1) By repairing, elevating, and strengthening the perineum and “perineal body” (the area just outside of and below the vaginal opening) and, if indicated, bringing the pelvic floor muscles into better apposition, both the “angle of attack” and the tightness of the vaginal opening are changed, leading to better gripability of the penis at the opening, and more pressure of this thrusting organ against the clitoral complex. (**But remember, a series of pelvic floor physical therapy sessions to bring you better in touch with, and build up your muscular strength in this area will significantly enhance your post-surgical results (and sometimes eliminate the need for surgery at all) Any surgeon who does not evaluate your muscular strength and offer you the adjunct of pelvic floor P.T. is not doing his/her job well (I always include P.T. in my post-op plans and, if not covered by your insurance, pay for the first 2 P.T. sessions!)
2) Frequently, after childbirth (especially a big baby; long and difficult delivery, etc.), the upper vagina will become significantly stretched, leading to looseness and little friction between penis or toy in the upper vagina. There are no muscles in your uppermost vaginal wall, so if you are considerably stretched, with looseness between the penis and vaginal wall, only a surgical procedure will minimize this enlargement. By surgically repairing the fibrous fascia of this area (to strengthen), and by removing wedges of vaginal skin, the size of this area may be minimized for a tighter grip.
3) Re: labiaplasty, anything that minimizes discomfort and labial rearranging, anything that, in the opinion if its “wearer” beautifies this area, anything that improves self-esteem will, by its nature, improve sexuality and sexual function.
Our research1 and that of others2-5 confirm these improvements in sexual satisfaction. Our study (1) is the largest outcome study of genital plastics published in the world thus far.
1) Goodman MP, Placik OJ, Benson RH III, Miklos JR, Moore RD, Jason RA, Matlock DL, Simopoulos AF, Stern BH, Stanton RA, Kolb SE, Gonzalez F. A large multicenter outcome study of female genital plastic surgery. J Sex Med 2010;7:165-77 2) Rouzier R, Louis-Sylvestre C, Paniel BJ and Hadded B. Hypertrophy of the labia minora; experience with 163 reductions. Am J Obstet Gynecol 2000;182:35-40. 3) Pardo J. Sola P, Guiloff E Laser labiaplasty of the labia minora. Int J Gynec Obst 2005;93:38-43. 4) Alter GJ. Aesthetic labia minora and clitoral hood reduction using extended central wedge resection. Plast Reconstr Surg. 2008;122:1780-89. 5) Pardo J, Sola V, Ricci P, Guiloff E, Freundlich D. Colpoperineoplasty in women with a sensation of a wide vagina. Acta Obstet et Gynec 2006; 85:1125-28.