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Perineoplasty is the surgical correction of the muscles and skin tissue in the perineal body, the area between the anus and vagina.
The perineal body plays a crucial role as the point where the muscles of the female genital region converge. If this area is cut during childbirth episiotomy or torn irregularly without an episiotomy, vaginal tightening without a perineoplasty surgery would be ineffective, as sagging and vaginal enlargement will recur.
The perineal body, located between the vagina and anus, is a 2–3 cm muscle group junction that forms the base of the pelvic region, or the “roof” of the vaginal area. The desired tightness in the vagina is provided by the integrity of these muscle groups.
When tears or separations occur in the perineal body, the “roof” of the vaginal area is disrupted, leading to sagging and vaginal widening. Perineoplasty involves opening the skin tissue, suturing these muscle groups together with permanent stitches, and restoring complete vaginal integrity.
The pelvic floor, or the base of the pelvic region, is located at the exit area of the vagina and anus. All vaginal and anal muscle groups converge at the 2–3 cm area known as the perineal body. This connection prevents vaginal widening and rectal prolapse into the vagina.
Pelvic floor disorder refers to the tearing or sagging of these muscle groups. If perineoplasty is not performed for a patient complaining of sagging, the prolapse surgery will be ineffective and provide only a temporary solution.
Similarly, if perineoplasty is not performed during a vaginoplasty (vaginal tightening) surgery, the intended vaginal tightening cannot be achieved. Thus, perineoplasty is crucial for pelvic floor correction.
Perineoplasty is usually performed in combination with rectocele repair (rectal prolapse into the vagina) or vaginoplasty (vaginal tightening surgery). It is rarely done as a standalone procedure.
In response to the question “How is perineoplasty performed?” the separated or torn muscle groups are clamped during surgery and sutured together with permanent stitches. Excess skin is also removed and sutured aesthetically.
Perineoplasty surgery can be performed under general or spinal anesthesia. It is generally not suitable to perform this surgery under local anesthesia, as it involves deep muscle adjustments. The standalone perineoplasty surgery takes about 15 minutes, but the total surgery duration increases when combined with pelvic floor procedures. Perineoplasty uses permanent sutures, and the skin sutures are applied aesthetically.
The cost of perineoplasty depends on the hospital where the procedure will be performed, the type of anesthesia, and whether additional procedures like vaginoplasty or rectocele repair are included. Since genital aesthetic surgeries are often combined procedures, the exact cost of perineoplasty is determined after a consultation.
The surgery itself typically takes 15–20 minutes. However, when combined with genital aesthetic and prolapse surgeries, the total operation time varies.
Postoperative care after perineoplasty is generally similar to other aesthetic surgeries. Key points include taking a shower the day after surgery, avoiding sexual activity and heavy exercise for the first three weeks, using antibiotics carefully, and maintaining personal hygiene.
Patients can return to their social and work life on the third day after perineoplasty surgery. Additionally, avoiding constipation post-surgery is important for preventing pain.
Patients who have undergone perineoplasty typically do not require painkillers after 2–3 days post-surgery. Furthermore, since sagging and vaginal widening are permanently corrected, patient satisfaction remains high in the years following the procedure.
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