Perineoplasty

Perineoplasty 2017-09-21T14:13:09+00:00
Perineoplasty

The perineum is the area between the vagina and the rectum. It may require surgical repair, or a perineoplasty, due to loosening, tearing or scarring.

Who is a Candidate for Perineoplasty?

During childbirth, you may experience tearing in the perineal tissue or require an episiotomy. While these generally heal naturally, large cuts or tears may require surgical treatment to heal properly. In other cases, scar tissue can change the look of your vaginal area or cause discomfort.

You may also notice stretched vaginal muscles and tissue that leaves you with a feeling of looseness in the vagina. This can be caused by vaginal delivery or extreme weight loss. Vaginal looseness may result in decreased sexual satisfaction. Speak with your OBGYN about any symptoms you may be experiencing to determine if perineoplasty is right for you.

Performing a Perineoplasty

Perineoplasty is an out-patient procedure that typically lasts 30-45 minutes. Your OBGYN will perform the perineoplasty with minor sedation and local anesthesia. Excess tissue and any scar tissue is removed using a small v-shaped incision. The two sides are then rejoined. You will likely be able to return home after about an hour of observation.

Recovering from Perineoplasty

It is recommended you rest with ice and medication for the first three to four days following the perineoplasty. You may experience some discomfort and minor bleeding. Wearing a sanitary pad can help catch any bleeding. Since the incision is closed with stitches, it’s important to keep the area clean and dry. The sutures should dissolve after about two weeks.

You may experience discomfort with urination or constipation. Drinking plenty of water and eating fiber can help reduce the risk of constipation. In addition, you should limit yourself to light activity for four weeks, at which you may resume normal activities. However, you should abstain from intercourse for six weeks following the procedure.

If you have any questions about perineoplasty- speak with your OBGYN.

