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Vaginal tightening refers to the procedure where the vaginal structure, which has become widened or sagged due to various reasons, is tightened either through the use of laser or surgical methods. For mild vaginal laxity caused by collagen or connective tissue loss, vaginal laser treatment can be used to correct the condition.
Vaginal laser treatment not only tightens the tissue but also stimulates collagen production and supports the mucosal structure of the vagina, providing a lasting effect that improves quality of life and sexual health. This method can be particularly effective for those with chronic vaginal discharge or menopausal women who only require minimal tightening, as long as there is no prolapse of the uterus, intestines, or urinary tract. Patient satisfaction with vaginal laser treatment is generally very high.
Vaginoplasty refers to the surgical procedure used to reconstruct and tighten a vagina where the support of the connective tissue has significantly weakened. Unlike vaginal laser tightening, this procedure involves surgical incisions and sutures. The effect of vaginoplasty is permanent, as the surgery provides structural support to the vaginal tissue. This surgery can be performed under general anesthesia, spinal anesthesia, or local anesthesia.
The pelvic floor and vaginal structures are capable of expanding to accommodate the passage of a baby during childbirth. The muscles and connective tissues forming the pelvic floor are located between the pelvic bones and provide structural support. The point where all the connective tissues meet is known as the perineal body, located between the anus and vagina in a 2 to 3 cm area. Vaginal widening is often associated with perineal body descent.
Vaginal width varies from person to person. Even in individuals with no risk factors, some may have a naturally wider vagina and may seek tightening procedures.
The vaginal structure is supported by the pelvic floor muscles. Unfortunately, most exercises, apart from specific Kegel exercises, do not increase vaginal tightness. Heavy lifting and certain sports can actually contribute to increased vaginal loosening.
The most significant cause of vaginal widening is normal vaginal childbirth. However, if a cesarean section was performed after labor started and the cervix was dilated, vaginal widening may be inevitable. Difficult, traumatic, or prolonged births are major contributors to vaginal laxity.
Other factors contributing to vaginal loosening include:
The vaginal structure is composed of mucosa (rugae),muscles, connective tissue, and the pelvic bone. Various traumas and pressures can cause the connective tissues to stretch over time. Vaginal widening can lead to several symptoms.
All these factors contribute to a decrease in both quality of life and sexual confidence. Vaginoplasty corrects vaginal laxity by restoring an ideal vaginal size, alleviating all the aforementioned issues.
The vaginal structure can expand to the extent necessary for childbirth. This flexibility is enabled by the mucosa and muscle structures. If no traumatic birth occurs, there will be little change in the pelvic bone structure. The degree of vaginal widening varies from person to person, based on anatomical structure and other factors.
The amount of tissue that will be removed during a vaginoplasty procedure varies from person to person. The final result aims to achieve a vaginal width that does not cause pain during intercourse while still being tight enough to improve sexual satisfaction.
Vaginal width can be reduced by 2 cm or more, with some cases requiring up to 10 cm of reduction. The key is determining how much width should remain after the procedure. The surgery will be designed based on the desired outcome.
Vaginal tightening surgery is performed at many centers in Istanbul. Patients from both within Turkey and abroad often travel to Istanbul for this procedure. Patients from outside the city typically return home one or two days after the operation.
The surgery typically lasts about 45 minutes. If no additional procedures are required, the duration may be shorter, especially in experienced hands. However, because of the proximity to the intestines, the procedure must be performed carefully to prevent infection. If labioplasty is also performed, the surgery time will be longer. In practice, labioplasty and vaginoplasty are often performed together.
Vaginoplasty can be performed under general anesthesia, spinal anesthesia, or local anesthesia, depending on the patient's needs. General anesthesia may be preferred for patients who cannot tolerate spinal or local anesthesia due to anxiety. For shorter surgeries, anesthesia can be administered using a laryngeal mask, a device used for short-term anesthesia. Spinal anesthesia is typically used for patients with additional health concerns, such as smokers. Local anesthesia is used only for smaller procedures, but it is not recommended for large surgeries or cases of severe vaginal widening.
The cost of vaginal tightening surgery depends on various factors, such as whether additional procedures like labioplasty, G-spot enhancement, or cystocele repair are performed, as well as the hospital or surgical center where the procedure is conducted. If you have previously undergone surgery in the same area, the cost may increase due to the extended duration of the surgery and additional operating room fees.
If vaginal tightening surgery is performed correctly and no subsequent vaginal delivery occurs, it is permanent. It is important to repair the muscle structure. If only the mucosa (the internal tissue) is removed and the muscle structure is not repaired, both the vaginal structure and the tightness may not be achieved adequately. As a result, vaginal widening may recur, and the level of pleasure during intercourse may not increase.
The area between the vaginal opening and the anus is called the perineal body. The perineal body is the area where all muscle tissue meets. In a proper vaginal tightening surgery, this muscle structure must be supported. If the perineal body is not surgically supported, perineal body collapse and vaginal looseness will occur, and the desired permanence in vaginal tightening surgery will not be achieved.
If all these factors are taken into account, vaginal tightening surgery will be permanent.
As with any surgical procedure, there are always risks related to infection and anesthesia. However, several important precautions can minimize these risks.
