Everything You Need To Know About Vaginoplasty

What is Vaginoplasty?

Vaginoplasty is a surgical procedure that tightens the vaginal opening and walls. In some cases, it is performed in order to reconstruct a vagina after a woman has undergone a vaginectomy for vaginal cancer. In other instances, women may elect to have vaginoplasty if they have experienced a natural loss of tone and tightness as a result of aging, hormonal changes, childbirth, or birth defects. Often referred to as vaginal rejuvenation, vaginoplasty has grown in popularity. Weakened vaginal muscles can result in physical discomfort and emotional insecurity for many women. In addition, the weakened walls can be the cause of displeasure or pain during intercourse. Some women may experience a loss of femininity. They may experience a loss of sexual pleasure and sensitivity as the walls of the vagina weaken, resulting in self-conscious feelings about their partner’s experience during intercourse. For millions of women who undergo vaginoplasty, a restored sense of femininity and sexual pleasure is a benefit.

This procedure is also sometimes referred to as vaginal rejuvenation. While most often performed to tighten weakened vaginal muscles, this procedure is also sometimes undergone to correct birth defects or create a vagina for transgender sex reassignment surgery. Some vaginoplasty procedures require removal of tissue or grafting from tissue taken from other parts of the body. In instances when vaginoplasty is performed to create a vagina, it is sometimes referred to as a neovagina, which quite literally means “new vagina.”

Different Types of Vaginoplasty

For women who elect to undergo a vaginoplasty procedure, a few different types of the procedure may be discussed. The most appropriate choice depends on various factors, such as a woman’s age or reason for undergoing the surgery. The particular type appropriate for a young, cisgender girl who needs the procedure to correct a birth defect would not be the same type of procedure indicated for an older woman who wishes to have her vaginal walls tightened after childbirth and aging has weakened them. The primary types of vaginoplasty are:

  • Intestinal or Sigmoid
  • Peritoneal
  • McIndoe
  • Buccal mucosa
  • Penile-Inversion

Intestinal or Sigmoid Vaginoplasty

This particular type of procedure creates a new vagina by utilizing a section of the sigmoid colon. Often performed as a laparoscopic surgery, this minimally invasive procedure requires only a small incision. For an intestinal vaginoplasty, a piece of the colon is removed and rotated to become the vaginal lining. The surrounding colon is then stitched together to restore its proper function.

Some criticisms of this type of vaginoplasty have been expressed, stating that it can result in excessive mucus in the vaginal cavity that creates an unpleasant odor. These side effects have not been significantly reported, and some see this excess mucus production as an advantage since it is self-lubricating. Additionally, the elasticity of the colon segment bears more similarity to a regular vaginal lining than some other tissue options used to line the neovagina.

Peritoneal Vaginoplasty

Peritoneal vaginoplasty, sometimes called the Louhu operation, is also usually completed as a laparoscopic procedure. This type of vaginoplasty utilizes the lining of the abdominal cavity, or the peritoneum, to create the new vagina.

As with all types of vaginoplasty, there is a risk of recto-vaginal fistula development, or a hole between the rectum and vagina. However, this risk is slightly greater with peritoneal vaginoplasty. Fistulas are easily treated with surgery.

An added benefit to this type of vaginoplasty is that women who undergo this procedure do not necessarily need to maintain dilation of the vaginal opening. This is particularly true if they are maintaining sexual intercourse on a regular basis.

McIndoe Vaginoplasty

McIndoe Vaginoplasty, or the McIndoe technique, uses a skin graft to create the walls of the vagina. Unlike the above two mentioned procedures, this method does not require abdominal surgery to create a lining. Instead, skin grafted from another area on the patient’s body is placed on a vaginal mold which is then placed into the area that has been opened to create the vagina. Necessary precautions to remove all hair and hair follicles from this piece of skin must be made in order to prevent future hair growth in the new vagina. The mold is used for several months and removed only for regular cleaning in an effort to promote healing.

Since skin is not a mucosal tissue, it does not self-lubricate. This increases the risk of the vaginal opening closing up. As a result, women who undergo a McIndoe procedure, and are not sexually active on a regular basis, will need to dilate the vagina regularly for the rest of their lives.

Buccal Mucosa Vaginoplasty

Buccal mucosa is the tissue lining of the mouth and is quite similar to that of the vagina in that both create mucus and are hairless. These similarities make it an ideal lining for a neovagina that is created during vaginoplasty.

