It’s no secret that the medical profession loves having its own language – but as helpful as it is for us to be precise amongst ourselves, we often end up confusing our patients. A classic example? The current terminology for all the reconstructive and plastic surgery procedures dealing with female genitals.
Anything from a complex anterior wall repair surgery to a “virginity restoration” gets lumped together and called a “vaginal reconstruction” or “vaginal rejuvenation.” In reality, these are all different and specific procedures – and the first step to determining if you should get one is learning which one you want.
Vaginal reconstruction versus rejuvenation: The basics
Both terms refer to a handful of different procedures. It would be impossible to cover all of them, but we can classify them into two distinct categories.
First, we have female reconstructive procedures. These full-blown surgical procedures restore or repair sexual function or a specific reproductive or sexual organ. These are often medically necessary and bring tangible effects to a patient’s physical or mental health.
Meanwhile, vaginal rejuvenation falls strictly within the cosmetic surgery specialty. Some types of rejuvenation involve surgery to modify the appearance of existing sexual organs, such as the labia or the vulva. Others use steam, lasers, or even massage to make the area look “younger.”
What is female reconstructive surgery?
The reconstructive surgery category seeks to create or repair different parts of the female genitalia. This may include the entire vaginal canal, the vaginal wall, or the pelvic wall (which separates and supports the vagina, rectum, and bladder).
These are all advanced gynecology procedures. Most of the time, they are performed by a gynecologist with extensive surgical experience and the assistance of a plastic surgeon. The main goal of these procedures is to improve function and health rather than appearance – although often, reconstructive surgeries do improve appearance.
What is pelvic reconstructive surgery?
A pelvic floor reconstruction is meant to tighten, repair, or reconnect the muscles around the vaginal wall or the pelvic floor.
In most cases, we do this for women who have a pelvic fistula – a connection or “tube” that joins two parts that shouldn’t be joined – or a prolapse (when the pelvic muscles fail to support the surrounding organs, which then begin to sag or press on each other).
This is the most common type of gynecological repair procedure. Depending on the size of the damage, we can “pull” the vaginal muscles using laparoscopic (keyhole) surgery. In more complex cases, we may need to go up the vaginal opening and use sutures (stitches) in the internal muscles.
What is a vaginal reconstructive surgery or vaginoplasty?
Vaginoplasties are much more complex surgeries, as they involve entirely building or rebuilding the vagina, vulva, clitoris, and labia — or performing extensive repairs. This may include creating a functional vaginal, removing vaginal tissue, or altering the size of the vaginal opening.
Sometimes, a vaginoplasty includes a labiaplasty (altering the size and appearance of the labia), a vulvoplasty (vulva reconstruction), or both. However, labiaplasties and vulvoplasties can also be done on their own, and as they don’t affect the vagina’s function, they are considered reproductive procedures.
What is a clitoral reconstruction?
Also called a clitoroplasty or a clitoral hood reduction, a clitoral reconstruction is probably the rarest type of reconstructive surgery. This surgery focuses on trimming or tucking the clitoris – the most sensitive part of the vagina, located right beneath the labia minora or inner labia.
Clitoroplasty is most often done to correct congenital issues: for example, some women may have an overly large clitoral hood. This can often rub against the skin, creating pain or reducing sensitivity. Clitoroplasties can also repair the damage done by female genital mutilation, which is fortunately rare in the U.S.
When are these surgeries necessary?
Sex and reproduction are central to our general health, mental well-being, and self-esteem. As a result, there are as many reasons for female reconstructive surgery as there are women getting them – and not all of them are physical.
Pelvic fistulas often result from accidents or previous surgeries. Occasionally, they can be congenital. While outwardly invisible, fistulas around the vaginal area can create a lot of complications, ranging from incontinence to pain during sex and frequent infections.
Pelvic prolapses usually happen because the muscles around the vagina progressively weaken over time, due to low estrogen levels after menopause, a hysterectomy, childbirth, or chronic disease.
Both pelvic floor repairs and vaginoplasties become necessary following cancer, chemotherapy, trauma, difficult childbirth, or malformations present from birth. When successful, these procedures can help minimize incontinence and make sexual intercourse more pleasurable.
Vaginoplasties are also done as part of gender affirmation surgery. In these cases, they’re usually accompanied by a labiaplasty, a vulvoplasty, and a monsplasty (which lifts the mound of skin in front of the pubic bone).
Almost every vaginal reconstruction procedure will be tailored to the patient and the degree of repair they need. For this reason, it is tough to give an accurate price tag.
As a general rule, pelvic floor reconstructions tend to be the cheapest and most likely to be covered by insurance. The heftier price tags often come with gender affirmation surgery: we are usually building new organs in these cases. This takes more time, pre-operative tests, and a longer post-operative recovery.
About vaginal rejuvenation
Vaginal rejuvenation procedures are often similar to reconstructive procedures. However, they are done to improve the appearance of the vagina. They only affect the outer genitals and rarely – if ever – involve altering the vaginal canal or the muscles beneath.
The most common procedures include:
Labiaplasty to trim the outer labia (labia majora) or to make them more symmetrical.
Minor vaginoplasties to make the vaginal canal narrower.
Clitoral hood reductions.
Perineoplasty, or “lifting” the skin between the vagina and the anus, so it looks firmer.
Hymen repairs (“virginity restore surgery”) to allow women to bleed the next time they have penetrative sex.
Laser procedures to lighten the skin around the vagina.
Infrared pulses that will make vaginal tissue firmer.
All these procedures have one thing in common: they aim to make genitals look more aligned with a specific beauty standard. For women self-conscious about their genital’s appearance, vaginal reconstruction procedures can help them embrace their sexuality. In turn, this will improve their sexual satisfaction and even their quality of life.
Finding the right type of vaginal reconstruction near me
Over the past few years, these surgeries have become increasingly popular. Some stats show that cosmetic labiaplasties are increasing by 30 – 35% yearly. Ultimately, nobody can tell us what we need to feel sexually desirable. We shouldn’t let explicit media sell us an “ideal vagina” that doesn’t match reality – but for many women, vaginal rejuvenation can be the final boost to recover their confidence.
Any board-certified plastic surgeon may do the technical aspects behind a vaginoplasty. However, deciding which procedure will bring you the best results will require deep thought and access to trustworthy healthcare providers.
Why is Dr. Aliabadi a top L.A. gynecological surgeon?
For Dr. Thais Aliabadi, this means building a rapport with patients, understanding their values and beliefs around sex, and carefully weighing the risks and possible benefits.
Whether you seek to undo the damage of cancer surgery, revitalize your sex life, or embark on a broader gender transition, Dr. Aliabadi can help you design a cohesive women’s health plan that includes surgery, recovery, and routine preventative care.
The gynecology practice of Dr. Thais Aliabadi is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
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Vaginal Reconstructive Surgery vs. Rejuvenation: Comparing the Options
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