Vaginoplasty and pregnancy- Is it a waste to undergo vaginoplasty if Im not sure that Im not having more children?

 Im 23 years old, but I have no man and cant see it ever happening the things are now. I cant feel much during intercourse, and have been dumped several times after beeing intimate with a man even tough we have been dating for long. I can fit 5 fingers in my vagina when not aroused so I guess Im what people would call pretty loose. Im going kegels regularly and participate in pelvis physical therapy.

Doctor Answers 7

Vaginoplasty and pregnancy- Is it a waste to undergo vaginoplasty if Im not sure that Im not having more children?

Dear Annabelle,

Thank you for your question.  As an obstetrician and gynecologist who specializes in cosmetic-plastic gynecology, I am asked this question all of the time.  However, there are many factors to consider when answering for your particular situation at the young age of 23. 

If your are talking about getting pregnant in the next few months and want a vaginal delivery, then I would recommend scheduling the surgery 3 to 6 months after the birth and nursing of your child.  If indeed pregnancy is in the near future, you might also consider non-surgical procedures, such as ThermiVa for vaginal tightening.  IF you are a good candidate for ThermiVa, based on your pelvic examination and clinical history, ThermiVa may be a good option for you and has been very successful for many of my patients. Again, remember that patient selection is very important to the success of these non-surgical options and you must be evaluated by pelvic examination.  

If pregnancy is just a possibility, then you should consider 'vaginal rejuvenation' (vaginoplasty and perineoplasty) to improve your quality of life and enhance your sexual gratification.  Please be evaluated by a gynecologist or urogynecologist who has specialized training in reconstructive vaginal surgery.  This surgery can help you feel feminine and confident again when done properly.  If and when you become pregnant an elective Cesarean Section should be performed by your obstetrician to protect your surgical repair.  Continue your pelvic floor exercises as recommended by your surgeon, this will only help maintain your results.

All of the best with your decision and chose a cosmetic-plastic gynecologist that is experienced and makes you feel comfortable.  

Take Care,
Dr. Serrao

Vaginoplasty and pregnancy- Is it a waste to undergo vaginoplasty if Im not sure that Im not having more children?

Hello and thank you for your question!

Although there is no direct relation between giving birth and the need for a Vaginoplasty, some surgeons would recommend you wait until you are sure you will not be giving birth again. You can always get a smaller procedure if you would like to feel more comfortable and confident, with the appearance of your vagina in between births. Fillers and fat grafting are good options in order to feel more comfortable or confident. You could wait until you are sure you will not be giving birth, but it is not "against the rules" if you don't.

Thank you for the question and please consult a board certified surgeon for the safest and best results.

Good luck!

Enriquillo Clime Rivera, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 8 reviews

Vaginoplasty and pregnancy- Is it a waste to undergo vaginoplasty if Im not sure that Im not having more children?

You have a couple of options. If you have a vaginoplasty and are considering having more children than I would agree that you might want to consider a C-section moving forward in hopes of avoiding the vagina stretching out again. The other option to possibly consider would be Thermiva which is an in office procedure that allows for vaginal tightening and allows you to avoid surgery. With Thermiva, it is likely you will need maintenance touch up treatments but it is a good option for patients that desire vaginal tightening that are still considering vaginal delivery in the future. Best wishes.

What if I decide to have a child after vaginoplasty/"Vaginal Rejuvenation?"

Hello "Annabelle,"

Please read Dr. Miklos' answer below. He and I have worked together on studies, and I endorse what he has said. I also endorse what my colleague Dr. Pelosi has said. But let's get to the answer to the question you asked. No, it is not a waste of time (or money) to have a sexuality-enhancing, self-esteem-enhancing vaginal tightening procedure (aka "perineoplasty" and "vaginoplasty;" sometimes termed "vaginal rejuvenation.") now, to enjoy the better sex, even with the possibility you will be having further children. HOWEVER... any future childbirths should be by "C-section" to protect your repaired pelvic floor and "breaking down" the (hopefully careful & thorough) repair you have had.

Other words of advice. The average "general gynecologist" or urogynecologist is not trained to perform a specifically sexually-enhancing (and, yes, my success rate is ~ the same as Dr. Miklos & Moore: 87-88%-- this is from a study we did together a few years ago...) and pelvic floor-strengthening vaginopalsty-type tightening procedure. For this you will need a gynecologist or urogynecologist who is specially trained and SPECIALIZES in vaginoplasty, otherwise you may be disappointed in your results. And-yes!- continue to do your pelvic floor exercises & work with your pelvic floor P.T. after surgery... Sex is one of the few things in life that is fun, free & healthy. The weblink below and other areas on the website may be helpful to you!

