The following are some of the most frequently asked questions we are asked regarding Connecticut cosmetic vaginal procedures. To learn more or discuss which procedure may be right for you, call and schedule a consultation today.

Q. I have delivered several children and since then, things just aren’t the same. Sex isn’t as satisfying as it used to be. My muscle tone is poor and there is no longer the sensation I once experienced. My doctor told me to perform Kegel exercises. I tried this for weeks but with no results. When I learned about your procedure I was happy to know that something really could be done to help me. Please explain how vaginoplasty can correct my physical problems and enhance my sexual pleasure.

A. Many women share your experience and have acted to change the quality of their lives. Vaginoplasty or vaginal rejuvenation is a modification of a well established surgical procedure. I utilize both the laser and most recently state-of-the-art high frequency (no scalpel) surgery with the Ellman Surgitron for reduced post-operative discomfort, minimal scar formation, enhanced healing and excellent cosmetic results. The techniques that we have developed result in a relatively bloodless procedure performed on an outpatient basis. In brief, we will tighten the vaginal muscles and supportive tissues, as well as reduce the vaginal lining. The procedure will improve vaginal muscle tone, strength, and control. It will effectively decrease the internal and outer vaginal diameters, as well as build up the perineum, the area immediately outside the vaginal entrance and above the anus. This increases friction during intercourse with greater sexual feeling. The procedure can also provide an restorative enhancement of the external vaginal structures by removing saggy, loose skin.

Q. I have had several children and lose control of my urine when I laugh, cough, sneeze, and exercise. This problem has terribly impacted my life. It is socially embarrassing. Can I correct my urinary problem and become tighter at the same time?

A. Your problem is called urinary stress incontinence. It is caused by the relaxation of the top portion of the vaginal wall. Vaginoplasty can correct your problem of stress incontinence along with providing vaginal tightening at the same time.

Q. How long does vaginoplasty take?

A. The surgical time depends upon the extent of the procedure. The procedure takes about one and a half to two hours.

Q. Where is the procedure performed?

A. Most of our surgeries are done at The Aesthetic Surgery Center in Darien, Connecticut,a licensed, state-of-the art ambulatory surgery center. For those patients who prefer an outpatient hospital setting, I use The Greenwich Hospital in Greenwich, Connecticut. Both facilities are less than one hour from Manhattan.

Q. The outside of my vagina is loose and floppy, and there is an open space between my lips. Can I have vaginal reconstruction?

A. In this case I only need to repair the outside of the vagina and the perineum (the area immediately below the entrance to the vagina). Usually vaginal relaxation is less extensive and the repair can easily be accomplished within an hour.

Q. I never had children but I experience some relaxation and would like to feel tighter. Can I have the procedure?

A. Many women who have not undergone natural childbirth experience a weakness in the vaginal floor, either due to genetics, diminished tone or previous surgery. If that is the case there is no reason to think vaginoplasty cannot improve your quality of sex life.

Q. What types of anesthesia are available?

A. You have your choice of anesthesia, be it local anesthesia with twilight sleep, regional, epidural or spinal. The type of anesthesia depends upon the extent of the procedure and what you are most comfortable with.

Q. When can I resume sex after surgery?

A. You need to abstain from sexual intercourse for six weeks in order to allow for complete healing. At this point I will teach you how you soften and prepare the vagina for comfortable intercourse.

Q. Will my partner feel any changes when we have sex after surgery?

A. If you have had vaginoplasty there will be increased friction from the tightening which he will appreciate. If you have had labiaplasty, both of you will experience less interference from the recontoured labial tissue.

Q. When can I return to work after my vaginoplasty?

A. In general, returning to work is dependent upon the type of work you do. Most patients can resume work within 5 to 7 days. If your occupation involves intense physical activity such as lifting or carrying heavy objects, it may take a bit longer. I can provide a letter of disability that you may need for your job.

Q. I am from out of town. How long do I have to remain in the area after labial reduction or vaginoplasty?

A. You can return home in two to three days, but much sooner for less complex procedures. For labial reduction you can return home the following day.

Q. How much discomfort will I have after surgery?

A. With our advanced techniques of using long acting local and regional anesthetics, you should be pain free for the first 6 to 10 hours. Afterwards, patients experience mild to moderate discomfort controlled by oral pain relievers and cold packs. I expect you will be able to walk, shower and get around easily within 24 hours. Since the pelvic floor and muscles surrounding the rectum have been brought together you most likely will have discomfort for a week or so, but under some circumstances a sensation of pressure can last for up to a month.

Q: Can you explain the cost of labiaplasty?

A:  Your surgeon has spent 50-60 hours personally trained by pioneers in the field to learn all the nuances of this surgery. He has mastered the use of laser and radiofrequency surgery to give you the best possible outcome. Very few labiaplasty surgeons have this experience. This is a precise surgery that should be done under the safest operative environment which is provided at an ambulatory surgery center rather than in an office examination room. The surgical facility and anesthesia generate an expense in addition to the surgeon’s fee.

