Perineoplasty

What is perineoplasty?

Perineoplasty is a surgical procedure to repair the perineum and external organs of your vagina (vulva). Your perineum is the space between your anus and vagina. Its purpose is to help support your reproductive organs and pelvic floor muscles. Childbirth, weight loss, trauma and other factors can damage this area and cause the skin around your vaginal opening to become loose and overstretched.

Perineoplasty aims to strengthen and tighten the perineum, narrow your vaginal opening and repair loose, scarred, or damaged skin around your vagina. This procedure can restore function and comfort and improve the appearance of your perineal area.

Why do people get perineoplasty?

People seek perineoplasty to address loose skin at their vaginal opening or affecting the labia minora or labia majora. This issue leads to decreased satisfaction during sex or feelings of self-consciousness.

The reasons people choose to get perineoplasty are:

• Loose, bulging, or gaping skin around their vagina.
• Excessive scar tissue or an adequate repair after episiotomy or tearing during vaginal delivery.
• Loss of sensation.
• Low self-esteem.
• Low libido (not wanting to have sex).
• Vaginal irritation, discomfort, or pain.

What causes damage to the perineum?

Childbirth is the leading cause of damage to the perineal area. Vaginal deliveries stretch and tear the posterior fourchette of the opening to your vagina to allow your baby to come out. Repeated vaginal deliveries increase your chances of having a loose, overstretched tissue and inadequate appearance and function.

Other things that stretch or widen your vaginal opening or cause damage to the perineum are:

• Extreme weight loss or weight gain.
• Trauma or injury.
• Repeated straining or impact (like from horseback riding).
• High-impact sports or exercise.
• Other gynecological diseases.
• Genetics.
• Age.

Does perineoplasty tighten the vagina?

Yes, perineoplasty helps to tighten the opening to your vagina. However, it does not affect your vaginal canal or the internal part of your vagina.

Procedure Details

How do they fix a vaginal opening with perineoplasty?

Dr. Ayoub repairs your vaginal opening by removing access or damaged skin and repairing the muscular tissue that supports it. During the procedure, your surgeon makes a small V-shaped or diamond incision at your vaginal opening. Next layers of suture placed to build up your perennial to the normal preaging or delivery appearance. We remove the tissue and repair any underlying muscles before stitching the area closed.

Before the procedure

A cosmetic gynecologist such as Dr. Ayoub often perform perineoplasties. Discuss your symptoms and desired results. We can answer any questions you have about the procedure and help you understand the risks and benefits. You should ask them what the recovery process is like and what arrangements should be made before surgery.

The procedure

Perineoplasty is performed under local or sedation anesthesia, depending on your condition and the extent of work. Your gynecologist makes an incision at your vaginal opening. Next, they cut out excess skin or scar tissue and repair the deeper muscle layers around your vagina. Finally, the edges of the incision are closed with layers of stitches to build up the cranium that has been lost due to aging or stretching or tearing during vaginal deliveries.

How long is perineoplasty surgery?

The procedure takes about one hour. After a short recovery in the office surgical suite.

What should I expect after a perineoplasty?

As with most procedures, your body needs time to heal after a perineoplasty. You can expect swelling and discomfort during the first several days. We recommend ice and pain relievers to help with this pain. Sitz baths and soaking your perineal area in several inches of warm water may also be soothing in the first weeks of your recovery.

Please adhere to the following post-operative instructions:

• Don’t insert anything into your vagina for at least six weeks. This includes tampons and refraining from sexual intercourse.
• Limit activities for at least four weeks. No heavy lifting or strenuous exercise during this time.
• Drink plenty of water and eat lots of fiber to avoid getting constipated. A stool softener may also help.
• Wear a sanitary pad if you experience vaginal bleeding.
• Keep the area clean and dry. Stitches should dissolve on their own within a few weeks.

Is perineoplasty painful?

You will not feel pain during the procedure, but you may experience discomfort afterward. Anti-inflammatory medications, ice and pain relievers can help ease your pain.

Risks / Benefits

What does perineoplasty help with?

Perineoplasty helps restore tightness and repairs damage to your perineum and vulva. Other benefits of the procedure include:

• Improved sexual satisfaction.
• Increase self-esteem.
• Returns your vagina to its pre-childbirth appearance and size.
• Fixes scars or removes scar tissue.
• Corrects deformities or other imperfections.

Who should not have perineoplasty?

You should not have perineoplasty until you have finished having children. It also should not be performed if you:

• Are pregnant.
• Have cancer.
• Have an active genital infection.
• Have an abnormal Pap smear.

What are the potential complications of perineoplasty?

Like most surgeries, there is a risk of complications after perineoplasty. Some of the most common are:

• Not achieving the desired outcome (tightness or strength).
• Dyspareunia (painful sex).
• Infection.
• Constipation.
• Bleeding from the surgical site.

Recovery and Outlook

What is the recovery time after perineoplasty?

It takes between six and eight weeks to recover from perineoplasty. During your recovery, follow your healthcare provider’s instructions. You should limit your activities for at least four weeks and refrain from sex for six weeks.

When To Call the Doctor
When should I see my Dr. Ayoub?

Talk to Dr. Ayoub if you are struggling with sexual dissatisfaction, pain, or lack of confidence over issues with your vagina. There may be nonsurgical and surgical treatment options recommended to relieve your symptoms.

Additional Details

Are vaginoplasty and perineoplasty the same?

No, they are not the same. But there can be an overlap in some instances.

A vaginoplasty may be done for several reasons. For example, in some cases, the surgery is meant to tighten or repair your vaginal canal (the inside part of your vagina). For other people, it is part of gender confirmation surgery to create a new vagina. In other cases, vaginoplasty reconstructs a damaged vagina.

Conversely, a perineoplasty only helps to restore function and tightness to the muscles at the opening of your vagina and perineum. Surgeons often perform perineoplasty and vaginoplasty together.