Procedures for Tightening the Vagina
The lining of the vagina can be reduced, removing excess and redundant mucosa decreasing the diameter of the canal. The muscle ring, pubococcygeus, at the entrance or introitus can be tightened. These procedures along with exercises such as Kegles can help keep the muscle tone in this area. Aesthetic Vaginoplasty, in many cases, can increase friction during intercourse, giving women more control of vaginal muscles, increasing sexual satisfaction, while also creating a more attractive and appealing appearance to the vaginal area.
First off, I would recommend you lose all the excess weight and get to a normal weight. Most people feel better about themselves, have better sex and libido by just doing this one thing. Plus, your health will be improved too. The vagina will grow and stretch with increasing weight and with pregnancy. Kegels are a good idea but you may also need a vaginal rejuvenation procedure of some type performed. See link below for further options.Good luck.
Pubic area sagging / pubic lift
It is not uncommon to have changes in the lower abdomen following childbirth. Without pictures it is difficult to give you the best advice, but from your description it sounds like you have some loose skin in the area. This bulge is a result of the loose skin and some residual (normal) fat that is in the area). If that is the case, then a pubic lift can correct the area adequately. If you had a C-section, the same incision can be used. This is a straight-forward outpatient procedure. If you have significant loose skin in your abdomen, you can do a pubic lift in conjunction with a pubic lift, but I would not do that if you plan on having more children.
Saggy outer lips and pubic fat
I really need to see photos. However, the fat can usually be liposuctioned. If you have excess pubic skin, you may need a pubic lift. Stretched labia majora can be improved by excising some of the extra skin to make it more youthful. Injecting large amounts of fat can cause the labia majora to be large and bulging, which can make the woman self-conscious in tight clothes. Reducing the skin and adding some fat can be done so that the best of both procedures can be done.
Saggy & Droopy with extra skin around my vagina: What to do?!
I echo what my colleagues, Drs. Litrel and Pelosi have said; I agree exactly. I recommend, in addition to proceeding with weight modification and especially FREQUENT vigorous exercise, visiting at least 2 very experienced cosmetic gynecologists or cosmetic urogynecologists and be personally evaluated and get their feelings about which procedure(s) would be best for you. Please note: your ":general Ob/Gyn" (...like, the one who delivered your baby/ies) is NOT (!) the person to see, as "usua"l gyn or urogyn training DOES NOT teach the specific procedures to prepare a doc to properly handle a lipo/mons reduction/ labia majoraplasty/sexual-cosmetic vaginoplasy that your symptoms suggest. The weblink below, and other educational material on the site may be helpful...
Michael P Goodman, MD
Davis, CA, USA
How to tighten the labia majora and mons pubis?
The best options for tightening skin around the vagina and mons pubis are determined by how much loose skin is present and how that skin moves when it is pulled in different directions. Some women achieve adequate tightening of these areas by the indirect pull of a tummy tuck. Others require specific nipping and tucking of the mons and labia. Schedule a consultation to see what your best options might be.
What is best way to fix my body?
Sorry you are having problems. Women have more difficult lives than men do because of the miracle of motherhood. When you dream about having a baby no one tells you that your genitalia can suffer consequences as a result - or that the changes in your body can make you unhappy and insecure about sexuality and relationships, not to mention decreased physical pleasure and unpleasant symptoms such as bladder leakage.
You can have the appearance and functionality of you genitalia improved. I suppose that is the good news. If you were my daughter I would recommend a few things before you consider surgical correction. Losing weight to where you were before you became pregnant is a good idea to see what things look like down there. Breast feeding is an excellent way to do this - its God's liposuction. It takes more calories to breast feed a baby than it does to be pregnant.
Kegel exercises are recommended to build up your muscle support but they won't help your appearance.
Surgery may be required. The timing of the surgery is best when you are finished having vaginal births. If you plan more children soon and don't want a c section then I would wait until you are done - unless its years in the future. If you are willing to get a c section with your next pregnancy then its ok to have your genitalia fixed.
Generally what is needed most likely is a vaginoplasty and perineoplasty - recreating the vaginal tube and fixing the outside. Liposuction or fat injections are sometimes indicated but not as commonly. Sometimes an abdominoplasty or pannilectomy can be performed - or removal of the fat on the mons or a lift.
There are office procedures such as thermiva that can help you as well. It all depends on the specifics of your complaints and what is evident on physical exam.