Daniel Sternfeld, MD

Femilift is a noninvasive method the resurfaces the vagina without surgery.  This non surgical procedure is performed without anesthesia and will tighten the vagina, improve sensation and even treat mild urinary incontinence.  My patients notice increased sensation during intercourse, and their partners also notic the difference.
If you want to physically change the appearance of your vaginal opening, you will need a vaginoplasty, a surgery which will surgically tighten the vaginal muscles.  
A qualified surgeon who offers both surgical and non surgical solutions can best advise you after complete pelvic examination.

Hymenal tags are usually removed under local anesthesia.  Your doctor may not have a set up in his or her office to remove these.  The discomfort from the local anesthetic is brief, and the procedure should be over in less than 5 minutes, even if the tag is large.

Your description of splinting with bowel movement and loss of muscle tone indicate a injury to the pelvic floor musculature after childbirth.  A grade 3 rectocele means that the posterior vaginal tissue in prolapsing or bulging beyond the vaginal opening.  Since your urogynecolgist says your "measurements" are normal and you say nothing is "hanging out", I would be concerned that you have other issues that are not being addressed, such as nerve damage to the pelvic floor and rectal descent. Both of these problems would not be addressed with a rectocele repair.   I think you need to get a third opinion from a competent pelvic floor surgeon, as an improperly performed surgery may leave you with pain during sex from scar tissue and continued symptoms. 

Your picture shows large hymenal remnants or tags.  Normally these don't bleed or become irritated. Before you remove these you should make sure these are the source of pain with sex and not another problem like scarring after your delivery.  A careful exam by a physician can determine if these are the source of your problem.  Cosmetically they would be easy to remove in the office under local anesthesia.

Childbirth may cause trauma to pelvic support structures that may lead to vaginal laxity.   For most women, newer methods of vaginal resurfacing stimulate collagen formation and lead to a very noticeable tightening of the vagina.  Our practice has been using the Femilift fractional laser with incredible results that has produced results that have markedly improved sexual satisfaction for the woman and her partner.  This procedure only requires several 15 minute visits that require no surgery or anesthesia.  There is no post procedure pain or discomfort. This approach is truly revolutionary in its minimal invasiveness and maximum patient satisfaction.  It also reduces and or eliminates urinary leakage, vaginal dryness and irritation.
For women with severe pelvic organ prolapse and damage to underlying muscular and tissue support, surgery is still required for proper repositioning of pelvic organs.  A gynecologic exam is needed to see if you are a candidate for nonsurgical vaginal tightening.