Is a perineoplasty and vaginoplasty the same thing?

So I'm freaking out a little bit. I went in for a consult for a "vaginal rejuvenation" and scheduled the "rejuvenation" for September 16. The nurse called me today for a preop and stated my procedures as " labiaplasty, hood reduction and perineoplasty". Upon further research, my understanding is a perineoplasty just repairs the perineum and a vaginoplasty is tightening of the entire vaginal canal. Is this correct? I don't want to be out $9,000 for a surgery I won't be happy with.

Doctor Answers 6

Is a perineoplasty the same as vaginoplasty?

No. This is a common confusion.   A vaginal rejuvenation procedure essentially restores the vagina and the opening to the vagina to a more youthful condition.  A perineoplasty is the reconstruction of the outside area between the vaginal opening and the anus.  There are muscles in this location that should be repaired.  This alters the appearance of the external genitalia.  But this is not a vaginal tightening procedure. This only tightens the opening.  A vaginoplasty tightens the vagina and should be done at the same time.The vagina is a tube; if you place your finger inside - your fingernail touches the posterior vagina that has the rectum underneath.  Your fingerprint touches the anterior part of the vagina that has the bladder underneath.  If you cough and feel a nose like structure hitting your finger tip then you may have prolapse of your uterus and/or your intestine.   This is common as vaginal relaxation is often accompanied by pelvic organ prolapse.Surgical repair of the external genitalia such as the labia and clitoral hood is different from a vaginoplasty.  Plastic surgeons can be very skilled at external reconstruction but are not trained in pelvic reconstruction. A urogynecologist is a female pelvic reconstructive surgeon and specifically handles issue with pelvic organ prolapse.  This surgeon is skilled at vaginoplasty.  Unlike plastic surgeons, not all urogynecologist specialize specifically in cosmetic surgery. Hence the confusion.   But if you have pelvic organ prolapse issues, this anatomical issue can be diagnosed and handled at the same time as a cosmetic procedure by urogynecologists specializing in cosmetic surgery -  and this part is typically covered by health insurance.

Woodstock Urogynecologist
5.0 out of 5 stars 4 reviews

No - they aren't the same!

Hello Brittany,What is it that you feel you need? If you have vaginal looseness as a result of childbirth and you have a gaping introitus then you most likely need both. If sex is great but you want to improve the appearance of the vaginal opening then you only need a perineoplasty.If you've had vaginal deliveries and have pelvic prolapse then you may also need vaginal reconstruction.Since you have doubt of what is currently scheduled you need to return to him/her for a clear explanation of what is planned. What is your surgeon's training? See link below for more information on the type of training that is required to provide the best results for women with pelvic and vaginal relaxation as well as large labia. You have all of the above concerns then you owe it to yourself to find a board certified urogynecologist with extensive experience in reconstructive and cosmetic vaginal surgery. Plastic surgeons are NOT trained to perform a comprehensive vaginal and labial rejuvenation. If you discover that your surgeon doesn't have the best training and experience then you'll need to get a second opinion.Women travel to Denver from all over the U.S. for their Intimate Makeover. We offer a travel credit to help with the additional expenses of travel.  We'd be happy to help you with this decision.

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 34 reviews

Perineoplasty and vaginoplasty are NOT the same

Hello. Thank you for such a great question submission. In fact these two procedures are not the same. Perineoplasty is a surgery that addresses the perineum (the area seen between the anal and vaginal opening. So having this done addresses gaping vaginas (seen from the outside), episiotomy scars, excess skin in that area. Vaginoplasty, on the other hand, tightens the vaginal skin inside, where you can't see. These surgeries may be done in conjunction or individually. Best Wishes~Dr Poucher

You need to know exactly what's going to be done in plain English. See your surgeon beforehand to clarify.

You have a communication problem with your surgeon's staff that needs to be fixed immediately. Vaginal rejuvenation is a general term that refers to over a dozen procedures of the vaginal canal and of the labia and perineum. A surgical plan focuses on the specific procedures that are required to achieve your goals. These specific procedures are explained at the time of your consultation. You are correct in your understanding of the difference between perineoplasty and vaginoplasty. Both of these can be considered as types of vaginal rejuvenation. Labiaplasty and clitoral hood reduction have nothing to do with tightening of the vaginal canal. These will simply reduce the size and shape of the labia minora and clitoral hood. Some surgeons also consider these as types of vaginal rejuvenation. If you did not want the labia reduced, then a mistake has been made by the surgeon's office and you need to clarify what you want and what you do not want before you pay and before you go in for surgery. As a side note, if you have had vaginal childbirth, you need vaginoplasty, not perineonplasty, in order to tighten the vagina adequately and properly. Failure to do so will leave you with simply a narrow ring of tightness at the opening only and a loose vaginal canal. If this is your situation, I would suspect that your surgeon is not an expert in vaginal surgery and I would highly recommend that you get a second opinion from someone with expertise in vaginal reconstructive surgery before you get botched.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.7 out of 5 stars 26 reviews

Perineoplasty vs vaginoplasty

You are correct about perineoplasty is not the same as vaginoplasty as the first only addresses the opening of the vagina and the latter addresses (or should only address) the distal 2/3 of the vagina.  You really don't want to tighten the upper 25% of the vagina as this could lead to pain with intercourse.

John R Miklos MD

Atlanta ~ Beverly Hills  ~ Dubai

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 20 reviews

What, really, is a "Vaginal Rejuvenation??"

Hi "Brittany,"
"Vaginal Rejuvenation" is a vague and misleading term that somehow has gotten into the popular vernacular. (How and why is an interesting story that would make up an entire Blog by itself, but that's another story...) What exactly does it mean? If a 65 year-old woman who is not on hormones and has not had sex in 15 years and has an atrophic tight vagina goes on hormones and uses vaginal dilators or laser therapy to help stretch her vagina to be able to have sex, that's :vaginal rejuvenation" isn't it??! But that's not at all what YOU are talking about.
Big communication problem! I suggest you contact your surgeon and "call a spade a spade." Here are the proper terms: 1. Labiaplasty is reduction of large/saggy labia. 2. Clitoral hood reduction is surgical reduction or the size and "flappiness" of "robust" sized clitoral hood. 3. "Perinoplasty" is the aesthetic and "strong" build-up of the perineal region (vaginal opening and the area between the vaginal and anal openings.) 4. "Posterior colporrhaphy" (aka "posterior repair") is the repair of a hernia that develops in the lower vaginal wall where the rectum pushes up into the vagina. 5. Vaginoplasty refers to a 3-layer "re-building" of the entire posterior vagina, bringing ht muscles together, removing all the scar tissue, and tightening and strengthening the entire outer 2/3's of the vaginal canal.
What procedure(s) do you wish and "...need..??" Are your lips large and in the way? Is your vaginal opening saggy and "open?" Does your vagina seem loose and lacking in friction, with orgasms harder to come by? YOU ASK: "Upon further research, my understanding is a perineoplasty just repairs the perineum and a vaginoplasty is tightening of the entire vaginal canal. Is this correct? " My answer: YES! You are correct.
For additional information, please access the weblink, and other areas on the website. Best wishes,
Michael P Goodman, MDDavis, CA, USA

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.