During the surgery, the area is near the intestines and a contaminated area. Care should be taken with cleaning the surgical area and avoiding contact with the anus region. It is important to administer antibiotics while the patient is under anesthesia.
After the surgery, it is crucial to follow hygiene protocols, avoid swimming for the first two weeks, and take the prescribed antibiotics as directed to prevent infection. It is also important to avoid constipation to prevent pain and tension on the stitches.
Recovery from vaginal tightening surgery is easier as waking up from anesthesia is relatively short. Pain, which can be controlled with painkillers on the first day, usually disappears by the next day. Starting from the second day, taking showers while standing is possible.
You can return to social and work life on the 2nd or 3rd day. Sexual intercourse can occur after the 4th week, once the stitches have completely healed. Sports and activities like swimming can also begin after the 4th week.
During the recovery process, light pink vaginal discharge is normal and expected as part of tissue healing. However, if there is foul-smelling or yellow-green discharge, you should consult your doctor.
In vaginal tightening surgery, narrowing of the vaginal opening allows for tighter contact between the penis and vaginal tissue during intercourse. This will improve sexual life quality. Furthermore, there will be no complaints such as vaginal gas or excessive fluid during intercourse, which will positively affect sexual confidence.
Sexual intercourse can occur after 4 weeks post-surgery. If ideal vaginal tightness is achieved, sexual life quality significantly improves.
After vaginal tightening surgery, the following points should be considered:
Pain is generally minimal. Some patients may experience hesitation when sitting or standing or while moving for a while. There is no restriction on sitting, standing, or moving after vaginal tightening surgery, and no movement will damage the stitches.
In clinical practice, labioplasty and vaginal tightening are often performed together. This is a very common combination surgery. If you are experiencing vaginal widening and labioplasty is planned, it is highly beneficial to perform both surgeries together to improve the outcome.
Since the vaginal opening is narrowed and the labia (inner lips) end at the vaginal opening during vaginal tightening surgery, it is very appropriate to perform labioplasty at the same time. If labioplasty is added to vaginal tightening surgery, the operation time may be slightly extended. The recovery process and post-operative instructions for both labioplasty and vaginal tightening are the same.
Vaginal tightening surgery is most commonly sought by women who have had a normal vaginal birth. During normal vaginal birth, the episiotomy line is often present during vaginal tightening surgery. While performing vaginal tightening surgery, this episiotomy healing line is removed to achieve a scar-free appearance.
In some cases, vaginal tears during childbirth or scarring from episiotomy can cause discomfort or hardness, especially when there are infections or bleeding during healing. In such cases, episiotomy scar revision (removal of the birth scar) is added to vaginal tightening surgery. If the birth scar is mild, vaginal tightening surgery alone may be sufficient, as it will overlap with the incision areas during the procedure.
Non-surgical vaginal tightening with lasers is possible, but only under certain conditions. The vaginal width should not be too large, and there should be no rectocele (rectal prolapse) or other hernia-like issues. When these conditions are met, laser vaginal tightening can provide satisfactory results by increasing collagen synthesis and supporting the vaginal muscle structure. However, for laser vaginal tightening to be permanent, there should be no vaginal prolapse or rectal hernia.
Patients often report high satisfaction with vaginal tightening surgery because it resolves issues such as recurrent infections, lack of pleasure during sexual intercourse, vaginal gas, and decreased sexual confidence. These issues often arise due to excessive vaginal widening, which prevents proper contact between the penis and vaginal tissue.
Vaginal tightening surgery has become more common with increased sexual awareness. However, the healing of the tissue may vary depending on factors such as the patient’s structure, surgical technique, and the presence of infection.
If, after the initial vaginal tightening surgery, one of the following issues occurs:
Revision labioplasty surgery can be performed at least 3 months after the first surgery. Because adhesions may form between the vaginal tissues after the first surgery, revision vaginal tightening surgery may take longer than the initial procedure. The recovery process is nearly the same. To support the tissue, PRP, vaginal laser, or vitamins may be added to facilitate quicker recovery after revision vaginal tightening surgery.
Proper pre-operative planning with the patient is essential to improve satisfaction and avoid the need for further surgery.
Vaginal prolapse or just widening can occur after a normal vaginal birth. The late postpartum period ends after the 6th month. Vaginal tightening surgery can be performed after the postpartum period, once breastfeeding is finished and the late postpartum phase ends (after the 6th month).
During the first 6 months, blood pressure, heart size, and the uterus return to their pre-pregnancy size. Any surgery performed earlier could put stress on the mother’s body. Additionally, internal and external genital organs return to their normal size several months after childbirth. For these reasons, vaginal tightening surgery is not appropriate during the early period.
During postpartum vaginal tightening surgery, episiotomy scar revision is also performed, the vaginal area is tightened, and the vaginal ruga (fold) structure is preserved.
Vaginal opening that remains naturally open in its position causes issues such as discharge, burning, vaginal gas, and frequent infections. During vaginal tightening surgery, narrowing the vaginal opening will prevent this natural opening. A properly performed vaginal tightening surgery will result in no opening in the natural position and a symmetrical appearance.
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