Frequently Asked Questions

The term Aesthetic Vaginal Surgery is also known by other names such as Vaginal Rejuvenation, Laser Vaginal Rejuvenation, Labiaplasty, Vaginoplasty, Designer Laser Vaginoplasty, Perineoplasty, and Hymenoplasty. Aesthetic Vaginal Surgery is a broad term that includes any one of these individual procedures. Since it is a rather new field dealing with the appearance and function of a woman’s private parts, the terminology has not been standardized. In simple terms, Aesthetic Vaginal Surgery and its many names deal with cosmetic surgery of the vulvar and/or vaginal region. It is cosmetic surgery of one’s “Private Parts.”
Surgery to improve the appearance and function of a woman’s vagina is important for both personal esteem and physiologic function. Childbirth is often traumatic resulting in tears that when healed are not personally satisfying. Far too often, women suffer from vaginal prolapses or “hernias”, urinary incontinence, vaginal laxity, and aesthetically unappealing labia after experiencing both complicated and uncomplicated vaginal deliveries. Many who have finished their childbearing years are now concerned about their personal appearance and are looking for ways to deal with this problem. Some feel that they have lost a great deal of sexual sensation due to “looseness” of the vagina.
Gynecologists, urogynecologists, plastic surgeons, and even some dermatologists do most of these types of surgeries. Gynecologists are trained specifically in repair of fallen bladders and rectums, fallen uteri or vaginas, and repairing tears in the vaginal region as part of their everyday work. Urogynecologists usually are highly sub-specialized and focus primarily on the worst incontinence and pelvic organ prolapses encountered. Plastic surgeons are generally trained in cosmetic surgery on men and women and very few are trained in vaginal surgery. Some plastic surgeons are highly trained in totally reconstructing new vaginas in transsexuals, transvestites, and pelvic cancer patients. However simply by their vast amount of training and experience, gynecologists and urogynecologists are best equipped to perform these specialized surgeries in my opinion.
The laser is an important surgical tool that has many advantages. Certain lasers are very precise and are used as scalpels. Some lasers are ablative (destructive) and used more to destroy abnormal tissue or to resurface the skin. Many dermatologist and plastic surgeons use this type of laser. However, there is no magic in the use of lasers. In fact, other modalities such as radiofrequency cautery units can give more precise cuts and less tissue destruction by a factor of ten or more. Other surgeons will avoid electrical units altogether and use highly precise scissors or scalpel units. Another way to look at lasers is to realize that it is a tool in the doctor’s bag but that it is not ultimately any better than a cold knife. However, it is undeniable that using the term “laser” adds glamour and a sense of prestige to a procedure.
Almost all of the cosmetic surgeries are outpatient. Labiaplasty and vaginoplasty cases are typically finished within an hour or two. If a repair of the bladder, rectum or bowel is needed, then a 23 hour overnight stay may be warranted. If a hysterectomy is needed than it is typical to stay one to two days. Many patients feel the pain involved is similar to the discomfort AFTER a baby has been born. They are somewhat sore but not in agony. Pain control is excellent in the large majority of cases.
The term labiaplasty is a general term referring to either a labia minoraplasty or a labia majoraplasty. Labia minoraplasty is the cosmetic reshaping of the inner folds of tissue, called the labia minora, or smaller inner lips of the vagina. Labia majoraplasty is the cosmetic reduction of the broader, outer lips of the vulva known as the labia majora. Various instruments are used such as pinpoint cautery, Yag lasers, fine scissors, or a knife. The edges are then sewn together with delicate absorbable sutures. A vaginoplasty (commonly referred to as vaginal rejuvenation) is when a diamond shaped section of tissue is excised from the inside of the vagina and brought down to the outside of the vagina. Often times a small triangular area is also excised from the perineum (the area right below the vaginal opening). This is called a perineoplasty or perineorrhaphy. If needed, sutures that bundle loose muscles together are used to narrow the vaginal opening. At the very end of the procedure, a radiofrequency unit may be used to smooth out any skin irregularities and further tighten the vaginal opening. This also provides for growth of new, softer, smoother, and tighter skin just as it would when used on a face.
Surgery can trim either excessively large labia minora or those that are asymmetric. It can also reduce enlarged, bulging, or sagging labia majora. The excess bulge of skin in the vagina can be trimmed, and the vaginal entrance may be tightened to ones satisfaction. The entire vagina can be made tighter by excising loose vaginal skin. Surgery alone will not improve the tone of your vaginal muscles. You need pelvic floor exercising similar to Kegel’s exercises. Surgery can also add support to your fallen bladder, rectum, bowel, or vagina. In some cases, radiofrequency devices are used to smooth out wrinkled vaginal skin. This is performed in order to make it look new and young again. Many women tell us that they once again are happy to be able to wear jeans, bathing suits, and form-fitting outfits simply because the rubbing and irritation have disappeared.
The procedure is usually done in a surgery center. If a simple labiaplasty is performed, then the option of performing the surgery in the office under local anesthesia and oral and injectible medication can be considered. We tailor the surgery to the patient’s projected pain tolerance, anxiety level, and health status.
You can have a short nap or be fully awake. General anesthesia is the most common anesthetic used because of the patient’s desire not to know or feel anything. Then there is the spinal or epidural anesthetic that allows you to be awake. This is ideal for those who have a fear of going to sleep or have other major medical problems. Sedation and use of local anesthetics is the least invasive of anesthetic options. Many choose this so that recovery is almost immediate and the down time is minimal. If the case involves bladder, rectum, or bowel repair of if a hysterectomy is performed then general anesthesia is the standard.
