Reconstructive vs Cometic for repair of genital injury? Would this be covered by insurance?

Great question!
The best way to find out is to have a consultation with an expert. You should seek out the expertise of a Urogynecologist who specializes in both Reconstructive and Cosmetic Vaginal Surgery. Only following this would you know what it is that you have and benefit from the most. The key, though, is finding the right surgeon and for this you may need to travel.
Go to the link below to see hundreds of B/A photos with this combination of procedures. You will likely find some examples that are quite similar to you. From that link you may schedule a virtual consult 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,

Thank you for your questionIt really depends on the injury and what is needed to repair. Although insurance states they will pay for repairs, their compensation for cosmetic repairs is generally so low so that it is not feasible for most competent surgeons to accept. Some teaching institutions might consider doing cosmetic repairs under insurance to train new surgeons. Most surgeons will give a free consult, see what is needed and explain your specific options.

Your genital injury and the nature of your pain need to be explained in detail to provide an answer to your question. Sometimes it's covered. Sometimes not. If you are simply trying to change the appearance for cosmetic effect, that typically would not be covered by insurance.