I lost a bit of weight so have some external and internal laxity. Laxity is why I chose this procedure. I'm not sure the laxity has improved, however, I'm having the strongest, hardest orgasms of my entire life. Worth every penny.
Excellent questions! The ThermiVa technology (radiofrequency heat) improves the health of the tissues, stimulates collagen and supports proper functioning of the tissues. I have treated younger women who have not had children, and never seen an issue with too much tightening, as it is enhancing the health of the tissues, not tamping them down. Healthy tissues are strong and supple, so too tight should never be an issue. (An ablative procedure on the other hand could potentially cause scarring and create an issue although I have not seen it personally but have heard stories of bad results and pain after Co2 laser treatments.) I usually treat both internal and external with every patient, as it is an enhancing procedure and will be beneficial externally for the health of tissues, clitoris, enhance orgasm etc.. and see no reason to not offer both areas. I have never had a patient request only internally but it could be done - for example if you only wanted to enhance lubrication and did not want treatment to the outside (too sensitive?), no reason why not but most people like having the full procedure, and the cost would be the same. (Consider asking an aesthetician to give you only a facial for your cheeks because your forehead didn't have any skin issues at the time... )
When ThermiVa first came out, the timing was a little different - usually 10 minutes internally and 10 minutes externally. Since then, recommendations and technique have changed a little bit, and I have found the perfect timing to be 12 minutes on the external areas, and then 15 minutes internally. If a patient has an episiotomy scar that is painful or thickened or vaginal stenosis, the timing and specific targeted treatments in addition may be added, to help soften or target those areas, but more time then that has not been necessary to see fantastic results. We have the upgraded Arvati device and it heats up immediately saving a few extra minutes for treatment as well.
I have been providing the ThermiVa treatment ever since it became available several years ago, and tightening is a major benefit in patients with laxity. I have seen great improvements with patients. It improves the health of the tissues, improves lubrication, builds collagen and supports the bladder as well, improving stress incontinence with laughing, coughing, sneezing and jumping too. Each person is different in terms of their laxity (how loose) and why -- It can come from losing a lot of weight, gaining a lot of weight, the process of pregnancy and delivery of children etc... On the opposite end of the spectrum, a woman with a stenosed vaginal opening from hormone deficiency and other reasons, often can gain better opening due to the procedure improving the health of the tissues! So I have seen it actually work well in both directions! I suggest anyone thinking about ThermiVa come in for a complimentary consultation to evaluate your individual circumstances and see what the procedure can do for you.
