Vaginoplasty/Posterior Vaginal Repair 1

thumb_IMG_2415_1024The Vaginoplasty/Vaginal Rejuvenation/Vaginal Tightening or Posterior Vaginal Repair is a surgical procedure performed to fix Vaginal Relaxation. Women with vaginal relaxation often complain they no longer feel the same amount of friction during intercourse. They will often describe vaginal looseness as a decrease in a woman’s ability to attain vaginal orgasms.

The main component of the lack of friction is the relaxation of the posterior inner vaginal wall. This is usually a component of relaxation at the vaginal opening. The cause of vaginal wall relaxation is a weakening of the pelvic support structures and thinning of the recto-vaginal septum in the posterior vaginal wall as figure 1.

The underlying causes of thinning of the Recto-Vaginal Septum are:

  • bullet_tickMultiple or prolonged deliveries.
  • bullet_tickThe use of forceps, vacuum, or other assisted methods of delivery.
  • bullet_tickA history of constipation and straining with bowel movements.
  • bullet_tickPerineum tears or an episiotomy into the rectum or anal sphincter muscles.
  • bullet_tickAging, occasionally likely in younger women or in those that have not delivered children.
  • bullet_tickThis problem may be preceded by hysterectomy, because it is involved in damaging different structures supporting pelvic organs, ligaments and tissues around cervix supporting the anterior and posterior vaginal wall.

Symptoms of Posterior Vaginal Wall Prolapse:

  • bullet_tickDyspareunia
  • bullet_tickConstipation
  • bullet_tickRectal pressure
  • bullet_tickPain in the lower back
  • bullet_tickFlatulence incontinence
  • bullet_tickRectal pain and vaginal bulge
  • bullet_tickFailure to completely empty the bowel

There are 4 methods of correcting relaxation of the vagina:

  • bullet_tick1) The Kegel Exercise is safe but would have to take 6 months until results would show, and does not guarantee full effectiveness.    
  • bullet_tick2) The Incisionless Laser Vaginal Tightening is a new trend of innovation to the Cosmetic Gynecology for mild to moderate vaginal relaxation; this procedure has limitations and cannot guarantee the results and satisfaction.
  • bullet_tick3) The Vaginoplasty or Posterior Vaginal Repair is the surgery to narrow the diameter of the vagina which results to a smaller, and tighter vaginal canal and vaginal opening. However, this surgery also has its limitations to the women with multiple deliveries.    
  • bullet_tick4) The Anterior and Posterior Vaginal Repair (A-P Vaginal Repair) is the surgical repair of pelvic prolapse by entailing the surgical removal of the excessive anterior and posterior vaginal tissues as well as bladder and rectum prolapse, thereby correcting the pelvic organ prolapse, at the same time tightening the vagina.

Recently, Laser has been applicable to the Vaginoplasty/Posterior Vaginal Repair. Benefits of Laser Vaginal Rejuvenation include: More precision and accuracy as a result of the surgical wound control, less blood loss, less risk of vessel and tissue damage, and quicker recovery time, thus bringing about better results than using the old conventional scalpel surgery.


Thinning Posterior Vaginal Wall between Rectum and Vagina
Figure 1: Thinning Posterior Vaginal Wall between Rectum and Vagina


General Notes & Precautions

1) Important points to consider about theVaginoplasty/Posterior Vaginal Repair

  • bullet_tickThe Vaginoplasty/Posterior Vaginal Repair
    aims to tone and tighten lax and overly stretched vaginal muscles and tissues. This is done by removing excess posterior vaginal mucosa to correct defects in the posterior vaginal wall and to narrow the diameter of the vagina which results in a smaller and tighter vaginal canal, thus permitting greater sensation during sexual experience. The tightening is done in the entire length of the vagina and not merely in the opening, differing from the perineoplasty surgery.
  • bullet_tickLike any other surgeries, the Vaginoplasty/Posterior Vaginal Repair has limitations and cannot absolutely ensure satisfactory results, because there are so many factors affecting the surgery’s success. In case of unsatisfactory results or complications, correction surgery may possibly be performed as appropriate. This will be discussed by you and Dr. Vitasna.
  • bullet_tickIf correction surgery happens due to a complication of the surgery, all expenses for services and treatment will no longer be charged to you. However, if the unsatisfactory results occur due to your non-compliance with the doctor’s orders, you will be charged accordingly.
  • bullet_tickThe Vaginoplasty/Posterior Vaginal Repair is not allowed for women with immunodeficiency. In addition, you must not become pregnant, or plan to become pregnant in the next 3 months. This is a suggestion, despite no research about the disadvantage to the pregnancy and the newborn. 
  • bullet_tickThe Vaginoplasty/Posterior Vaginal Repair is not recommended unless you have a discussion with your spouse because this may lead to problems, and misunderstandings caused by refraining from sexual intercourse for quite a time.
  • bullet_tickThe Vaginoplasty/Posterior Vaginal Repair is performed in our operating room for approximately 1-2 hours under the Intravenous (IV) Sedation and Local Anesthesia, or the General Anesthesia. You have to refrain from drinking water or food for at least 6 hours prior to the surgery in order to decrease the risk of aspirating gastric contents during or after the surgery. This complication is very serious, and you need to strictly follow our recommendations. Within the day of the appointment, you should not drive yourself after the surgery to avoid any accidents caused by dizziness, an effect of the Intravenous Sedative or the General Anesthesia used during the surgery.
  • bullet_tickYou should take a rest (refrain from any physical activities) and be still for at least 2-3 days after the surgery to enable the wound to heal faster. You may return to work within 3 to 5 days after surgery, you should have little movement as possible to avoid wound disruption for 1-2 weeks after the surgery. You should refrain from some types of exercise affecting pelvic muscle movement and sexual intercourse for at least 6-8 weeks after the surgery.


loosened vagina

loosened vagina


tightened vagina

tightened vagina



Vaginoplasty/Posterior Vaginal Repair is one of the most complex and meticulous cosmetic surgeries performed today. It requires extensive experience, precision, and accuracy to create the optimal results you desire and deserve. Many surgeons have little to no experience with this type of advanced cosmetic surgery. You should research and be conscious of the surgeon’s educational background, training, and practical experience.


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