A patient interested in aesthetic vaginal surgery usually calls to set up an initial appointment for evaluation. If at the time of evaluation the patient and physician agree that surgery is the correct choice, then a surgical date is finalized. If the individual is an established patient, then I will usually see her within a week of surgery to perform a pre-op examination. They may also have this pre-op evaluation with their primary care physician for surgical clearance. This is where blood work, X-rays, EKGs are done if needed. The majority of the time a simple blood count is all that is needed.
Dr. Thomas has many years of experience and has undergone special training in aesthetic vaginal surgery. In fact, Dr. Thomas is one of the only surgeons in Texas who has been trained by Dr. Red Alinsod and is a fellow of the Alinsod Institute of Aesthetic Vaginal Surgery (FAIAVS). He has concentrated his skills in the art of aesthetically pleasing vaginal cosmetic surgery. Furthermore, Dr. Thomas is always in the forefront of his field and travels regularly to meet, discuss, and train with other prominent physicians in order to better serve his patients. Dr. Thomas truly cares for his patients, and it is this commitment to service that drives his entire team.
Call us at 972.566.4555. You can also email [email protected]
Anesthesia is a risk factor because of the very rare possibility of a reaction to either the injected medication or inhaled agents. You can also aspirate food or fluid that can obstruct your breathing tube or even cause a pneumonia. There is risk of infection at the surgical site. There is also a possibility of bleeding or hemorrhage and a need to have a transfusion. With transfusions there is risk of HIV, Hepatitis, and perhaps other unknown viruses. There is even the risk of death. A risk you should also consider is one similar to “buyer’s remorse” when one is not fully happy with the result of surgery. The risk of having the surgery redone or amended is present but fortunately is very rare. We will fully review the risks of surgery before the case is even scheduled and give you every opportunity to have your questions answered.
We advise “Pelvic Rest” for six to eight weeks. This means nothing goes inside the vagina, such as tampons or vibrators, and no sexual intercourse for that length of time. The only thing allowed in the vagina is the applicator full of estrogen cream we give you to aid in the healing process. We also recommend loose clothing and no tight underwear, thongs, or jeans that may cause rubbing and discomfort. We advise against lifting objects heavier than a six-pack of Cokes or a gallon of milk. We also advise against participating in activities that can cause you to strain or bear down. We do not want tension on our suture line nor do we want to stretch tissues we have just tightened. Basically, treat yourself like a princess during this healing phase.
If you had a labiaplasty or vaginoplasty, you can return to light duty at work or reduced activity within 4 days. If you had both a labiaplasty and vaginoplasty, then it may take you a whole week before you feel comfortable to go back to work. Much depends on the type of work you do. For example, a woman who has a desk job will return to work sooner than one who has to walk or run and carry objects from place to place. We will need to individualize your return to work date. In any event, you are usually healed by six weeks although complete healing takes up to three months.
We recommend that you wait six weeks before resuming sexual intercourse. If you had a vaginoplasty, it is also recommended that some stretching exercises of the surgical site start at six weeks to soften any scarring that may occur and to make the sexual experience more comfortable after surgery. This stretching exercise is not needed if you had a labiaplasty alone.
There are many sites on the Internet that address the topic of sexual gratification and surgeries that may enhance this experience. In summary, there is an opinion that aging and the trauma of childbirth results in looseness of vaginal tissue, weakening of vaginal muscles, and resultant decrease in friction, hence, decreased sexual gratification for both men and women. Unfortunately, this topic is much more complex than simply tightening a vagina to increase frictional forces for both sexes. Surgery can indeed result in tightening of the vagina, but there is no guarantee that your sex life will be better or that your orgasms will be more pronounced. You must weigh carefully the claims of an improved sexual experience. Sexual response is multifactorial and it is often the case that a person’s personal relationship with his or her partner is the primary determining factor in the happiness of an intimate relationship. Surgery is no panacea but it certainly can improve appearances and increase friction involved. A positive body image is priceless. One more thing, surgery does not affect a woman’s ability to become aroused or her ability to become moist prior to having intercourse.
If you had a labiaplasty, there will probably be a dramatic decrease in the interference of tissue that will be felt by both you and your partner. If you had a vaginoplasty or vaginal rejuvenation, there will be increased frictional forces that both partners will feel. You may need to perform some stretching exercises of your vagina after surgery to allow comfortable intercourse. This is even more important if your partner is large in size.
Yes. I work with highly respected Aesthetic Plastic Surgeons who are able to perform anything from liposuction, tummy tucks, to breast implants or facial reconstruction. Those names can be provided upon request. Your whole “mommy makeover” can be achieved at one time!
Aesthetic Vaginal Surgery is not covered by health plans since it is cosmetic in nature.
The initial consultation is $200. During this initial consultation, we will discuss the risks/benefits/options of surgery, do an examination, discuss costs, and give you every chance to ask questions that are vital to you.
Labia minoraplasty is $3,500. Labia majoraplasty is also $3,500. Clitoral hood reduction is $1500. Vaginoplasty is $4,250. Perineoplasty is $2500. A perineoplasty is included when paying for a vaginoplasty. Combination surgeries are given a discount as are those individuals paying cash for the procedure(s). These prices include surgeon fees, a preoperative visit, photo documentation, and postoperative care. These prices do not include the facility fee or the anesthesia fee. We have negotiated for their best cash paying fees. The facility will roughly range between $1200 and $1800 depending on the extent of surgery being performed. The anesthesia will approximate $1000. The final cost for both the facility and anesthesia will be determined and paid for prior to surgery.
Yes we do. We have financing programs available, and the application process is quite easy.