Childbirth can stretch the vagina and the birth canal, reducing both tone and strength. An overstretched or wide vagina and the resulting smoothening of the area can reduce friction and pleasurable sensation during sex for both partners. It can cause intercourse to be painful and in some cases leads to urinary incontinence and even bowel movement issues.

Vaginal stretching can also lead to difficulty keeping tampons in place and may produce gas-like noises during intercourse.

Exercises—sometimes referred to as perineal and sphincter re-education—can help restore lost muscle tone while strengthening the pelvic floor. Kegel exercises are also helpful. The benefits of exercise can be limited, however, especially for women who have had multiple children.

An end to secret shame

For far too long, women have carried the secret shame of these problems. They were too embarrassed to raise the issue with their gynaecologists, and it certainly wasn’t being discussed in the media. Many women lacked adequate information about vaginoplasty, a surgical option available to correct their problems.

Thankfully, times have changed. Today vaginoplasty—or vaginal rejuvenation, as it is sometimes called—is discussed freely and is gaining in popularity. Anyone who has laxity of the vagina and is not pregnant is a candidate for this life-changing procedure.

A procedure whose time has come

Vaginoplasty was listed as the 18th most popular cosmetic surgical procedure in 2009 and 2010. According to the International Society of Aesthetic Plastic Surgeons, demand for vaginal rejuvenation procedures worldwide is increasing dramatically. From 2009 to 2010, the number of vaginoplasties jumped from 47,208 to 67,665, an increase of 43%.

During this period in Australia, surgeons performed nearly twice as many vaginal rejuvenations, from 428 surgeries in 2009 to 727 in 2010, a 170% increase.

Vaginoplasty may be part of a broader overhaul, combined with other female genital surgery such as labiaplasty, hymenoplasty (the surgical restoration of the hymen) or G-spot amplification.

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What to expect

Vaginoplasty usually takes about an hour. The procedure may be performed either under general anaesthesia or local anaesthesia with sedation. It is normal to stay in hospital overnight for observation. 

During surgery

During vaginal rejuvenation surgery, the stretched muscle at the back of the vagina is shortened and stitched together, generally with dissolvable stitches. Unwanted skin or excessive vaginal lining is removed, tightening vaginal muscles and the soft tissue around the vagina. The tools used to perform the procedure include a laser, scalpel, and stitches.

By reducing the diameter of the vagina and increasing tightness of vaginal muscles, vaginoplasty restores the vagina and the supporting structures to a pre-pregnancy state.

After surgery

To ensure proper healing, you will see your surgeon for follow-up appointments and check-ups. Some redness, swelling, bleeding and bruising are to be expected, and most women experience them after surgery. You may initially have difficulty walking, but most patients are able to walk comfortably within a few days.

Scarring, if any, is inside the vagina.

You will be able to see the final results of the tightening after two to three weeks, and sexual activity can generally be resumed after four to six weeks, depending on the individual patient’s healing.

The best surgical outcomes result when both patients and surgeons do their part to ensure success.

Do’s and don’t before vaginoplasty

There are several things you can do to prepare for any surgery, but this is a list of specific do’s and don’ts related to preparing for vaginoplasty:

• Avoid any food and drink for 10 hours before the surgery.
•  Do not engage in sexual intercourse the day before a vaginoplasty. It is necessary to maintain the vaginal tissue in its regular state prior to surgery.
•  Arrange to take a few days off work. Walking may be difficult, and the demands of work may stress your body.
•  Get ready for your recovery. Before your surgery, have everything that you will need to stay at home during the recovery process.
•  Follow your surgeon’s instructions. You may need to provide blood, urine, and pap-smear tests prior to the procedure.
•   Expect a pregnancy test. Vaginoplasty is not performed on pregnant women. Expect a routine pregnancy test prior to surgery.

After vaginoplasty

In addition to following the general steps that can speed up the healing process—limiting activities, caring for the wound area, etc. —there are important things you must do after your vaginoplasty procedure.

•  Monitor post-surgical redness, swelling, and bruising. Talk to your surgeon immediately if any redness or swelling persists for more than a week, is far more serious than you have been told to expect, or occurs suddenly.
•  Watch for signs of infection. Excessive redness or tenderness around the incision area or an unusual discharge from the surgical wounds cans be signs of a problem.  Notify your surgeon immediately. You may need an additional check-up.
•  Monitor post-surgical bleeding. Non-dissolving stitches that are inadvertently pulled can cause bleeding. Should you experience this or any other kind of excessive bleeding, contact your surgeon immediately.

Possible risks and complications

There are a number of complications that can occur as a result of any surgery. The best way to reduce surgical risk is to choose a fully qualified surgeon with formal training in vaginoplasty surgery who has performed the procedure many times.

Unlike most other cosmetic procedures, and despite increased demand for the procedure, there is little scientific evidence to suggest that the benefits of vaginaplasty outweigh the risks.

Some complications that may occur after this surgery include:

•  Reduced pleasure during sexual intercourse. Fibrous bands or adhesions may form between organs and tissue during the healing process, causing pain during intercourse.
•  Altered sensation may occur as a result of nerves being cut or damaged during the procedure. This can be semi-permanent and disappear over time, or can be permanent and alter sensations forever. Some women will feel some degree of vaginal numbness, making sexual penetration less pleasurable than before.
•  Dyspareunia or pain during intercourse can also occur as a result of vaginoplasty.
•  Damage to other organs is another risk. The bowel, bladder, ureters, and vascular structures are all in close vicinity to the vagina and may be accidentally damaged during surgery. Further surgery could be needed to correct such problems.

Just as you would discuss potential benefits before surgery, it is always advisable to ask your surgeon to address the potential risks as they apply to you. Your surgeon can also advise you on how to avoid or minimise some types of risk.

As with any surgical procedure, there are risks involved in vaginal rejuvenation. You should be fully aware of these before you elect to have the procedure. It is always better to err on the side of caution.

Rough costs involved

You can expect to pay around $7,900 (AUD) for a vaginal rejuvenation. The cost of the procedure varies depending on a variety of factors:

• Surgeon’s fee
• Assistant Surgeon’s fee
• Anaesthesiologist fee
• Hospital costs
• Follow-up visits during the first six weeks after surgery

You should expect the costs to be higher if you are having other procedures at the same time. Your surgeon will help you estimate potential costs during a preliminary consultation.

If your private fund does not have hospital cover, expect to pay an additional $2500 (AUD).

This information is correct as of 2019.