (To be safe, don't plan on having sex for two months.) The typical vaginoplasy costs approximately $7,000, with labiaplasty of the minora or the majora priced at just a bit less (around $6,000). The cost of a surgical suite and anesthesiologist will usually run you extra, unless the doctor performs the surgery in his/her office (as Dr. Alinsod does).

And now the big question: Is it worth it? Well, that answer is up to you.

What's your opinion on the "vaginal facelift?" Share your thoughts.

23 comments so far | Post a comment now
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