What you need to know about perineoplasty (surgery to reshape the area around the vagina)

Many women, especially after having children, are hesitant to talk about changes in their vaginal area. You may have experienced things like a feeling of tightness in the area, discomfort during sex, or pain from scars from childbirth. These are common things, but the important thing is to know that there are solutions. That's exactly what we're talking about in this article.

Simply put, what is Perineoplasty?

Perineoplasty is a surgical procedure that reconstructs the area between your vagina and anus, called the perineum , and the external parts of the vagina (vulva). The main function of the perineum is to provide support for the organs of our reproductive system and the muscles of the pelvic floor.

Consider, for example, childbirth, sudden weight loss, or an accident that can damage this area. Then the skin around the vaginal opening can become loose and stretchy. The goal of perineoplasty surgery is to strengthen and tighten the perineum area, reduce the vaginal opening, and repair loose, scarred, or damaged skin. This can restore your body's function and comfort, and improve the appearance of that area.

Why would someone want to have a perineoplasty?

Many people resort to this surgery because of problems caused by loose skin around the vaginal opening. This can lead to decreased satisfaction during sexual intercourse or low self-esteem. In some cases, the damage to the muscles can even lead to incontinence.

See the table below for the main reasons for resorting to this surgery.

How can this perineum area be damaged?

The main cause of damage to this area is childbirth. During a normal delivery, the vaginal opening naturally stretches to allow the baby to come out. With continued childbirth, this opening is more likely to loosen and stretch.

If the vagina is torn extensively during childbirth, or if an episiotomy is performed, there is a higher risk that the wound will heal with scar tissue or that the muscles will not heal properly. This scar tissue can cause discomfort and loss of sensation.

Apart from that, there are several other reasons why this area can be damaged:

• Sudden significant weight gain or loss.
• An accident or injury occurs.
• Activities that involve frequent exertion, such as horseback riding.
• Strenuous exercise or sports.
• Other gynecological diseases.
• Genetic factors that come from heredity.
• Aging.

Does this surgery really tighten the vagina?

Yes, perineoplasty surgery helps tighten your vaginal opening . However, it does not affect the inner part of the vagina, which is the vaginal canal. If you need to tighten it, you will need to have another surgery, such as vaginoplasty.

What happens before and during the surgery?

These surgeries are performed by a gynecologist. Talk openly with your doctor about your symptoms and what you expect from the surgery. He or she can answer any questions you may have about the surgery and explain the risks and benefits.

The surgery is performed under local anesthesia or general anesthesia, depending on your condition. During the surgery, the doctor makes a small V-shaped or diamond-shaped incision in the vaginal opening. Then, the excess skin or scar tissue is removed and the underlying muscle layers are repaired. Finally, the incision is closed using a type of dissolvable suture. The surgery usually takes about an hour . You can rest for a while after the surgery and go home. A hospital stay is very rare.

What to expect after surgery?

As with any surgery, you need to give your body time to heal after a perineoplasty. You can expect some swelling and pain for the first few days. Doctors recommend applying ice and taking painkillers to help manage this pain. Also, sitting in a warm water bath (sitz bath) can help relieve the pain for the first few weeks.

Your doctor will likely give you the following advice:

• Do not insert anything into the vagina for six weeks . Avoid using tampons and having sex.
• Limit strenuous activities for at least four weeks . Heavy lifting or strenuous exercise is not recommended during this time.
• To prevent constipation , drink plenty of water and eat foods high in fiber (fruits, vegetables). If necessary, you can take a stool softener as prescribed by your doctor.
• If you have vaginal bleeding, wear a sanitary pad.
• Keep the incision area clean and dry .
• The stitches will dissolve on their own in a few weeks.

Once you are fully recovered, many doctors recommend doing Kegel exercises to strengthen the muscles in that area.

Benefits and potential risks of perineoplasty surgery

Like anything, this surgery has its benefits as well as some risks.

Also, this surgery is not performed if the following conditions exist:

• If pregnant.
• If you have cancer.
• If there is an active infection in the reproductive system.
• If the Pap smear report is abnormal.

How long does it take to heal?

It can take six to eight weeks to fully recover from a perineoplasty. It is very important to follow your doctor's instructions carefully during this time. If you are experiencing discomfort, pain, or concerns about your appearance, don't hesitate to talk to your doctor. There may be other options available without surgery.

Are Perineoplasty and Vaginoplasty the same thing?

No, these two are not the same. But sometimes both of these surgeries can be done together.

• Perineoplasty: This involves tightening and repairing the vaginal opening and surrounding perineum area.
• Vaginoplasty: This involves tightening or reconstructing the vaginal canal .

Simply put, Perineoplasty is something done externally, while Vaginoplasty is something done internally.

Perineoplasty, vagina, childbirth, episiotomy, gynecology, women's health, surgery