What is the difference between reconstruction and rejuvenation of the vagina?

Doctor Answers 7

Vaginal rejuvenation vs reconstruction

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Does a patient need rejuvenation or reconstruction?  The only way you will know is to be assessed by a surgeon who is well versed in both reconstruction and vaginal rejuvenation.   Rejuvenation is utilized when a patient is worried about a cosmetic/or function type problem  ( i.e. sex is not tight enough) and reconstruction is utilized when a patient knows she has prolapse as there is a bulge or pressure and she wants to get rid of the symptoms.  This is restoration of the anatomy without worrying about vaginal tightening. 

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.      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.

What is vaginal reconstruction?  Vaginal reconstruction is what most urogynecologist have been trained to do...to reconstruct the vagina to give the support back and this does NOT focus on tightening the vagina. Reconstruction is for the restoration of the anatomy and also to fix things like urine and fecal leakage or retention.  The urogyencologist has extensive training and is the most experienced of all surgeons in operating on the relaxed vagina.  The second most experienced surgeon for vaginal reconstruction would be the gynecologist.  The urogyn  is trained by first spending  4 years in a residency in obstetrics and gynecologic surgery and instead of going out to practice they then tspend 3 more years of subspecialty training in vaginal reconstruction or the rebuilding of the vagina (when it falls down aka vaginal prolapse - see the next few paragraph for an explanation).  Vaginal Prolapse is the general term for a woman who has one or many areas each area of the vagina or uterus which has fallen. 

Each area  has its own descriptive name" Uterine prolapse - the uterus is falling down into the hollow of the vagina and towards the opening of the vagina in severe conditions the uterus can actually fall  out of the vaginal opening and it hangs between a womans legs.  Cystocele - the deeper portion of the ceiling of the vagina gives way and the bladder which is being supported fall downward into the hollow of the vaginal canal. Often these patients will suffer from frequency and urgency of urination as well as vagina pressure.  If the condition is very severe the patient will have difficulty emptying her bladder. Urethrocele - the ceiling of the vagina near the opening of the vagina gives way and the urethra sags.  Often these patients will suffer from cough urine leakage ( aka stress urinary incontinence) Rectocele - the floor of the vagina gives way and the rectum pushes upward into the vaginal canal producing a bulge pushing towards or out of the the opening of the vagina.  Often patients will complain of difficulty emptying their rectum of stool and then this becomes a catch 22 situation where the harder you strain to get your stool to evacuate the worse the rectocele can get and the larger the rectocele gets the more difficult it is to evacuate.  Urethrocele means there is a lack of support of the urethra and often (but not always) these patients will leak with coughing  and sneezing. Urogynecologist have been trained to treat the anatomy of the vagina to support each of these structure as well as consider the function of urination and defecation as they perform surgery.   However most urogynecologist have not been trained in the concept of cosmetic vaginal surgery or  vaginal rejuvenation .

You certainly would benefit from a thorough evaluation by a urogynecologist or a pelvic floor surgeon/gynecologist.  But you would probably want to choose someone who is also trained or has expertise in vaginal rejuvenation.   Remember Vaginal rejuvenation means to tighten the vagina so its enhances intercourse for the woman.  So I caution you to choose a surgeon wisely............choose a surgeon who can accomplish both of your needs: 1) restoring friction during intercourse and   2)  decreasing the pressure  inside of the vagina ( which maybe best accomplished by restoring the supportive anatomy of the vagina and NOT JUST TIGHTENING the vaginal opening.  Choose a surgeon who is specialized in urogynecology or vaginal floor reconstruction and cosmetic vaginal surgery.  Please see both sections of my website to get a full understanding and the different between cosmetic vaginal surgery and vaginal reconstruction.  Remember your choice of surgeon should be based upon: experience, expertise, reputation and results and do not solely focus on location, convenience and cost.

