WTH! Vaginal Tightening/Vaginal Rejuvenation/Vaginal Reconstruction…

Woman thinking about questions vaginal rejuvenation

WTH! Vaginal Tightening/Vaginal Rejuvenation/Vaginal Reconstruction…

The language relating to the upgrades available involving female vaginal appearance and function can be confusing. So many descriptive terms exist. Vaginoplasty. Perineoplasty. Vaginal tightening. Vaginal Rejuvenation. Vaginal Reconstruction. What’s what, and how do these terms compare and differ? What exactly is indicated in order to achieve each woman’s ultimate goal?

The purpose of vaginal reconstruction is an improvement in sexual function and pleasure, as well as improved self-confidence from an improved, less wide-open appearance of the vaginal opening. By reconstructing the vaginal/pelvic floor in such a fashion, the penis (or fingers, toys, or other items) is pushed more snugly upward against the internal clitoris and G-spot for increased friction and sexual pleasure.

The term vaginal rejuvenation was first used in the early 2000s by one of the
fathers of genital aesthetics, Dr. David Matlock, M.D. Dr. Matlock utilized a laser fiber as his cutting tool when he was surgically reconstructing a patient’s vagina and was the first to coin the term vaginal rejuvenation, referring to a surgical reconstruction of the vaginal/pelvic floor for the purposes of tightening, re-building, and better functional and aesthetic appearance.

How is this done surgically? Surgery is performed in the hospital, in a surgicenter (usually under spinal or general anesthesia), or in an office surgical suite under a local (awake) anesthetic by those few well-experienced specialists who are masters in this operation.

(This includes me and Dr. Goodman here in Davis, CA; Dr. Red Alinsod in Laguna Beach, CA; Drs. Miklos and Moore in Atlanta, GA; and perhaps one or two others in the U.S.) While the technique is reproducible from patient to patient and has a basic surgical structure, I cannot emphasize enough the importance of seeking a surgeon experienced in the performance of these procedures specifically for reasons of enhancement of sexual pleasure, and not simply for correction of incontinence or “pelvic relaxation” (although these goals may also be accomplished with a “tightening” operation).

After suitable anesthesia, and after adequate exposure of the outer half of the vagina and perineum has been established via a special retractor system designed specifically for this purpose, a “kite-shaped” incision is made with a special radiofrequency (“RF”) needle, laser fiber, or scalpel, with the top of the “kite” in the midline (approx. 1 1⁄2 – 2 1⁄2 inches within the vagina), the “wings” of the “kite” at the vaginal opening/old hymenal ring area (at approx. the four o’clock and eight o’clock positions), and the “tail” of the incision in the midline (around 1⁄2 to 1 inch above the anal verge). After the (frequently attenuated) fibrous sub-vaginal support tissue has been taken down from the vaginal skin, the superficial vaginal, vestibular, and perineal skin, as well as all of the underlying scar tissue from obstetrical episiotomies/lacerations and subsequent repairs, is removed, exposing the supportive but stretched muscle bundles.

The whole area is repaired with a “three-layer” closure, first re-approximating the pelvic floor (“levator”) muscle bundles with large-caliber absorbable sutures, then covering these by re-approximating the fibrous fascia, gathering and strengthening it in the process, placing two or three “crown sutures, firmly building up and re-approximating the muscular wall of the vaginal opening, and finally effecting an aesthetic, cosmetic reconstruction of the vaginal opening, to a degree re-creating the vaginal opening that existed “pre-babies…”

In addition to bulking and strengthening the pelvic floor, these operations are designed to anatomically change the “angle” of the vaginal canal from its frequently lax, more horizontal post-childbirth position and re-establish the “downward tilt” that nature gave it prior to the terrific forces of childbirth breaking it down (in some women more than others). By tightening the “barrel” and elevating the perineal body, additional “bulk” is in essence provided to a penis that in reality may be a bit smaller than it once was. This allows the penis to “push” more firmly against the G-spot and allows both the dorsum of the penis and your lover’s pubic bone to better “massage” the outer clitoral structures.

It does make a difference in who you choose to perform your pelvic floor tightening procedure. While most general Ob-Gyns have adequate training in general vaginal pelvic floor operations, only a few are specifically trained in surgery designed for the purpose of vaginal tightening for the purpose of enhancement of sexual pleasure.

I have always had the vision to provide women with awareness, options, and solutions. Taking pride in providing a safe space for women to explore
choices for their sexual health, rejuvenating their appearance, and
improving their lives. I understand the intensely personal and sexual health
issues involved in these surgeries and am dedicated to patients having the
best outcomes with the highest levels of safety and comfort. If you have
questions, please contact my office and make arrangements for a personal

Dr Michael A Reed