African American female, 45, 230lbs, 5’5 height, 6 children, how to correct vaginal laxity?

Thank you for your questionVaginoplasty literally means plastic surgery of the vagina. It is not a specific procedure (though originally it meant the creation of a new vagina) and every surgeon has a different idea of what technique(s) comprises a vaginoplasty. There is no consensus on which surgical procedure(s) is performed. The effectiveness depends the type and degree of problems, on which procedures are performed and the quality of the surgeon(s) that perform them. For example: The vagina is like a six sided tube: entrance, apex, upper inside(bladder), lower inside(rectum) and two sides. Each of these needs to be evaluated and has different treatments. My best analogy for understanding what is going on the inside is the steel belted tire which which has a strong support structure (fascia like the steel belt) and a flexible stretchable surface which has grooves(mucosa like the tread). When the steel belt tears, the tread balloons out increasing the surface area and smoothes out the grooves. This is what is called prolapsing or "an acquired sensation of smooth/wide vagina." There typically are several defects that can occur from childbirth and these can all be corrected best by a procedure called " site specific defect repair".. You need a surgeon who knows how to identify and correct each of the possible defects within the length of the vagina. Also, there can be defects on the entrance(orifice) and apex. These also must be evaluated and repaired. I doubt the surgeon who did your procedure correctly addressed your anatomy so as to fix your problem.These procedures can be done safely by well trained surgeons but requires you to do your homework, investigate training, ask their approach to repair the different parts of the vagina, look at reviews, before and after photos and evaluate the quality of the consult.

You need an exam in person to determine what is going on. If your vaginoplasty "didn't work" and it was done expertly, there are several reasons for this - sometimes muscle issues, other times pelvic floor issues, other times connective tissue issues, etc, etc, etc.

Hello, in vaginoplasty surgery, narrowing along the entire wall and muscle repair must also be performed.If there is vaginal looseness of the size you describe, surgery will be the best option.

Hello, If you have a vaginoplasty surgery before you may continue with non invasive or minimal invasive procedures. Femilift vaginal laser is good for the vaginal mucosa tightening and increasing the sensation. Aptos vaginal threads are good for the vaginal tightening at the submucosal level which means deeper of the vaginal walls and it is also good for the perineal tightening. I would also recommend Emsella electromagnetic chair which will be good for the pelvic muscles tightening surrounding the vagina. As you gave 6 vaginal births you most probably have pelvic floor muscle relaxation too and this will not be corrected with vaginoplasty, only Emsella will help this. as these are non invasive and minimal invasive procedures the effects will start gradually.

Aesthetic is whole in our practices, we do primarily for women's self-confidence. You can feel your own femininity again with appropriate vaginal narrowing along the entire vaginal canal and external appearance aesthetics. Thank you
Dr. Mehmet Bekir SENGenital Aesthetic Expert

Hello jrbmason,
I'm sorry to hear about your vaginal looseness still being an issue following a vaginoplasty. I would recommend you consult with surgeon experienced in reconstructive and cosmetic surgery. You need an evaluation to see what your best treatment options are.
Go to the link below to learn more about some of your options. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

Hello, it is very important for the surgeon performing vaginoplasty to have knowledge of the female pelvic floor anatomy. Because for a successful vaginoplasty, it is important not only to cut and narrow the mucosa but also to stitch the rectovaginal fascia, which can break off during normal birth, back to its original location, the uterosacral ligament. If the underlying anatomical defect is not corrected, any surgery may require repeat surgery in a short time. Therefore, it would be beneficial for you to go to a good gynecologist who specializes in urogynecology and genital aesthetics.