Q: Is labiaplasty covered by insurance? Do you participate with surgical loan programs such as Cosmetic Credit or offer a payment plan?

A: Unfortunately insurance companies view all labia reduction or reconstructive surgeries as cosmetic and provide no coverage or reimbursement. This is true even for labial tears, lacerations and obstetrical trauma.

We do not participate with any surgical loan programs. Their interest rates are exorbitant  for the patient and they demand significant fee reductions from the surgeon. The ethics of these services are questionable. We do not offer installment payment plans.

Finally, you should never use the least expensive physician as your major decision making factor. In fact, when it comes to all restorative vaginal surgery it is always worthwhile spending more to achieve the best outcome. Meticulous surgery takes time, and the overall cost of the surgery center and its staff, anesthesia and the surgeon is based on time. You are paying for an expert and a team who has devoted a lot of training, expense and effort to provide the best cosmetic result, not to have you realize a less than desired outcome.

Please note, these are just a few of the literally hundreds of questions we receive at The Greenwich Center. To learn more, you can schedule a free telephone consultation with Dr. Jacobson in his Greenwich, CT by calling 203-869-8360 or by email Skype consultations with The Center for Vaginal Restorative Surgery can be arranged as well.


Q. What are the surgical risks for vaginoplasty?

A. Vaginal rejuvenation is a safe procedure with very low risk, with the chances for excessive bleeding and infection, as well as adverse reactions to anesthetics, is less than 1%. If one requires surgery on both the upper and lower walls of the vagina, there is a potential for injury to the bladder and the rectum. As with any surgery one can encounter postoperative tissue contraction which can potentially result in painful sex. These complications are rare.

Q. Can vaginoplasty be combined with labiaplasty or hymenoplasty?

A. Yes. These procedures are frequently done at the same time.

Q. Can these procedures be combined with other cosmetic surgical procedures?

A. Absolutely. Vaginoplasty or labiaplasty can be combined with many cosmetic surgical procedures such as liposuction, breast augmentation, eyelifts and rhinoplasty. I would help you coordinate these multiple surgeries with our excellent plastic surgeons.

Q. Does insurance cover vaginoplasty or labial reduction?

A. Unfortunately, most insurance companies view these surgeries as cosmetic and are reluctant to reimburse patients. An exception is the patient who has urinary stress incontinence and sometimes if a prominent rectocele is present. Depending upon your insurance carrier and the terms of your individual policy, reimbursement may be available. Many of our patients have received significant payment from their insurers after their surgery. We will work with you to maximize any reimbursement you are entitled to.

Q. Is There a Difference in Sexual Sensation After Vaginoplasty?

A. For many patients, dissatisfaction with sex is one of the issues that leads them to look into having a vaginoplasty procedure. A slack or loose feeling in the vagina can reduce friction, and therefore sensation, for both partners. Vaginoplasty can repair the lost elasticity that results from age, childbirth and hormonal shifts.

By restoring a youthful, healthy muscle tone in the vagina and surrounding tissues, vaginoplasty usually results in increased sexual satisfaction for the woman and her partner. The procedure doesn’t change the sensitivity of this nerve-dense tissue, but the increased tone and tightness results in greater pleasurable stimulation of the nerves.

Q. How Risky is Vaginoplasty?

A. Vaginal rejuvenation is an increasingly popular outpatient surgical procedure. Usually done under local anesthesia, vaginoplasty typically takes less than two hours to complete. Many patients choose twilight sedation, so they’re more comfortable with the procedure.

Because vaginoplasty doesn’t require general anesthesia, it carries a lesser risk than surgeries that do. With many surgeries, anesthesia carries a higher risk than the procedure itself.

Although rare, there are risks of certain complications. Injury to the rectum or bladder is possible. Scarring and tissue contraction have also been reported by a small number of patients. Infection may also occur, particularly if the patient fails to follow her post-operative instructions.

The overall risk of adverse effects of a vaginoplasty is less than one percent.

Q. How Long Does Vaginal Reconstructive Surgery Take?

Vaginal reconstructive surgery, in the hands of a skilled, experienced gynecological surgeon, is a relatively short procedure. Every woman’s body and goals, and therefore every surgery, is different. However, in most cases, you’re looking at an outpatient procedure that will not require an overnight hospital stay.

Most vaginal reconstructive surgeries take between 20 and 90 minutes to complete. You will need to arrive approximately an hour and a half before your surgery and will spend up to an hour in recovery afterwards. This brings the total time you’ll spend in the office to somewhere between three and four hours, approximately, and slightly longer if you are having labiaplasty at the same time.

You should rest for at least 72 hours afterward, and full recovery should be complete in less than six weeks in most cases.

If I have not answered your questions, please call or email me at I would be very happy to speak with you personally to answer your questions. Just give me a time and number to call you. As always, discretion and privacy are an integral part of my practice.