Best wishes,

Michael P Goodman MD
Davis, CA, USA

Vaginoplasty now or later?

If your loose vagina is ruining your sex life, get a vaginoplasty, but commit to elective cesareans in your future pregnancies to protect your investment. I would recommend a thorough pelvic exam to assess any pelvic floor damage you may have sustained during childbirth. This would need to be repaired at the same time. Kegels and PT will make your muscles stronger, but only surgery will bring them closer together to achieve the tightening effect that you seek.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.6 out of 5 stars 24 reviews

Should a vaginoplasty be performed before finishing childbirth?

There are many young women who are not finished having children who want to have surgery to tighten their vaginas because of sexual dysfunction that you describe.  A five fingerbreath vagina is a significant physical finding.  It is unlikely that exercise or physical therapy or even office procedures such as thermiva will get you the results you desire.  For many patients who are in your shoes I tell them to have c sections a week before their due date if and when they get pregnant.  This is very reasonable as you have required reconstructive surgery.  A patient who I performed a vaginoplasty on two years ago had a baby last year by c-section.  With her earlier pregnancies she had suffered preterm deliveries.  After the reconstruction she carried the baby to full term.  

If you are not willing to consider c section then I would encourage you to wait to have corrective surgery.  Don't be pushed into vaginal delivery by an uncooperative obstetrician with your next pregnancy.  Have good communication right from the start.

Michael Litrel, MD, FPMRS, FACOG
Woodstock Urogynecologist
5.0 out of 5 stars 3 reviews

Vaginoplasty at 23 years old

Dear Annabelle111:

thank you for your question as this is a question asked often.  Academics (professors) and elitists will tell you that you should never have a reconstructive surgery on your vagina until after having children.  Though academically this has teeth it doesn't hold up in the real world.  You see those people ( including brilliant doctors [sarcasm])  shouting out orders can easily make such statements because they are not afflicted with your condition nor are they experiencing  your quality of life.   They are not living your life or walking in your shoes.

In theory:  The reason why they tell you not to undergo reconstructive vaginal surgery is simple and honest  --- you can destroy the results of surgery by getting pregnant and or having a child.  So in theory they are CORRECT but education, a medical degree and political connections does not mean they are right. Academics does not directly translate to the real world~~~

In reality:  You are a young vibrant healthy woman who is seeking answers about  a condition because you are not enjoying a fulfilling sex life.   What are you supposed to do suffer for the rest of your life and have a child or two at 40 and then get fixed???   At that point you wasted the next 17 years of not having a more fulfilling sex life.   I can almost guarantee if others could walk in your shoes they would feel different about you getting surgery.  When a condition a situation or a diagnosis doesn't affect you personally it is easy to spout off academic prose.  

My recommendations are:  1) Kegel exercises  ( which you have done) 2) consider a PT to help you with Kegels ( which you have done) 3) consult a reconstructive vaginal/pelvic surgeon who specializes in cosmetic vaginal surgery.  Vaginal tightening is not strictly a cosmetic surgery.  The average ob/gyn won't even understand what you are talking about and tell you that vaginal tightening can not be performed. The average cosmetic surgeon will tell you to see a gynecologist.  

Now lets talk about you specifically--- you and only  you can tell if you are not having enough friction with intercourse.  Of course there will be a man who might suggest a woman is not tight enough but how do we know its not his penis size or he is having trouble maintaining an erection (he has E.D. i.e. erectile dysfunction).  When a woman, such as yourself, states :   1) I don't feel anything during sex and 2) I can fit 5 fingers into my vagina--------doctors should listen and either help or send you to someone who can help.   A normal healthy woman just doesn't want to have surgery without a reason.  

In most cases such as yourself---- I would recommend an evaluation and most of the time would recommend surgery.  When choosing a surgeon please choose a surgeon with experience, expertise and results.   You don't want to go to some fly-by-night surgeon who "thinks" he knows what he is doing.  No surgeon can guarantee a 100% chance of success but a surgeon should be able to tell you their success based upon analyzing their patients results.   Dr Moore and my patients have a successful surgery 88% of the time at 1 year after surgery.  That means at 1 year 88% of patients are satisfied with the results of their surgery for vaginal tightening.  If in the first year a patient is not happy or not tight enough we will redo the tightness operation at no additional cost i.e. surgical fee but the patient still needs to pay for the anesthesia and operating room.  You need a surgeon who has a high success rate and a low complication rate.  Please do your research carefully and do NOT let a surgeons location dictate  your decision as to who your surgeon should be.

Best of luck with your decision

John R Miklos MD
Urogynecologist & Cosmetic Vaginal Surgeon
Atlanta ~ Beverly Hills ~ Dubai 

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.