Do I need a revision? I saw my period today can it be reason for change !Would the one or one and half make a difference?

Had vaginaplasty and perinoplasty over 7 weeks ago asked the doctor to give me a one or one half finger size he says to tight will do two finger size ok the first time very tight second time still tight third time not as tight however last night forth time it was like it was originally prior to surgery I was very very very wet this should not have made a difference I was disappointed because it didn't feel like I had surgery

Doctor Answers 5

How come your vaginoplasty loosened up?

A properly conducted vaginoplasty (vaginal rejuvenation) should not loosen up unless you have another baby vaginally. It is possible that your surgery was not done as thoroughly as necessary or that you had pre-existing damage to the pelvic/vaginal supports that was not identified or repaired during your surgery. Those are the most common reasons, but there is no way to tell without examining you. If you need a revision to get tighter, wait 6 months. Feel free to email me privately.

7 weeks post op vaginoplasty

Thanks for sharing.  I would not rush to surgery in the next 1 month but if you are not feeling intercourse at this time i.e. only 7 weeks postoperative and is more likely that nothing is going to improve.   I would recommend to continue  with sexual encounters for now and if after 12 weeks you are not tight enough  then I would recommend you could consider a revision.  Only you can tell the surgeon if you are not enjoying intercourse and whether rejuvenation is actually work.    

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

Do I need a revision surgery?

I typically offer tightening to my patients from one to one and a half fingerbreaths if they want to be "virginal."  There is a large subjective component to this of course but generally if you make a little bit tighter then a patient will loosen appropriately with sex but if you make the patient too loose then she will not tighten.  Another factor which should be discussed is how much lubrication the patient generates.  Lubrication decreases sexual friction and makes a woman feel less "tight."  It sounds like this may be the issue that you are confronting.  I wouldn't rush to a repeat surgery necessarily.  There are office procedures such as thermiva that you can consider.  Its possible if you are not satisfied that another surgery will eventually be required.  

Post vaginoplasty experience

It is not only about the tightness but as previously mentioned, the thickness and adequate repair of attenuated tissues of the affected structures.  During a childbirth, usually the integrity of the whole vagina is affected due to a stretching mechanism; therefore an adequate vaginoplasty usually consists of a repair of almost the whole vaginal length utilizing required number of layers. If only the introitus and possibly peritoneum was addressed but not the remaining part of the relaxed anatomical area, the outcome may not be optimal. You mentioned that you have the impression as " no change" is noted as compared to your pre-surgical status. You may consider contacting your surgeon and discuss a possible revision of the still lax vaginal tissue, if and whenever feasible.

All the best,

Yvonne Wolny, MD

Vaginoplasty loosening up??

A properly performed vaginal tightening operation includes deep intravaginal vaginal floor reconstruction ("vaginoplasty") and an outside repair that both aesthetically tightens and bulks the vaginal opening ("perineoplasty.") Ideally also is the work you yourself do to exercise the muscles that were properly re-approximated. In your situation, it is possible that only the outer but not the inner vagina and deep muscles were "tightened."


I would suggest that you visit your surgeon and ask about your working with a "pelvic floor physical therapist." If, after another several months this "loosening" persists, I would suggest a visit with a gynecologist or urogynecologist who can PROVE to you that (s)he has been specifically trained to perform "...vaginal tightening surgery specific to improve sexual function..." (By the way, Miami is a short flight from Atlanta, where 2 of the U.S's experts, Drs. Moore and Miklos, practice...)


Best wishes,


Michael P Goodman MD


Davis, CA, USA

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.