Plastic surgery of the vaginal walls (colporrhaphy): myths and truth

Restoring women's health and improving the quality of intimate life after childbirth!

Age-related changes, childbirth, injuries and hormonal imbalances of a woman inevitably affect the condition of internal and external intimate organs. With the active development of the intimate surgery industry in Russia, the demand for vaginoplasty (colpoplasty) has increased significantly. Women do not want to lose the quality of their intimate life or put up with discomfort and physiological problems of the genitourinary system, so they do not hesitate to trust their most intimate secrets to intimate surgeons. Vaginoplasty surgery is indicated from a medical and aesthetic point of view. Vaginal plastic surgery restores elasticity to the muscles of a woman’s intimate area, eliminates prolapse of the vaginal walls and allows you to achieve a tight fit around your partner’s penis during intimacy.

Surgery - vaginal plastic surgery - is not only a means of improving the appearance of a woman’s genital organs, but also an opportunity to return pleasure and joy to sexual life. With a competent approach to solving this intimate problem (choosing a clinic and a good surgeon), all costs for intimate vaginal plastic surgery will more than pay off.

Vaginal surgery should be taken very seriously. This is not a procedure, but a full-fledged operation in the pelvic floor area. Vital organs are located in this area. If we consider the female anatomy: in front is the bladder, in the back is the rectum. A good result of vaginoplasty should be the correct anatomical distribution of organs. During vaginal plastic surgery, the surgeon literally “wins” back from the bladder and rectum the space that was previously occupied by the vagina.

After a properly performed vaginoplasty, a woman’s internal organs should be positioned in the same way as before giving birth!

Indications for vaginal plastic surgery

The motivation of patients asking about vaginal plastic surgery varies, ranging from dissatisfaction with aesthetics to physiological discomfort. Impaired urination, nagging pain in the lower abdomen, feeling of a foreign body in the vagina, nagging scars in the perineum. Separately, it is necessary to consider requests from patients who do not have pain syndromes, but want to improve the quality of their sexual life. In this case, the doctor must decide whether there are significant indications for surgery. The gynecologist surgeon evaluates not only the condition of the pelvic organs, nearby organs, ligaments and muscles of the pelvic floor, but also carefully listens to the wishes of the patient.

Our surgeons take special care in choosing patients who want to improve their sex life through vaginal plastic surgery. The positive or negative response of the doctor depends on the presence of compelling evidence.

Sarvar Bakirkhanov comments: “The main indication for surgery is, of course, the presence of pathologies and, extremely rarely, sexual discomfort, although one usually does not exist without the other. If after the birth of a child, 6-8 months later, a couple realizes that they experience discomfort during intimacy, then they can contact a specialist for consultation and examination, after which surgical intervention is often recommended.”

Deciding on any operation is not easy, and even more so on surgical vaginal plastic surgery. In order to change something about yourself, it takes desire, courage and opportunity. However, the first thing that is necessary for intimate vaginal plastic surgery is the indications.

Let's look at each of them in more detail:
1. Vaginal plastic surgery for prolapse or stretching of the walls. This indication is also called: “prolapse of the vaginal walls.” Plastic surgery for vaginal prolapse is the most common reason for colporrhaphy. Depending on which vaginal wall (anterior or posterior) has lost elasticity, either anterior or posterior vaginoplasty is performed. Stretching of the vaginal tissue leads not only to the formation of aesthetic defects and discomfort, but also to partial or complete loss of sexual pleasure for both partners. Thus, when the walls of a woman’s vagina are not tightly adjacent to the man’s penis, the necessary tension and friction is not created, which guarantees mutual satisfaction. In the absence of surgical intervention, this problem remains for life;
2. Vaginal plastic surgery after episiotomy (cutting the walls of a woman’s vagina to allow easier passage of the baby’s head during childbirth) or rupture of the perineum with the formation of noticeable scars;
3. Vaginal plastic surgery for prolapse of the uterus (partial or complete) in combination with plastic surgery of the vaginal walls for prolapse;
4. Vaginoplasty for cystocele (prolapse of the bladder), which is very often accompanied by the first indication. Bladder prolapse can be identified by the following symptoms:
   urinary incontinence during exercise;
5. sudden muscle contraction as a result of laughter, hiccups, sneezing, etc.;
6. frequent urination, including at night, which is interpreted as bladder hyperactivity;
7. rare urination, accompanied by pain.
8. Lack of sexual pleasure, joy of intimate life due to discomfort and heaviness in the vaginal area, which may also be present as a separate symptom;
9. pain in the lower abdomen and lower back.

