Hi Island Girl! Great question and while there certainly concerns about the use of the term "vaginal rejuvenation", if you are specifically interested in increased sensitivity, lubrication, decrease in incontinence and tightness that both you and your partner can perceive during relations, there are several answers. Either way, you need a good history and physical examination of the area before any meaningful treatment can be prescribed or surgeries suggested. Humans are soooo complex!! But lets look at the SCIENCE!!! How does each modality WORK and what CAN it possibly do? Fractional CO2 lasers (we have several) put tiny, usually bloodless, holes, penetrating less than half a millimeter into the tissue-through into the dermis, but not into the sub-dermal fat or muscle. It's like aerating the mucosal "lawn" that lines your vagina, so that it increases nerve and blood vessel ingrowth as it heals and hence there can be some improvement in sensitivity and lubrication and often a slightly thicker skin happen. If you make a few extra passes, in the 11 to 1 o'clock part of the vagina, the tissue may thicken a bit and help support the urethra. That can decrease some forms of incontinence--mainly stress (SUI), and sometimes a bit of urge incontinence over several treatments and then maintenance keeps the result up. There are several Erbium YAG lasers made for this treatment, but their penetration into the mucosa is even more shallow, so they may not be as effective unless they have a very powerful energy output and bigger spots. Either way, laser treatments take only a few minutes compared to RF which takes 20-40 minutes, but there are more differences! RadioFrequency (ThermiVa, that we have, and others) use monopolar radio waves that travel from one antenna (on the tip of a blunt, vaginal probe, rubbed against the mucosa), through the body, to another antenna that looks like a grounding pad on the outside skin of your back, belly or thigh. RF likes warm, moist tissue, and the radio waves cause enough microscopic movement of water molecules in the tissue, that the tissue warms-usually about a third as deep as the electrode is wide. Precise thermal feedback from the primary electrode allows us to know the temperature on the surface of the vaginal mucosa in real time. We know from data on thousands of different people that the surface temperature in a human is 5-8 degrees C lower than the temperature 1 to 3mm under the skin. This non-surgical heat, for a specific amount of time on tissue, causes ingrowth of blood vessels and nerves and actual visible tightening of the vaginal canal and can improve the appearance of redundant tissue on the outside (labia) over a number of treatments. Then there is recommended maintenance annually. The deeper heat and hence deeper change in tissue thickness works as well or better on SUI too. Other modalities. It's like a buffet and you can mix and match as you please! How about the Oshot?! We have pretty good success improving lubrication, sensitivity and incontinence with just a few drops of your own platelet rich plasma injected painlessly -hard to believe but true!-into specific areas down below. Our RN and NP (who has a passion for women's health and 15 years experience) do those most of the time. That's usually a once or twice treatment to start and then annual maintenance, but they don't call it the Oshot for nothing! We offer the Pshot so your partner can keep up with you too!! Additionally, there is the new FDA approved--for all types of incontinence--Emsella! Yep, we have that one too! You sit for 30 minutes, over a powerful electromagnet (think MRI magnet in a chair, powerful!) that causes the pelvic floor muscles to contract about 12,000 times (that's a whole lot of kegles girl!!) a session. Most gals do 6 painless sessions over 2-3 weeks and then some do maintenance quarterly. No more PEEEZING!! (when you pee when you sneeze!) All these non surgical treatments can be used alone or together to optimize your outcome for the lease risk, expense and downtime.... Now that you understand the SCIENCE better, maybe that will help you make a decision. If you go to a practice where they only have one way to treat your issues, it's kinda like when you have one hammer and all the nails look the same! But it just ain't true! Caveat Emptor! Hope that helps pull it all together! Ed Zimmerman, MD Medical Director Las Vegas Laser & Lipo, An IMQ Accredited Surgical Facility