Vaginal Rejuvenation: Enter the Designer Vagina

Brandi Glanville recently boasted about having it done, and the Kardashian sisters love it too. Thanks to reality TV, we now know that it exists, and yet it seems like no plastic surgery procedure remains more taboo than vaginal rejuvenation.

In fact, several surgeons declined my requests to be interviewed for this article.

The American Society of Plastic Surgeons began collecting data on vaginal rejuvenation in 2005, reporting 793 surgeries that year. By 2012, the number had jumped to over 5,000 procedures in the United States alone. Many experts attribute this upward trend to the prevalence of internet porn, while others link in to population aging and a broader acceptance of plastic surgery in general.

Whatever the root causes may be, the end result is that throngs of women of all ages and socio-economic backgrounds are now rushing to their surgeons to undergo the following procedures:

• Labia reduction surgery
• Hyperpigmentation treatments
• Mons pubis reduction
• Fat grafting or injections to the labia majora
• Clitoral hood reduction
• G-shot injections
• Vaginal canal tightening

We tracked down two expert surgeons to find out more about this intimate topic, and to understand why the American College of Obstetricians and Gynecologists warns women against what they refer to as “designer vaginoplasty”.

What is vaginal tightening?

Vaginal tightening may be achieved through surgery, or through the use of non-invasive devices that stimulate collagen production and vaginal tissue regeneration.

Surgical vaginal tightening — also known as vaginoplasty — is performed by reducing excess vaginal lining to tighten the underlying vaginal muscles and surrounding soft tissues. After surgery, the patient is usually able to walk comfortably within a few days, and may return to sexual activities within 4 to 6 weeks.

Many doctors believe that such procedures are often performed unnecessarily, and in some cases will recommend non-invasive, laser-based technologies instead.

San Antonio, TX plastic surgeon Dr. Thomas T. Jeneby explains: “Over the course of a woman’s life, the structure of the vagina can overstretch as a result of childbirth and aging. This is referred to as vaginal relaxation syndrome (VRS), and it can lead to a loss of sensation during intercourse.”

In such cases, Dr. Jeneby provides a service called Intimalase, one of several no-knife vaginal rejuvenation procedures to have recently hit the market.

“IntimaLase is a non-ablative laser, meaning it affects underlying vaginal tissues without damaging or irritating the sensitive skin surface,” says Dr. Jeneby. “By gently heating the vaginal wall, collagen production is increased and existing collagen fibers are coagulated, creating a tightening effect in the vaginal canal and a restructuring the vaginal walls, leaving the vagina feeling refreshed and more fitting, if you will.”

How do these no-knife procedures work?

Dr. Jeneby believes IntimiLase’s increase in popularity is due in part to its novelty, but can also be attributed to its relatively non-invasive nature.

“It’s for women of various ages, but typically for those who have had vaginal deliveries or whose vaginas have become stretched out, uncomfortable, and even painful.”

“I think the more familiar people become with a procedure that works, the more likely they are to use it,” he adds. “Until recently, this is something that women didn’t necessarily know they could fix up, particularly so painlessly and quickly. Other vaginal tightening methods can cause discomfort and may require extensive healing, whereas the IntimaLase provides a safer, gentler, and more patient-friendly solution to vaginal rejuvenation.”

Although results may vary from patient to patient, best results are usually seen after two treatments that are performed 15-30 days apart.

How about the side effects and downtime? “Other than abstaining from sexual activity for about 48 hours, there is no recovery or downtime necessary for treatment with IntimaLase. The system comes with built-in safety features that keep the skin and tissues from becoming overheated, creating a comfortable treatment experience for the patient and making it easier to use for the technician.”

There are added benefits too, says Dr. Jeneby: “The procedure results in increased sexual pleasure and satisfaction, and if you suffer from incontinence, it will also help to realign your urethra.”

What is labiaplasty?

Labiaplasty — also known as labial reduction — is a surgical procedure to remove excess skin from the folds surrounding the vulva. It is most commonly requested by women who wish to alter the appearance of their genitals for cosmetic reasons, or to reduce physical discomfort caused by friction.

