Once a very rare surgical procedure, vaginoplasty has gained acceptance—and popularity—in recent years. One question that tends to come up often is whether these cosmetic vaginal procedures are cosmetic in nature or reconstructive. The answer is that they can be either, or both—depending on the patient’s needs.

In some cases, particularly after a vaginal childbirth (or several), the walls of the vagina and the surrounding supportive tissue can become so stretched as to affect basic functions of the pelvic region. If the vagina or perineum tears during childbirth, or if a doctor’s episiotomy doesn’t heal properly, the vaginal walls may lose their elasticity and never regain their tone.

If the vaginal opening remains wide, a woman may not be able to use tampons without slippage or leaking during her menstrual period, resulting in embarrassment and inability to enjoy certain activities such as swimming. In extreme cases, the woman can lose bladder or even bowel control. This can also result from certain injuries to the pelvic area.

In cases such as these, vaginoplasty is a reconstructive procedure; and may be covered under your health insurance plan. For more information, consult with a Connecticut vaginoplasty surgeon today.

Steps of a Vaginoplasty

Once you are sedated, the vaginoplasty surgeon in Connecticut will do a thorough evaluation of the pelvic floor, assess the vaginal diameter, muscular tone, and strength. While under complete relaxation from twilight anesthesia, the doctor will determine the degree of tightening discussed in our earlier consultation.

After sterilely washing and draping the area, your surgeon will administer a regional anesthetic, numbing the entire vagina for several hours to keep you comfortable long after your surgery is over. The vaginal lining is then injected with a dilute solution of anesthetics and adrenaline, which blanches the tissue to prevent it from bleeding.

Marking the Skin

Next, the skin is marked. A vaginoplasty surgeon in Connecticut will follow the surgical markings on your perineum using high frequency (no scalpel) surgery with the Ellman Surgitron. It is a unique instrument because it has a cool tip so that thermal damage to the underlying tissue is measured in microns, instead of in millimeters. Compared with the laser, high-frequency surgery produces far less post-operative swelling, inflammation, and pain—yet achieves superb cosmetic results.

The surgeons with our practice have used a laser for many years but now my patients experience the remarkable difference the Surgitron makes. It is without comparison in its finesse and no touch technique. To help with certain bleeding sites we use fine point electrocautery or an argon laser.

If urinary stress incontinence or a fallen bladder needs to be corrected, the bladder is surgically elevated out of the vagina and replaced into its proper position in the abdomen.

Various techniques are used to reestablish the normal functional relationships necessary for the control of voiding.

Final Steps

Operating on a normally functioning bladder and vaginal roof will often not enhance the sexual effectiveness of vaginal rejuvenation and should be avoided. In fact, the sensitivity of the G-Spot may be compromised and always has to be taken into consideration.

At this point, the floor of the vagina is elevated away from the underlying muscles and the incision is extended three to four inches inward, almost up to the level of the cervix. This is a very important part of the procedure.

To many vaginoplasty surgeons and gynecologists, vaginoplasty only means tightening the entrance of the vagina. However, true sustained tightness along almost the full length of the vagina can only be achieved by going deeper inside so the separated muscles on the sides of the vagina can be identified and brought together.

This significantly diminishes the vaginal diameter and at the same time, your degree of tightness can be highly individualized.

Once this is completed any excess vaginal skin is removed and the edges are carefully approximated with strong absorbable suture. Fine-tuning or additional tightening can be done at this time.


All of your stitches will dissolve over the course of several weeks while your tissue regains its strength. Virtually all your stitches will be gone when you are ready to resume sex. However, our Connecticut vaginoplaty doctors are still not done!

The perineum (the area between the vaginal opening and the anus) is often flattened out and lacks tone. This is usually due to childbirth and needs to be restored to its original form.

When the perineum tightens during sex, it pushes your partner up against the clitoris to increase friction and stimulation. To regain this function a perineoplasty, or restoration of the perineum to its original state, is undertaken.

Finally, the skin edges are smoothed out and brought together with fine stitches that are tied under the skin to minimize irritation from the knots. Vaginal rejuvenation is a meticulous procedure and usually takes 1 to 2 hours. When your surgery is completed, you wake up within two to three minutes, transfer to the recovery suite, and go home or to your hotel shortly thereafter. You’ll be pain-free for hours, without the need for a catheter in the bladder or a pack in the vagina.