There’s no wrong way to have a vagina – they’re all beautiful – but personal preference is just that, personal. Vaginal rejuvenation is the umbrella term that refers to an array of surgical and non-surgical solutions that can address both functional (think: urinary incontinence, vaginal dryness, vaginismus, etc.) and aesthetic (i.e. vaginal skin laxity, labia shape and size, etc.) concerns related to the vagina and the vulva as a whole.
For many women, conversations about sexual health primarily happen between friends, and they don’t necessarily center around things like appearance, hormonal changes (postpartum and menopause), or other functional concerns. If the discourse steers towards that topic, it’s often by comparison and without a clear solution. After all, not everyone is friends with medical and sexual wellness experts.
That’s where we come in. We’re here to have that in-depth chat with a true expert in the field, Usha Rajagopal, MD, a board certified plastic and reconstructive surgeon and founder of San Francisco Plastic Surgery & Laser Center who specializes in vaginal rejuvenation, to get clear answers to your ‘below the belt’ questions and learn more about the in-office procedures that exist to treat an array of female sexual wellness concerns.
1. It’s Not Just One Procedure
First things first, the term ‘vaginal rejuvenation’ doesn’t refer to any one thing. “Vaginal rejuvenation is really a combination of vulva rejuvenation along with vaginal rejuvenation,” Dr. Rajagopal explains. Translation: there are options. We break them down below:
- Labiaplasty: “To improve the aesthetic appearance of the labia minora and labia majora, we offer a labiaplasty,” she shares. The surgical procedure can benefit those experiencing discomfort during exercise, urinary tract infections, painful intercourse, and other physical activity. The surgery can be performed alone or as part of a mommy makeover.
- Monsplasty: For those who have excess skin and/or fat in their upper pubic area that is impacting their quality of life, Dr. Rajagopal recommends monsplasty (a.k.a. mons pubis reduction or pubic lift). It can involve liposuction (to remove fat), surgical excision (to remove skin), or a combination of the two.
- Emsella®: “Emsella® consists of high-intensity focused electromagnetic stimulation (HIFEM) that is similar to MRI magnetic technology,” Dr. Rajagopal explains. “It stimulates and enhances the function of the pelvic floor muscles.” She says the treatment is ideal for those experiencing urinary incontinence and/or an inability to achieve strong orgasms. The non-invasive treatment (you sit on a chair-like device that stimulates the muscles) calls for six 30-minute sessions in a three-week span.
- Botox: Yes, you read that right, Botox for vaginal health. The neurotoxin is used off-label for the treatment of vaginismus, a medical condition that causes involuntary vaginal muscle spasms that can make inserting tampons and penetrative sex painful — if not impossible. Botox is injected into the bulbospongiosus muscle (i.e. the muscle that surrounds the opening of the vagina) to relax it and relieve the spasms.
- Infini™ RF: If a surgical labiaplasty isn’t for you, Dr. Rajagopal says “you can also have just a labia majora reduction with Infini™ RF.” When used on the vulva, the RF microneedling treatment can firm the tissue of the labia majora to enhance its appearance and even tighten the vaginal canal after natural childbirth. “We call it a vagi-facial,” she notes.
- Laser Therapy: Dr. Rajagopal uses FemiLift®, a fractional C02 laser, to treat patients with vaginal dryness due to age and vaginal atrophy (a condition that can cause painful intercourse). The intravaginal laser is inserted into the vaginal canal (she assures us the treatment is much more tolerable than it sounds). Some patients enjoy the benefits after the first appointment, but Dr. Rajagopal recommends three sessions in three months for best results.
- PRP: To improve pleasure, the so-called O-Shot injects platelet-rich plasma (PRP) into numbed areas of the vagina, clitoris, and labia to heighten orgasms and improve sexual wellness. For some, the effects are immediate, while an initial series of treatments may be needed for others. Results can last three to six months.
2. It’s Highly Customizable
The vulva is made up of multiple organs – including the vagina – and just about all of them can be addressed. While vaginal rejuvenation is often talked about in relation to childbirth, hormonal changes, genetics, and even stress can impact both the form and function of the genital area. “There can be functional issues that may interfere with her lifestyle and how much pleasure she gets out of sex,” Dr. Rajagopal shares. “There can also be aesthetic issues that she may want to address and that’s what we offer.”
Many of the procedures listed above can be combined to create a treatment plan that best addresses a patient’s unique anatomy and goals. Consulting with a board certified plastic surgeon or gynecologist who specializes in vulva rejuvenation is the best way to learn more about your options.
3. Candidates Vary
As with any procedure, those interested in vaginal rejuvenation should consult with their provider to ensure their preferred procedure(s) is right for them. As we mentioned, treatments that address vaginal health and appearance aren't one-size-fits-all, nor should they be. “With each treatment, we have an examination first to see who is a viable candidate,” Dr. Rajagopal explains. Topics such as medical history and overall health and wellness should also be discussed during the examination process. Women may also want to consider whether or not they are planning to have children or want to further expand their family. While some of these solutions treat sexual health concerns, others have the ability to be impacted or undone by pregnancy or childbirth.
4. Sensitivity Can Be Compromised
Although it’s uncommon, a decrease in sensation is always possible after cosmetic procedures – and vaginal rejuvenation is no exception. There is no surefire way to prevent this, though cosmetic gynecology performed by a highly skilled provider who specializes in the practice is the best way to ensure a safe and effective outcome. Prior to booking a procedure, be sure to use the consultation process to learn more about your provider. Research their credentials, review before and after photos, inquire about how often they perform the procedure(s) you are interested in, and even seek out patient testimonials to ensure you find the right fit.
5. Recovery Is a Process
The beauty of many non-surgical solutions (vaginal rejuvenation or otherwise) is that they come with minimal downtime and recovery. Even so, there may be some guidelines as to when certain activities, including sex, can be resumed. Be sure to ask your provider about any recovery protocols.
Recovering from surgery is a bit more involved. Depending on the procedure, a few days to a week of downtime may be needed. Side effects of most vaginal rejuvenation surgeries include swelling, bruising, and discomfort. Infection is a greater risk due to the nature of the area, so practicing good hygiene after surgery is key. Those who have vaginal rejuvenation as part of a larger mommy makeover will need to factor in the recovery of the other surgeries as well.
From genetics to age to childbirth, there are a wide variety of reasons you may be interested in vulva rejuvenation. For too long, women haven’t had reliable resources to learn more about their options. It’s time to change that. “It has been taboo to speak on female genitalia, while men’s concerns aren’t,” Dr. Rajagopal says. “They have medication to help with erectile dysfunction and aesthetic surgeries to improve the appearance, so I think the time has come for women to feel confident with that area.” Hear, hear!
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