Unfortunately, most women think about the need for vaginal plastic surgery only after removal of the uterus, its complete prolapse, when the bladder prolapses, or when the vaginal walls prolapse. While the loss of sexual pleasure or the formation of deforming scars (most often due to perineal plastic surgery after childbirth) also creates significant discomfort and deprives a person of a full life.

For mild vaginal ptosis, laser vaginal rejuvenation may be an alternative to surgery.

Separately, we note that if the indications for surgical vaginal plastic surgery are not expressed (degree 1-2 ptosis of the vaginal walls), there are initial signs of urinary incontinence, the patient has not given birth or has had childbirth once and plans to have children in the future, then an alternative option is plastic surgery of the vaginal vestibule and its walls. Can be laser vaginal rejuvenation using the Beatrice system.

Types of colporrhaphy

Colporrhaphy is a surgical procedure that changes the size of the vagina. Most often, problems with stretched vaginal walls, excessive width of the organ, prolapse, and urinary incontinence arise as a result of labor or age-related changes. Depending on the factors that caused the changes, the types of colporrhaphy are selected:

• Anterior colporrhaphy . This type of operation is a plastic transformation of the anterior vaginal wall. The intervention is prescribed for prolapse - prolapse - of the anterior wall of the organ, when it falls out simultaneously with the posterior wall of the bladder.
• Posterior colporrhaphy . Plastic surgery affects the posterior vaginal wall and becomes necessary when there is prolapse of the posterior portion of the organ, caused by insufficient tone of the pelvic floor tissues or ruptures formed during labor. Such intervention may become necessary if there is a threat of uterine prolapse or if there is a hernia in the rectum.
• Median colporrhaphy . Most often, surgery is prescribed for final organ loss in older women who are not sexually active. This approach is based on possible complications of the operation - the consequence may be the impossibility of sexual intercourse and loss of access to the uterine cervix for examinations. A prerequisite is a preliminary examination to exclude a predisposition to cervical cancer.

When prescribing colporrhaphy, they are guided by secondary changes associated with prolapse of the vaginal walls, both anatomical and functional. For the most part, the decision to undergo surgical intervention is based on the development of complications in adjacent organs.

Important. For first-degree vaginal prolapse, surgery is not an immutable solution; conservative treatment can be prescribed, based on special gymnastic exercises to strengthen the muscular system of the vaginal area and pelvic floor.

Vaginal plastic surgery after childbirth

Often girls resort to vaginal plastic surgery after childbirth, and this is very correct! You shouldn’t give up on intimate relationships with your partner after the birth of your baby.

If, before the first birth, a woman, due to genetic characteristics, experiences prolapse of the vaginal walls and/or a wide vaginal opening, which does not allow her to receive sexual pleasure, then most likely she will need vaginoplasty (colpoperineolevatoplasty). The same applies to women who give birth again after colporrhaphy. The price of vaginal plastic surgery after childbirth depends on the degree of ptosis of the walls, the presence of pathologies such as prolapse or prolapse of the uterus and bladder. However, when putting the material component, your health and a full sex life on the scales, it is important not to make a mistake.

Remember that you can be a caring mother and a sexually happy woman at the same time!

Operation process

Before colporrhaphy surgery, the patient is given general or local anesthesia. A speculum is inserted into the vagina to keep it open during the procedure. An incision is then made in the vaginal skin and a defect in the underlying fascia is identified. The vaginal skin is separated from the fascia and the defect is folded and sutured. Any excess vaginal skin is removed and the incision is closed with stitches. Risks of colporrhaphy include potential complications associated with anesthesia, infection, bleeding, damage to other pelvic structures, dyspareunia (painful intercourse), recurrence of prolapse, and failure to correct the defect.

