One year of pelvic exercise, and I still have a gaping loose vagina? (Photo)

Hello. One year ago I posted a question about my gaping and loose vagina. See https://www.realself.com/question/cincinnati-correct-my-loose-gaping-vagina-vaginal-rejuvenation I got a lot of response and advice: from pelvic exercise to surgical vaginal rejuvenation. First wanted to try non-surgical options. For one year I have done intense pelvic training. Enclosed an actual picture of my vagina (pre-sex) after one year. Still gaping quite a bit. I assume the next step is vaginal rejuvenation?

Doctor Answers 13

Vaginoplasty may be necessary

Good job committing to pelvic exercises for so long. It seems that you may require a surgical narrowing of the floor of the vagina. I have used ThermiVa for vaginal tightening but am not sure if you will respond to the degree that you may desire.  My recommendation for the West Coast would be Dr. Red Alinsod in Laguna Beach. He is a great urogynecologist with extensive aesthetic experience.


Boston Plastic Surgeon
4.7 out of 5 stars 16 reviews

Will kegel excercises work for my gaping vagina?

The good news about Kegel exercises is that they won't hurt you.  Improving the strength of your pelvic floor as you have done this past year will also help with a surgical outcome.  But to close the gaping opening will require surgical repair if you desire.  Its important to choose a surgeon who specializes in this surgery.  There are many in southern California including David Matlock and John Miklos who are both leaders in this field.  

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

Surgical repair

Your image shows some significant gaping of the introitus (vaginal opening).   Non surgical options such as Thermiva or Femilift will narrow the vagina somewhat, but based on that image some kind of surgical intervention will be required to achieve the results you are most likely looking for.  This would involve a perineal repair and vaginoplasty.  

Nicholas Fogelson, MD
Portland OB/GYN
5.0 out of 5 stars 2 reviews

Gaping vagina

Hi Sandra,

Gaping vagina can be treated both by surgical and non surgical methods. Newest technique using readiofrequency is a great way to treat it. I have seen great results. You will need series of 3 treatments but will see results right afer 1 treatment itself. 

Vaginal rejuvenation

Thank you for sharing your picture and question. After reviewing your pictures it looks like you are a candidate for vaginal rejuvenation. Your next step should be to consult in person with a board-certified plastic surgeon who specializes in vaginal rejuvenation to find out your options for a successful surgery. Good luck!

Jimmy S. Firouz, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 18 reviews

Gaping & loose vagina question

Hello Sandra,


Yes, I remember your photos and original question. YES, your "next step" is VRJ (more properly expressed: "Perineoplasty + Vaginoplasty...") Your muscles are separated; your introitus (vaginal opening) is "gaping," and only surgery (NOT so-called "minimally invasive" techniques!) will correct this. However, your year of work will greatly improve both your recovery, and the ability of your genital plastic surgeon to identify and re-approximate the musculature when rebuilding your pelvic floor ("vaginopalsty") and aesthetically remodeling your introitus and re-building the angle at the vaginal opening. Additionally important s for your surgeon to check the nerve supply to your vagina and make sure there is no damage.


Choose your surgeon carefully to assure your surgeon is specifically trained in aesthetic and functional pelvic floor remodelling and is 'way-experienced. Cost may also be a factor. As we perform most of our pelvic floor reconstructions in-office under local anesthesia (as does Dr. Red Alinsod, another very experienced aesthetic pelvic floor surgeon in your area...), out TOTAL "out-the-door" fees for full perineoplasty + vaginoplasty, including pelvic floor exercise work, is US$7250. If a FemiLift is added for incontinence and far upper vagina toning, this is $1500 additional.


Best wishes,


Michael P Goodman, MD


Davis, CA, USA

Options

I am sorry that you did not find relief with kegel exercises. I agree with Dr Miklos that I am yet to see kegel exercises tighten up the opening of the vagina to any significant degree. Surgical correction would be your best option.

Best wishes!

Vaginal rejuvenation surgery

Dear Ms Sandra:

Thanks for sharing  but unfortunately kegel exercises and physical therapy are not a cure all for most patients and judging from your photos I have never seen kegel exercises actually tighten the vaginal opening.   

What is vaginal rejuvenation?  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).   There are only 4 papers written on this topic and my partner, Dr Moore and I are co-authors of two of these papers.    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.    

So based on your letter, photo and without the knowledge of your examination you would need an internal vaginal tightenting as well as a perineoplasty to tighten the opening both anatomically and functionally.

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai


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

One year of pelvic exercise and I still have a gapping loose vagina?

Thank you for your question and photo. It sounds like you did all you could to strengthen your pelvic floor. Based on this frontal photo, you would need a vaginoplasty and perineoplasty to tighten the vaginal canal and the vaginal opening. See a board certified plastic surgeon or gynecologist for an in person consultation. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Vaginoplasty

if you want a tighter vaginal opening the only option is a vaginoplasty and perineoplasty. In your case non surgical options won't be aggressive enough. Remember that any repeat childbirth or anything that will re-stretch your vagina can undo some of the procedure. Best to go in for a consult. 

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 200 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.