While Buccal mucosa may seem like an ideal option at first, this type of vaginoplasty is not as common as some others. This primarily is because only a small amount of tissue is available. Thus, patients are concerned about side effects that may result in the mouth and cheeks. Additionally, most gynecologists are not as familiar with the inside of the mouth. As such, collaboration with a facial surgeon may be necessary.

Penile Inversion Vaginoplasty

Penile inversion is a type of vaginoplasty surgery only performed on transgenders. This procedure involves removing skin from the outside of the penis and inverting it to create the lining for the neovagina. A clitoris is then shaped from the head of the penis, and scrotal skin is utilized to create the labia majora and labia minora.

This procedure requires a lifetime of dilation and is not self-lubricating. As with the McIndoe vaginoplasty, precautions must be made to ensure no hair follicles remain.

Who is eligible for vaginoplasty?

Vaginoplasty is generally only recommended for women with vaginal defects or who have undergone surgery for vaginal cancer. In some instances, it may be recommended to correct vaginal looseness caused by childbirth. Even in these instances, a variety of natural alternatives may be explored before resorting to surgery.

In cases of gender transition, surgery should never be the first step. A number of other social and medical transition options should be thoroughly explored before considering a vaginoplasty procedure. Individuals who do choose to have vaginoplasty generally do not do so until they have taken other steps, such as supplemental hormones. In order o qualify for vaginoplasty as a transitional surgery, most doctors and hospitals require the individual to meet certain age requirements.

What is the cost of vaginoplasty?

The overall cost of vaginoplasty will vary depending on a number of factors, such as the location of the medical facility and physician, the type of procedure needed, other medical procedures that might be necessary, insurance requirements, and other factors. In all, the overall cost can range anywhere from a few thousand dollars to a hundred thousand or more, depending upon your particular circumstances. For example, the average penile inversion vaginoplasty generally costs around $20,000 on average. However, a secondary labiaplasty may be necessary.

The majority of health insurance plans do not cover vaginoplasty as an elective plastic surgery rather than a medically necessary procedure. Only if the procedure can be deemed medically necessary will most insurance companies cover the surgery.

What happens during vaginoplasty?

After the correct amount of tightening has been determined, a wedge is marked to indicate what extra skin
is to be removed from inside the vaginal area. The tissues under the skin are then tightened with sutures. After the vaginal canal is tightened, the mucosal skin is also sutured closed. Once this part of the procedure has been completed, any visible external skin protruding from the area can be reduced.

What happens after vaginoplasty?

A significant length of recovery time, as well as ongoing self-care, is necessary after a vaginoplasty procedure. One can expect to spend approximately a week or more in the hospital after the surgical procedure has been completed. After being discharged from the hospital, a patient must return for follow-up appointments for some time until the area is completely healed and your doctor releases you from care. The healing process can take a good length of time. As such, you should not engage in any strenuous physical activities or do any heavy lifting for at least six weeks following the vaginoplasty surgery.

You should also expect to use a catheter for urination for one or two weeks after the procedure. You will be provided with detailed instructions on care and maintenance of the catheter. Additionally, your doctor will instruct you on how to check for signs of infection around the surgical site. You most likely will be able to perform light activities and walk around normally after about a week or so. Within six to eight weeks, you should be recovered enough to go back to normal activities. Complete healing, however, can take as much as a year to two years.

What should I do in the time leading up to my vaginoplasty surgery?

Depending upon the type of vaginoplasty surgery you are scheduled for, your pre-op instructions can vary. Your doctor should go over these instructions with you carefully. In addition to specific instructions related to the procedure, you should follow a list of generalized pre-operative instructions. Following are some examples of basic pr-op instructions you can expect to follow:

  • Make sure you receive plenty of rest in the days leading up to surgery.
  • Follow a balanced, nutritional diet, and drink plenty of water.
  • In the event you develop a sore throat, fever, cold, or any other illness before surgery, contact your doctor in case a reschedule may be necessary.
  • Alcohol consumption should be discontinued for at least the 24 hours prior to surgery as it can increase bleeding.
  • Smokers should stop smoking before surgery.
  • Patients who smoke recreational or medical marijuana should discontinue smoking at least a week prior to surgery. Edibles and vaping are acceptable, however, you need to let your medical care team know as marijuana can affect anesthesia.

Closely following your pre-operative instructions and making advanced preparations can help you recover and recuperate successfully.

What should I expect following a vaginoplasty procedure?