In most cases, colporrhaphy can be done without complications and the woman can resume normal activities, including sexual intercourse, approximately four weeks after the procedure. After successful intimate repair, symptoms associated with a cystocele or rectocele resolve, although separate therapy or intervention may be required to treat the incontinence. Anterior colporrhaphy has an approximately 66% success rate in repairing bladder prolapse.

Vaginal plastic surgery: progress of the operation

There are many techniques for performing reconstructive surgeries for vaginal plastic surgery, but which one is right for you depends not only on the initial complaints and motivation, but also on your future plans for life. The plastic surgeon evaluates not only physiological, but also psychological factors that became the reason for your treatment.

In recent years, plastic methods for vaginal prolapse using synthetic materials have proven themselves well. Reinforcement of the vagina provides a 100% guarantee against further prolapse of the pelvic organs. However, before using this operation, you need to know whether the woman intends to give birth in the future.

Sarvar Bakirkhanov comments: “Colporrhaphy has strict indications: it is performed when stretching or prolapse of one or both vaginal walls occurs. There are many correction methods, but in each specific case the technique is selected individually. The art of the surgeon consists not only in technical skills (surgical), but in choosing the right technique, taking into account the condition of the pelvic organs, their relationships, the condition of the walls and muscles of the vagina, the patient’s age, concomitant diseases, the woman’s desire to give birth in the future, etc. d. Only full-fledged techniques with suturing of fascia, ligaments, and restoration of the pelvic frame allow maintaining lasting results for many years.”

Before performing vaginal plastic surgery, you need to find out whether your surgeon has a gynecological education. Be sure to inquire about the doctor's qualifications. It is very important! There are a lot of nuances in intimate plastic surgery that ordinary doctors do not know about. Even minimally invasive methods (laser vaginal rejuvenation, vaginal rejuvenation with fillers) should be carried out by gynecological surgeons, but not by cosmetologists.

Vaginoplasty should be performed by a qualified gynecologist surgeon!

Vaginoplasty restores elasticity to a woman’s vaginal tissue, and depending on which vaginal wall is stretched, the doctor performs either anterior or posterior colpolasticity (plasty of the anterior and/or posterior vaginal wall with levatoroplasty - tightening the muscles at the anus). In some cases, the surgeon combines both operations. In the practice of our clinic, about 60-70% of requests involve plastic surgery of one of the vaginal walls. Most often, women present with prolapse of the posterior wall.

If you are thinking about vaginoplasty, you should understand that each woman has an area of ​​tissue excised that is optimal for achieving the best result for her. Therefore, you should not determine in advance the number of centimeters you would like to remove. Insufficient tissue removal may not result in a noticeable vaginal shrinkage effect. If tissue is excised excessively, the woman will experience a feeling of tightness, accompanied by aching pain. Both cases will require repeated intervention by an intimate surgeon.

The essence of the “vaginoplasty” operation, which lasts from an hour to an hour and a half, is that the surgeon excises an oval or diamond-shaped flap of mucous tissue from the “problematic” vaginal wall. After this, the vaginal tissues are brought together and stitched while simultaneously strengthening the muscle frame.

Contraindications for surgery

Unfortunately, in some cases, medical indications and the wishes of the patient themselves do not play a role, since there are a number of contraindications to plastic surgery. General prohibitions are very similar to restrictions when performing any surgical intervention for which general anesthesia is used. This list includes:

• Complicated decompensated somatic pathologies in which damage affects the vascular system, kidneys, heart muscle and liver.
• The presence of infectious diseases in acute form.
• Development of acute thrombophlebitis.
• Clearly impaired blood clotting.
• Recovery period (acute or early) after a heart attack or stroke.
• In case of a dangerous combination of various injuries.
• During the postpartum period.
• Plastic surgery is not advisable in the case of the formation of malignant pathology and in the presence of diseases that are transmitted through sexual contact.

There are also relative contraindications, which include age. Colporrhaphy is not indicated for patients under 18 years of age, but such a prohibition applies only to situations where the changes performed are of an aesthetic nature. If the reason for the operation is abnormalities that interfere with the functionality of the organs, or there are medical prescriptions for changes, the intervention is carried out regardless of age.

