I need a Labioplasty, Vaginoplasty, and repair Perineoplasty, can they all be done at the same time?

Labia minor are too long and get caught in clothes and underwear and are painful. So need labioplasty I have a 'recticele prolapse' (bowel is going into vagina) I have no muscle tone at all and am completely stretched out in vagina. So need vaginoplasty and repair My Peronism (between vagina and anus) is tiny, less than a centimetre when should be about 6-7cm. Due to tearing in child birth. I wasn't stitched back up properly. So need perineoplasty.

Doctor Answers 9

You need The Works

If you have a rectocele, you have damage to your pelvic floor and you will require pelvic reconstruction at the time of your vaginoplasty. A real vaginoplasty includes a perineoplasty and tightening of the deep vaginal muscles (aka the levator or kegel muscles). You need a surgeon who is expert in pelvic reconstruction as well as vaginoplasty. The labiaplasty can certainly be done at the same time.

Jersey City OB/GYN
4.7 out of 5 stars 26 reviews

Prolapse surgery for rectocele, vaginoplasty and labiaplasty - how to schedule

Thank you for your inquiry. Typically, we schedule patients for prolapse surgery first, which is performed in the hospital under general anesthesia. One to two weeks after their prolapse surgery, patients will come into the office for their labiaplasty. Each surgeon will have different guidelines for how to proceed with the multiple procedures. Seek a consultation with an experience surgeon, preferably in urogynecology and cosmetic surgery. 

George Shashoua, MD
Austin Urogynecologist
4.9 out of 5 stars 38 reviews


Thank you for the question. All the procedures can be done at the same time. Please see a pelvic surgeon for consultation. Hope this helps

Armen Kirakosyan, MD, FACOG, FACS
East Aurora Urogynecologist
5.0 out of 5 stars 1 review

Combining procedures

Thank you for sharing and yes it is always a great idea to combine these types of procedures.

Make sure you get properly evaluated by someone who frequently performs not only labiaplasties but true pelvic reconstruction surgery.  Aside from having a rectocele, I am sure there are others areas of weakness within your pelvic floor that need to be addressed for maximum post surgical results and satisfaction.

Best of luck and keep us posted.

David Ghozland, MD
Santa Monica OB/GYN
5.0 out of 5 stars 27 reviews

Can Labiaplasty and Vaginoplasty be done at the same time?

Hello Anne,

Thank you for your excellent question! Yes, of course these procedures can (and should) be performed at the same time. You also have a rectocele and likely other prolapsing areas of your vagina which should be addressed at the same time. You need to see a Reconstructive and Cosmetic Vaginal Surgeon, preferably a Urogynecologist with expertise in Vaginal Rejuvenation, for a proper evaluation who will then develop the best surgical plan for you. Do not settle for less. You will likely need to travel to see the very best.

See link below for information on the type of specialization and training that you should look for in a surgeon. Many women travel to Denver from Europe for their surgery so we are accustomed to making this a smooth process.

Best of luck,

Oscar A. Aguirre, MD
Aguirre Specialty Care - Pelvic Surgery & Intimate Aesthetics®

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

Can labiaplasty and vaginoplasty and perineoplasty be done at the same time?

These operations are commonly done at the same time.  You have pelvic organ prolapse and likely enlargement of your labia minora.  You will need to find a specialist who does all of these operations.  This will include a pelvic reconstructive surgeon as well as one who does cosmetic surgery.  

Michael Litrel, MD, FPMRS, FACOG
Woodstock Urogynecologist
5.0 out of 5 stars 4 reviews

Labioplasty, Vaginoplasty and Perineoplasty

Yes, all the procedures can be performed in one session.   Depending on the severity of the rectocele the procedure may have to be performed by a coordinated effort between a plastic surgeon and OBGYN.  

Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 51 reviews

I need a labiaplasty, vaginoplasty, and perineoplasty. Can they all be done at the same time?

Thank you for sharing your question.  Yes, all three procedures can be safely performed in a single procedure and I would advise seeing your ob/gyn and urogynecologist in consultation to maximize your results.  Best wishes.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

Labiaplasty & vaginal rejuvenation

Dear Anne32:

Thanks for sharing your questions. First let me start by saying they can be done at the same time:  labiaplasty, vaginoplasty and perineoplasy if you choose a surgeon with the right experience and expertise.  Let us discuss each of your issues separately:

1) Labia minora reduction - the two most common techniques are linear resection and a wedge resection. based upon your photos and you desires I would recommend a linear resection. Each surgeon has their own technique and their technique coupled with artistic talent is what gives a woman their results.  In a study written in 2010 a review of 550 patients requesting labiaplasty over a 3 . 5 year period  were interview ed about their postoperative expectations.  99% of  the caucasian woman ( of which I assume you are based upon your photos--  though i might be wrong) wanted their labia reduced so they no longer protruded beyond the majora and 99% preferred a lighter skin color i.e. pink versus dark.  Of  course the surgeon should ask you personally on what you hope to achieve as you might not be in agreement to 99% of caucasian women.   FYI 70% of patients getting a labiaplaty will also benefit cosmetically from a lateral prepuce reduction (#2 below).  

2) Lateral prepuce reduction ( can be seen on my website) - which is the extra layer of tissue lateral to the clitoral hood known as the prepuce.  Obviously this  your decision, but it has been my experience that patients get a better cosmetic results if when they have lateral prepuce it is reduced concurrently with the labia reduction. 

2) Vaginal Rejuvenation/Vaginoplasty or tightening surgery--- 

Vaginal rejuvenation really means the internal tightening of the vagina and tightening of the vaginal opening usually to enhance friction for intercourse.   In experienced hands this surgery is approximately 85-90% successful as defined by the patient ( i.e. she is satisfied with the enhancement of friction during the act of intercourse 12 months after surgery).      This surgery is usually accomplished by performing posterior vaginal wall surgery ( known as a posterior repair and coupling this with a levator muscle plication) + a vaginal opening repair known as a perineoplasty.   This requires experience, expertise, and good knowledge of  the pelvic floor.      Patients who have had spinal trauma i.e. lower back injury, chronic straining due to "constipation' and or lifting heavy things, multiple childbirths may need more than just tightening procedure they actually need vaginal reconstruction and this depends upon whether their is more than just the floor of the vagina is broken.

I hope this is helpful and please choose a surgeon with experience, expertise, a great reputation and one who achieves great results.  A good surgeons all also give you sometype of guarantee, in my practice: 1)  labiaplasty - if your labia are slightly uneven or one side is not symmetrical with the other I will redo the labiaplasty and not charge a second surgical fee also 2)  vaginal rejuvenation- if you are not tight enough in the first year the surgeon should  do a 2nd tightening procedure and not charge you a surgeons fee.  Again choose  a surgeon with experience make sure you do you due diligence prior to signing up with the cheapest surgeon or someone in your locale.  Choose a surgeon who can prove they have experience.s.  I wish you the very best in your care.


John R Miklos MD

Urogynecology ~ Cosmetic Vaginal Surgeon

Atlanta  ~ Beverly Hills ~ Dubai

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

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.