“Labiaplasty has been around for more than a decade, but with the internet, it has definitely increased in popularity. It’s still frowned upon by some gynecologists though, and there’s a lot of pushback from some groups that argue that there is no such thing as abnormal-looking labia,” says Toronto plastic surgeon Dr. Marc DuPéré.

“Some women notice changes after a pregnancy, and the labia are actually longer… It’s also very common for women to want the procedure done because they find that there’s too much protruding when they wear underwear or a bikini. In such cases intercourse can actually be painful. Their reasons can be either functional or cosmetic.”

Several other procedures are performed at Dr. DuPéré’s clinic to enhance women’s genitalia, sometimes in conjunction with labiaplasty:

“The outer labia can get deflated after a pregnancy or during menopause, just like breasts can lose volume with time or following hormonal changes. Fat grafting allows us to plump the lips up, and if there’s excess skin we can also reduce it, just like we do with a breast lift procedure.”

Filler injections can also be used, but the cost is prohibitive as the labia majora is a fairly large structure. “We would need too many filler injections for that,” says Dupéré. “Fat grafting also tends to last longer.”

What’s the Barbie procedure?

In some extreme cases, patients will ask for the Barbie look. Dr. Dupéré explains:

“Basically, the Barbie is when you don’t see the inner labia anymore. It’s the equivalent of a girl wanting 800cc implants. It’s for each of us to determine whether we want to do this kind of stuff of not, but it’s definitely frowned upon by many surgeons. The same labiaplasty technique is employed, it’s just that a little more mucosa is removed.”

For this, surgeons either use a scalpel or a laser. “I use a scalpel,” says Dupéré. “I find it easier, sharper, and there’s no burning around the tissue. If the mucosa or the tissue is burned, you don’t get the same kind of scarring.”

Do designer vagina come with designer price tags?

The cost for a labiaplasty in the United States varies between $5,000-$8,000, whereas vaginoplasty, the most common of vaginal rejuvenation procedures, can cost anywhere between $1,500 and $6,000.

At Dr. DuPéré’s clinic in Toronto, Canada the cost of a labiaplasty starts at $3,500 CAD. “A lot of labia minora procedures can be done under local anesthesia, but I usually recommend intravenous sedation. This brings the cost up a little since I need to pay for an anesthesiologist, and provincial regulations state that if we sedate a patient three nurses are required in the operating room. That being said, I’ve done lots of labia minora reductions with purely local anesthesia.”

In some cases, local anesthesia simply isn’t an option. “If a patient is concerned about having a male plastic surgeon work on her labia for an hour, then we give her a deeper sedation so that she’s not fully asleep but she isn’t fully there either. It’s a lot more comfortable for her that way, even though I always have a nurse with me. Sometimes I’ll be doing another procedure at the same time, such as a tummy tuck or a breast augmentation, so she’s already asleep and that way we can do it all at once.”

So who are these women, exactly?

The answer might surprise you: all sorts of women are interested in vaginal cosmetic surgery.

Women who look up to lingerie ads online and don’t want excess flesh showing when they’re in their underwear. Young moms who want to feel “tight again.” Women who don’t want any hyperpigmentation down there. Older cougars dating younger men. Millenials, established professionals, stay-at-home wives, and reality TV stars.

And contrary to what some may believe, men’s sexual tastes have very little to do with it.

According to Dr. DuPéré, women are rarely — if ever — coaxed into undergoing labiaplasty by their partner. He gives the example of a 71-year-old patient who recently came in for a labiaplasty because she was concerned about the effects of time on her appearance, and was interested in the procedure for essentially the same reasons as other female patients who undergo facelifts.

“I do not recall a man ever being behind this decision,” says DuPéré. “Although I’m sure it’s happened… I often hear about men wanting a breast augmentation for their significant other, but I’m not aware of this being the case when it comes to vaginal procedures.”