Recovery after vaginal surgery

When turning to a vaginoplasty specialist, a woman should count not only on the surgeon’s experience, but also on her own discipline in the postoperative period after vaginal plastic surgery. The pelvic area at this time needs to be protected more than ever. Restrictions during rehabilitation after vaginal plastic surgery apply to all aspects of life, and not just the sexual sphere, as some women mistakenly believe.

• Firstly, you should not lift heavy objects or strain yourself. Any physical stress can lead to seams coming apart. Sexual rest after colporrhaphy lasts for 2 months.

• Secondly, during the rehabilitation regime after vaginal plastic surgery, it is necessary to exclude from the diet foods that provoke fermentation processes and constipation. Any increase in intra-abdominal pressure is extremely dangerous due to complications after vaginal plastic surgery.

• Thirdly, following the rules for treating the operated area (douching with disinfectants) will help avoid consequences after vaginal plastic surgery. To avoid inflammation after surgery, you must take a course of antibiotics.

• Fourthly, you cannot sit at a right angle for up to 7 days and you cannot squat for 2 weeks.

Reviews from patients after vaginoplasty

Impressions are divided into early, that is, in the first 2 weeks after the operation, and late, when rehabilitation is already over, they usually relate to sexual life.

Pain immediately after and hard not to sit

Yes, at first it’s quite painful, for about 3 days, it’s hard not to sit, but patients who used the orthopedic circle say that from the second day they could already move comfortably behind the wheel.

Swelling and external changes

The swelling of this area lasts about 10 days; by the way, the most common concern is the fear that “there” everything is completely sewn up. This is due to the fact that the appearance of the genital area after the operation changes dramatically, the genital slit is closed, the mucous membrane is not visible, and this is often frightening.

Pain during sex and tearing

Pain during sexual activity lasts from one to three months, until everything there stretches. Sometimes the posterior commissure is partially torn; this is the junction of the mucous membrane closer to the perineum.

There is nothing wrong with this, it will heal quickly, and this does not in any way affect the quality of the operation.

Complaints disappear

Almost immediately in the very first days, the feeling of heaviness in the lower abdomen disappears, urinary incontinence and thrush disappear. Water no longer gets into the vagina in the pool or bath, air does not come out during sex, other strange sounds, squelching also go away.

Threads jab and get in the way

The threads prick and itch. All threads are self-absorbing, that is, they go away on their own within one month. In principle, if this bothers you greatly, you can remove them 10 days after the operation.

Everything burns and itches

After just a week, everything may itch. This is thrush. Prescribing antibiotics and treating with antiseptics often leads to this. Prescribing conventional antifungal agents can quickly solve this problem. Using vaginal suppositories is often difficult, so tablets are prescribed.

Vaginal plastic surgery: rehabilitation period and timing

After vaginal plastic surgery, rehabilitation is 1.5-2 months. Therefore, advertisements about “instant results from vaginoplasty” should be treated with skepticism.

Vaginal plastic surgery is not an “office” procedure, but a full-fledged operation with a rehabilitation period!

Remember that you cannot perform vaginoplasty by running into the clinic for a few minutes. In addition, depending on the initial pathology, not one, but several reconstructive operations may be needed.

Vaginoplasty - complications

Despite the complexity of the operation, the main advantage of vaginoplasty is the relatively quick recovery and painless rehabilitation process. If vaginal plastic surgery is performed by an experienced plastic surgeon and you follow all the doctor’s instructions, there should be no complications after the operation.

After the operation, the woman remains in the clinic under the supervision of a doctor for up to two days. After discharge from the hospital, you can return to your daily activities, while dosing physical activity. Provided all rules are followed after vaginal plastic surgery, unpleasant consequences are excluded.

Sarvar Bakirkhanov comments: “The most important thing in such operations is the correctly chosen day of the operation, since the postoperative period is also important along with the operation. Therefore, when planning an operation, you need to be prepared to strictly adhere to restrictions on physical activity, sitting for 7 days and heavy lifting. It is necessary to exclude efforts and some foods from the diet. In other words, you need to find a moment in life when a woman can lead a safe lifestyle, enlist the support of loved ones, while in everyday life activity is not limited, the patient can lead a home life as before.”

