Perinoplasty VS Vaginoplasty? (Photo)

Hi I am very confused about these two terms: Vaginoplasty and perinoplasty. Could someone please explain the difference and also tell me which one may be the best procedure for vaginal opening repair after birth? In my case (please see picture attached) the opening looks too big and awfully ugly :(( accompanied by loss of friction during intercourse and a sense of looseness inside, resulting in no pleasure unless I am on my side and with my legs closed. Many thanks in advance.

Doctor Answers 4

If you've had kids, you need a vaginoplasty. If you haven't had kids, you might only require a perineoplasty.

Vaginoplasty tightens the muscles of the deep vagina and the perineum (the entrance). Perineoplasty only tightens the muscles of the vaginal opening. From the outside, the final appearance of both procedures is identical. See the video link for more details:

Difference between Vaginoplasty and Perineoplasty

Hello Alegria,Thank you for your excellent question and description of your symptoms and concerns with accompanying photo. Vaginoplasty - refers to surgical tightening of your vaginal canal to improve friction, sensation, and pleasure during intercourse.Perineoplasty - refers to surgically approximating the muscles at the entrance to the vagina (perineum) and improving the aesthetic appearance of the introitus so that your opening doesn't look so big.You need to consult with a Urogynecologist with experience in both reconstructive and cosmetic vaginal surgery. Your photo shows some signs of vaginal prolapse which is a condition covered by most insurance providers. You'll need any symptoms of urinary or bowel control evaluated to provide you with a well planned out surgical plan. During your reconstruction you could choose to add a vaginoplasty for internal vaginal tightening and a perineoplasty to tighten the entrance as well as make you look like you did before babies. You may also choose to have a Labiaplasty at the same time I your bothered by the size and color of your labia. You should not have a plastic surgeon attempt to tighten your vagina. You are not a candidate for non-surgical vaginal rejuvenation with Radiofrequency or laser. Below is a link to more information on choosing the surgeon with the best training and qualifications for these complex surgeries.Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 21 reviews

Vaginoplasty versus Perineoplasty ?

Vaginoplasty versus Perineoplasty?  A rather simple explanation, vaginoplasty addresses the vaginal canal and the opening, perineoplasty the perineum; both next to each other representing different anatomical structures. Vaginoplasty usually refers to a surgical correction, reconstruction of lax and attenuated vaginal wall structures.  Multiple factors may affect the function and health of vaginal walls but mainly it is the stretching during vaginal deliveries or a childbirth ( even if followed by a cesarean delivery). Depending on the extend of vaginal wall laxity and desire of the patient, the diameter of the tubal structure ( vagina) is surgically restored. Vaginal rejuvenation, which could be easily confused with vaginoplasty represents a broader spectrum of management options. It may include surgical as well as non-surgical approach such as laser ( Monalisa Touch), radio-frequency and other technologies to tighten and rejuvenate the tissue. Treatment of atrophic vaginal walls with hormonal agents in menopausal or in premenopausal, estrogen deficient women is considered a form of a vaginal rejuvenation as well. In your situation, a surgical reconstruction of the vaginal canal would most likely be the most reasonable approach, in addition to a perineoplasty procedure. Perineoplasty refers to a surgical reinforcement of the perineal muscles and the entire perineum which extends from the opening of the vagina to the opening of the rectum. Following childbirths, perineal muscles as well as the connective ( supportive) tissue is frequently stretched and lax leading to a wider vaginal opening and a shorter perineal body. In order to optimally restore the post childbirth anatomical changes, both vaginoplasty combined with perineoplasty will most likely provide the most desired outcome. 

Best regards,

Yvonne Wolny MD

What's the difference between perineoplasty and vaginoplasty?

Picture the vagina as a tube.  The Vaginoplasty makes the entire tube smaller and tighter.  The perineoplasty tightens the opening to the tube or the outside.  (the outside part of where your vagina and anus are is called your perineum - "neum" means to empty or evaculate and "Peri" means around).Looking at your photos you may also want labiaplasty performed for your inner labia or labia minora.  When the labia minora extend past the outer lips or labia majora some women have discomforts.

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