Elizabeth A. Hutson, MD

From your day #6 photos, I think the labia minors just look swollen which is to be expected 6 days after surgery. Use ice and get off your feet to reduce swelling and enhance healing. Stop looking at it every day so it doesn’t stress you out. I think you will be really happy with the final results. Be patient with the healing process.

It is hard to tell for sure looking at the photos, but it looks suspicious for a rectocele. A rectocele is a hernia of the rectum into the vagina. This is more likely to happen after a vaginal delivery.

I recommend seeing your OB/GYN for an evaluation and exam. This condition is not dangerous but may cause bothersome symptoms. Often, the symptoms can be overcome with good bowel control and regularity. Surgical correction restores normal anatomy and helps relieve symptoms.

It depends on the amount and location of the loose skin. Radio frequency energy may be better at shrinkiing and lifting the skin if it is healthy. If it is saggy secondary to atrophy with menopause then laser may work better to make the skin plumper and healthier, then RF to further optimize results if needed.

Because your problem started at the time of menopause, MLT is likely to work. Atrophy effects the elasticity of the skin, as well as, lubrication, suppleness, and inflammation. The 2 most problematic areas to experience pain with intercourse (especially if no vaginal deliveries) are at the hymenal ring and at the opening where the skin meets the vaginal mucosa. I would recommend having the MLT treatments and if the issue continues, have a band release to open the area that is sore with intercourse. This will optimize your skin and allow enough room for painless penetration.

I have had variable results treating LIchen Sclerosis with MLT. MLT will certainly improve the overall health of the vulvar and vaginal skin relieving the symptoms that come with atrophy thus, lessening any symptoms from the LSA.

About 1/3 of my LSA patients treated with MLT now have normal appearing skin and are asymptomatic. Most of these patients are treated more frequently and lighter each time until the skin is healthier. I think it is definitely worth a try. Also, Clobetasol cream can be used in conjunction.