Preparation

A physical examination is required before colporrhaphy. Most often, to diagnose pelvic organ prolapse. A speculum is inserted into the vagina and the patient is asked to tense up or sit upright. The doctor then checks the front, back, top, and sides of the vagina for the presence of a bulge. In some cases, physical examination may not provide a definitive diagnosis. The patient should refrain from eating or drinking after midnight on the day of colporrhaphy. Your doctor may prescribe an enema the night before your procedure if you are having a posterior colporrhaphy. After surgery, the patient will be placed on a liquid diet until normal bowel function is restored. Your doctor will recommend that you avoid activities for several weeks that may put stress on the surgical site, including heavy lifting, coughing, long walks, sneezing, straining your bowels, and sexual intercourse.

Vaginoplasty results

The duration of the effect largely depends on the genetically determined characteristics of the connective tissue of each individual woman. The effect of gravity is inevitable: over time, not only facial tissues sag, but also internal organs. Possible prolapse of the kidneys, spleen, etc. The only method - vaginal plastic surgery using mesh implants - provides a 100% guarantee that there will be no recurrence of prolapse in the future. However, if you are planning to give birth and are sexually active, then reinforcement with mesh implants is unacceptable.

Vaginal plastic surgery – where to do it?

If you have discovered that you have indications for vaginoplasty, then you need to be especially careful when choosing a clinic and an intimate surgeon. At the initial consultation during the examination, the doctor will tell you whether surgery is really necessary and what method is best to perform it.

Remember that the main thing for you is the choice of a surgeon, not a clinic, since it is in his hands that you trust your health.

When choosing a surgeon, pay attention to the following points:

1. Reviews and opinions. Of course, you need to search the Internet for reviews of those who have had a similar operation and can share their impressions with you. Today, there are many forums on plastic surgery, where you can read reviews from women about the operation itself, clinics and specialists. Most of these platforms allow you to write reviews anonymously, which gives women the opportunity to discuss even the most sensitive issues.
2. Information about the qualifications and experience of surgeons. Identify a few surgeons who have received the best reviews from patients and search for detailed information about each of them online. Pay attention to the doctor’s experience and specialization. You need to choose a surgeon who specializes specifically in intimate plastic surgery and has a higher education in gynecology.
3. Find out about the surgeon's approach. Try to find interviews and other publications about the surgeon of your choice. From them you can glean a lot of useful information about how a particular doctor performs vaginoplasty. The presence of scientific and medical publications, although not obvious, indicates the reputation of the surgeon.
4. Author's methods. Doctors with extensive experience often improve existing vaginal plastic techniques and develop their own (read more about the Beatrice laser vaginal rejuvenation technique). This is definitely a plus.
5. Surgeon consultation. After you have chosen several specialists, go to each of them for a consultation. Ask as many questions as possible about how long it will take to prepare for the surgery, how long it takes, what the recovery period is like, and what complications there may be. Do not be lazy to clarify all these points with your doctor, since what is written about vaginoplasty on the Internet may be very different from what is in reality. This will become a kind of test for a specialist. The doctor must answer all your questions in detail and patiently. If he tries to brush it off and change the subject, then this is a reason to think about whether you need such a surgeon.

Where to get vaginoplasty in Moscow?

For most patients, when searching for a plastic surgeon, the determining factors are: price, level of the clinic and the doctor’s reputation. This approach is fundamentally wrong. Focusing solely on the highest or lowest price, you risk making a mistake in choosing a worthy surgeon. A high price does not guarantee high quality of services provided. In turn, a greatly reduced price should also alert you; it may indicate insufficient experience of the doctor and/or poor-quality technical equipment.

How much does vaginal plastic surgery (vaginoplasty) cost?

Name	Price
Plastic surgery of the anterior vaginal wall, category 1	60,000 rub.
Plastic surgery of the anterior vaginal wall, category 2	65,000 rub.

