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.”
Laser Vaginal Tightening Options
There are two general types of lasers on the market used for vaginal regeneration: erbium lasers and CO2 lasers.
“They all work effectively, causing superficial micro injuries, which stimulate the bodies response to heal the injury with healthy collagen and new blood vessels,” says New York City obstetrician and gynecologist Dr. Carolyn Delucia. “ This returns elasticity to the tissue as well as a natural sensation upon lubrication.”
“I prefer Femilift because it has a disposable probe, as well as a patent beam splitting technology that allows me to cover more area in the vagina per treatment,” adds Dr. Delucia.
Femilift is an FDA-approved laser treatment that utilizes a specially designed singular-use probe that is inserted into the vagina, at which point the laser triggers tiny pixels of light to stimulate the vaginal tissue.
This stimulation results in more collagen formation and tissue regeneration, which remodels the vagina and produces enhanced elasticity, as well as help rebalance the vaginal mucosa to enhance lubrication.
Femilift can be used to treat:
- Urinary incontinence
- Vaginal dryness
- Painful intercourse
- Vaginal looseness
Treatment involves three 10-minute sessions roughly 4 weeks apart. It is painless and you can return to normal activities immediately, except for intercourse, which you must refrain from for a period of at least 3 days.
Dr. Delucia informs that for a package of 3 treatments Femilift costs between $1,800 to $3,000.
Intimalase uses laser therapy for non-surgical tightening of the vaginal canal to stimulate vaginal tissue rejuvenation and collagen remodelling. The result of this remodelling is tightening the vaginal canal.
Two sessions of Intimalase are usually recommended. There is no pain or downtime so patients can return to their normal everyday activities straight after the treatment.
Intimalase is particularly helpful for treating vaginal relaxation syndrome.
Fem Touch uses a CO2 laser technology that promotes the stimulation of new vaginal tissue growth by triggering collagen production.
Fem Touch can be used to treat:
- Painful intercourse
- Vaginal dryness
- Irritation and burning sensation
The MonaLisa Touch also uses laser technology and is an ideal solution to address vaginal changes that occur during menopause.
MonaLisa Touch can be used to treat:
- Vaginal dryness
- Painful intercourse
- Side effects of hysterectomy
Radiofrequency Vaginal Tightening Treatments
“All radiofrequency devices are used to create heat without micro injury. They damage collagen like heating protein on a grill. The initial damage causes the collagen to recoil like a tightening spring before the body has an inflammatory response bringing new collagen to the area,” informs Dr. Delucia.
“Generally speaking, radiofrequency isn’t quite as effective as lasers. However, the field is growing exponentially with innovative new technology and machines continually hitting the market. So I’m excited to see what they offer,” adds Dr. Delucia.
Dr. Delucia provides a treatment called the Orgasm Shot, or O-shot.
O-Shot is a suitable treatment for:
- Women who have difficulty reaching orgasm during intercourse
- Mild stress incontinence
The treatment begins with your doctor appling a numbing cream to your vaginal area, after which blood is drawn and the platelet rich plasma (PRP) and growth factors are isolated. These substances are then injected into areas of vaginal tissue where they attract your own natural stem cells and generate more functional tissue in the vagina.
“The O-Shot brings new collagen blood vessels and nerve fibers to the area to improve sensation in the vagina,” says Dr. Delucia. “Patients experience a heightened sensation of sexual response and improvement with urinary continence.”
The procedure takes 40 minutes, is painless, has no downtime, and you can return to normal activities immediately. Largely depending on your location, the O-Shot costs between $1,500 and $2,500.
ThermiVa treatments use radiofrequency energy to gently heat tissue without discomfort or downtime.
ThermiVa can be used to treat:
- Vaginal looseness after childbirth
- Vaginal aging
ThermiVa treatment usually involves 3 treatments over the course of 3 months.
“The issue with first generation machines like ThermiVa is the length of the procedure. It takes from 30 to 45 minutes per treatment with the probe being put in and out of the vagina to assure even heating of the vaginal walls. The good news is that the treatments do improve the sensation of tightness so patients are willing to endure the therapy regardless,” says Dr. Delucia.
Updated, April 2018
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.”
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.”