John R Miklos MD

Urogynecologist  & Cosmetic Vaginal Surgeon

Atlanta ~ Beverly Hills ~ Dubai

Vaginal rejuvenation vs vaginal reconstruction

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This is a great question. Both of these terms are very general and broad in terms of what each represents. Vaginal rejuvenation is the broad term for the many plastic surgery options available to rejuvenate the appearance of your vaginal area, including your labia. Vaginal reconstruction refers more to the procedures that restore and reconstruct any functional issues you may be experiencing. The best thing for you to do is to consult in person with a board certified plastic surgeon and discuss your vaginal concerns and goals for surgery. Once the surgeon understands your needs and performs and in-person examination, he or she will be able to tell you if you need a vaginal rejuvenation vs vaginal reconstruction, or possible a combination of both. 

What is the difference between reconstruction and rejuvenation of the vagina?

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The definitions are a bit fuzzy, but in general vaginal reconstruction would refer to surgical repair of significant congenital or acquired defects of the vagina. Commonly bad tears during childbirth or portions that have had to be removed for cancer. Rejuvenation is more of a reversal of changes to the vagina that occur with age or normal childbirth. Common examples are correction of stretched labia or tightening of loose vaginal openings. Hope that helps! 

What's the difference between vaginal rejuvenation and vaginal reconstruction?

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This is a very good question.  Vaginal rejuvenation is a colloquial term that does not really have a specific meaning.  It is more of a marketing phrase that can encompass different things depending upon who you talk to.  Vaginal reconstruction is the surgical repair of the vagina.  There are many aspects to surgery depending upon the anatomical issues a woman has and what she is trying to achieve.  The decision of what to have done really depends upon these last two issues - anatomy and goals.  There are office procedures that can help many women that don't require surgery.  But sometimes the anatomy is so damaged or distorted that surgery is the best option.  A good relationship with an experienced surgeon who can offer you the many different options is the key step. A good relationship requires the doctor listens to the patient with exquisite care.  The bottom line is Avoid surgery when you can but don't do useless office procedures if surgery is required to accomplish adequate repair.

Vaginal Rejuvenation/Vaginal Reconstruction, Difference?

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Hello jrobin,

Thank you for your question. It is understandable to be confused about the differences between "rejuvenation" and "reconstruction" in that frequently the procedures and terms used for them get used interchangeably and in some instances can slightly overlap. In the most simple of terms vaginal reconstruction is used when a variety of surgical procedures are done to "repair" damaged tissue (ligaments/fascia) that are responsible for the proper support and function of the pelvic organs such as: bladder, rectum, vagina, uterus etc). The most common term applied to the need for these procedures is prolapse with or without associated urinary/fecal incontinence. Vaginal rejuvenation on the other hand can be done surgically or non-surgically (via lasers). The main goal with rejuvenation is for tightening of the entrance to the vagina or cosmetically reducing or repairing the tissues at the entrance of the vagina as well as the vaginal tissue itself (lasers). Rejuvenation procedures most commonly can be performed in the office setting rather quickly with local anesthesia while reconstructive procedures are more reserved for surgical facilities and require more down time and slightly longer recuperation prior to resuming normal activities (intercourse). 

If you are not certain which would apply to you the best next step would be to obtain an in person consultation with a pelvic surgeon (gynecologist/urogynecologist) adept at both reconstruction and rejuvenation to assess your needs and discuss your options. 

Paul Pietro, MD
Greenville Physician

What is the difference between reconstruction and rejuvenation of the vagina?

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Thank you for your excellent question.  Vaginal reconstruction involves repair or correction of the pelvic floor musculature due to birth issues or traumas, while vaginal rejuvenation involves aesthetic correction of the vagina, labia minora, or labia majora through either reduction of excess tissue or tightening of the tissues.  Hope this helps.

The difference between vaginal rejuvenation and vaginal reconstruction

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Vaginal reconstruction or pelvic reconstruction is surgery done to repair broken supports of the pelvic organs. Examples are anterior repairs (cystocele repairs, paravaginal repairs), apical repairs (hysteropexy, colpopexy, enterocele and vault repairs), and posterior repairs (rectocele repairs, perineocele repairs, levator repairs). The goal of these repairs is to put the organs back into their normal positions. None of these operations tightens the vaginal canal for better sex. Vaginal rejuvenation seeks to tighten the vagina for better sex. However, it doesn't work if pelvic reconstruction needs to be done and isn't done.

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.