Depending upon the technique used for the vaginoplasty procedure, dilation of the neovagina may be required for the rest of your life. To accomplish this, a silicone dilator on a rod with a curved end is inserted into the vagina and left in place for approximately 10 to 15 minutes. Dilation of the neovagina is used to keep the area from closing up when skin is used to line the vagina, such as with McIndoe or penile inversion vaginoplasty. It also is used to increase the width and depth of the vagina through gentle stretching. This may serve to help women who have difficulty or pain during intercourse after a vaginoplasty surgery. The frequency dilation needs to be completed depends upon the specific type of procedure completed, as well as the length of time since the vaginoplasty was performed.

What natural alternatives are available?

Vaginoplasty is an invasive procedure that requires hospitalization and a long recovery time. Follow-up treatments or other surgeries might be required, bringing the overall costs associated with vaginoplasty procedure to extensive heights. In addition to the costs and extensive recovery time associated with this surgery, there are possible side effects, some of which are extreme risks. The side effects connected to having vaginoplasty surgery can be quite severe and even can lead to a complete loss of sensation in the vagina and around the vaginal area. Because of these extreme risks, as well as costs and other factors, many women prefer natural alternatives to vaginoplasty. The surgery itself should only be considered after carefully discussing all possible alternative options with your physician.

A number of natural alternatives to vaginoplasty are available, such as exercise, activity, reducing weight, or using a natural product like V-Tight Gel, an herbal supplement which has been used for centuries in eastern civilizations. Not all natural alternatives to vaginoplasty are equally effective. The particular remedy you select, the way you go about it, and some other factors will all play a role in the remedy’s effectiveness. Using a holistic approach in which you don’t rely solely on one method often achieves the best results. Additionally, some remedies on the market that claim to be natural simply are not so. It is best to steer clear of these and carefully read and study the ingredients to determine if the product truly is natural.

Reduce Weight

A slender woman may develop a loose vagina as she ages while an overweight woman may maintain a firm vagina. However, obese or overweight women are more susceptible to weakness in the pelvic area and are thus more vulnerable to vaginal relaxation as they age. This actually has more to do with the pelvic floor than the muscles of the vagina. As women gain excessive weight in their waist, hips, and abdomen, their core muscles inevitably weaken, causing the pelvic floor to drop. This drop may be slight or substantial depending on the amount of weight gained and muscle strength lost. As a result of this pelvic drop, vaginal relaxation occurs. A weakened pelvic floor is unable to support the abdominal organs properly, resulting in an inability to exert as much control of muscles in the vaginal area.

In contrast, a woman who maintains a healthy body mass index will most likely have stronger core muscles and a properly aligned pelvic floor. She will have an easier time controlling vaginal contraction and expansion. It is therefore advised that women experiencing a loosened or weakened vaginal area attempt to lose weight as a natural alternative to vaginoplasty surgery. This weight loss may be achieved through a healthy diet, natural supplements, and a healthy exercise routine.

Exercise & Activity

While all types of exercise will have a positive impact, some pelvic exercises can assist in restoring tightness and natural firmness to the vaginal area. Long walks, jogging or running, squats, crunches, push ups, and cross training all have a positive effect on the body, including the pelvic area. Even taking part in a sport that results in a bit of physical effort and exhaustion can be beneficial to all parts of your body. Kegal exercises and some others are especially designed to work on the muscles in the pelvic area. When applied on a regular basis, these exercises are capable of bringing about amazing changes in women who have experienced a weakened or loose vagina. Stay active, eat right, and exercise. A sedentary lifestyle has the same effect on a woman’s pelvic floor as excessive weight does.

Vaginal Tightening Gels

Vaginal tightening gels, or V-Tight Gel, is a safe and effective natural alternative to surgery. This gel can help restore the natural suppleness of the vagina, tighten and firm the muscles, and enable better contraction on the muscles, which can lead to re-shaping of the vaginal walls. In addition, the gel helps to restore natural lubrication, leaving your vagina feeling rejuvenated.

As women grow older, the muscles around the vaginal area naturally begin to lose some elasticity. The amount of loss often depends on hormonal changes, childbirths, or a number of other factors. The majority of women who experience vaginal loosening and weakness are mothers, approaching menopause, or maintain a sedentary lifestyle with a lack of exercise and an unhealthy diet. Addressing all of these issues with the right combination of exercise, activity, a nutritional diet, and a natural product like V-Tight Gel can combat the effects of a loosened vagina and is often a better, natural alternative to vaginoplasty surgery.