Female intimate surgery is a field in which aesthetics is closely related to the physiology and reproductive system of a girl. That is why you should be extremely careful when choosing a vaginoplasty specialist. When choosing a surgeon to perform vaginoplasty, you need to make sure that this operation is one of the priorities in his practice. In Moscow, many specialists perform intimate plastic surgery, but it is one thing when a doctor can, in principle, perform an operation, and quite another when a surgeon specializes in performing it and performs it regularly, sometimes even daily.

Sarvar Bakirkhanov comments: “A competent surgeon operates a lot and often - not occasionally, but literally every day.”

Our clinic uses modern equipment and high-quality materials to perform vaginoplasty. Operations are carried out in an operating room equipped with the latest technology, taking into account all the requirements of international standards.

The surgeons of our clinic are among the best specialists in the field of intimate surgery and operative gynecology. Doctors have more than 20 years of experience and regularly perform intimate surgeries, including vaginoplasty. By contacting our specialists, you can be sure that the result of vaginoplasty will meet and even exceed your expectations.

We guarantee complete transparency of the surgeon’s work at all stages of the operation:

• At the initial consultation, the surgeon will tell you a detailed surgical plan;
• Will give recommendations during the rehabilitation period;
• Will ensure full achievement of the expected result.

Vaginoplasty is a complex operation and cannot be cheap. Surgery is not a lottery; you shouldn’t hope for luck here; it’s better to immediately trust a reliable specialist who guarantees high-quality vaginoplasty.

Pros of intimate plastic surgery

• Speed

Aesthetic intimate surgery does not take much time and does not require hospitalization; most procedures, together with a doctor’s examination and reconstructive manipulations, take no more than 4 hours.

• Improving the quality of sexual life

The vast majority of women note that after intimate plastic surgery they began to like sex much more than before: the intensity and frequency of orgasms, sensuality have increased - for example, according to women who have undergone intimate plastic surgery, after correction of the labia minora, the partner’s genital organ is felt more tightly, which, Of course it brings more satisfaction.

• Increased self-confidence

It would seem that a delicate defect that is completely invisible to a wide circle of the public can have an unexpectedly strong impact on a woman’s self-esteem and her behavior. After the vaginal procedure, the inner feeling of attractiveness grows, the woman becomes more relaxed and open, which not only improves her mood, but also has a positive effect on sexuality.

Obstetrician-gynecologist Svetlana Rogovskaya about intimate plastic surgery. Source - Live Healthy!

• Health improves

Eliminating unwanted connective tissue and moisturizing the intimate area has a beneficial effect on the vaginal microflora. Plastic surgery of intimate areas restores the natural water balance and rejuvenates the external genitalia, making them more elastic, resistant to injury and firm.

• Invisible result

With the help of the latest innovations in aesthetic surgery, there will be no traces or noticeable stitches left from the intervention, you can calmly make love without worrying about a possible awkward situation.

However, no matter how effective and relatively simple intimate plastic surgery for women is, it should be remembered that this is a full-fledged operation, before which a doctor’s consultation is necessary.

If for some reason aesthetic procedures are not currently indicated, the gynecologist can replace them with special cosmetics or gymnastics.

Modern gynecology has all the necessary knowledge and means to regulate not only women’s health, but also the aesthetic appearance of the external reproductive organs, and special cosmetics help maintain the vaginal microflora and pH balance, improving the effect of medical procedures.
Washing gel for intimate hygiene GINOCOMFORT promotes the effective restoration of the physiological pH level of the intimate area, including after operations on the external and internal genital organs. The gel relieves irritation and accelerates the healing of tissue damaged during surgery. GYNOCOMFORT gel is hypoallergenic and suitable for daily use. Sources:

1. Analysis of the experience of using laparoscopy in the treatment of anomalies of the reproductive system in children with gonadal dysgenesis. Poddubny I.V., Faizulin A.K., Fedorova E.V. and others // Androl. and genit. hir. – 2012. – No. 1. – P. 33–38.
2. Defining, assigning and designing sex. Chau P.L., Herring J. // Int. J. Law, Policy Family. – 2002. – Vol. 104 – R. 327–367.
3. Tactics of reconstructive plastic surgery in patients with disorders of sex development classified as female. Adamyan L.V., Kurilo L.F., Makiyan Z.N. and others // Androl. and genit. hir. – 2010. – No. 3. – P. 56–62.
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