Vaginoplasty 7 weeks loosened after four encounters, would the laser vaginoplasty be better ?

Received a size two only felt tight four times the fifth time back to normal 1: should I have gotten one finger verses 2? Second question should I get laser instead? My doctor insisted for a size 2 I think a one would have been better The same Dr did my cousin and she is now complaining about lossing up after three months

Doctor Answers 6

Why am I loose after having sex after vaginoplasty?

Its unclear why you would loosen up so soon after surgery.  Typically laxity is related to having children: vaginal tightening restores your body and assuming you don't have more vaginal births you should not become loose - particularly with just a few sexual encounters.  Obviously, surgery would never be worthwhile if that was the result.  I don't think the laser is better or worse - this is a technique issue and a marketing issue rather than "the best thing around."   As office procedure such as the thermiva would be better to start rather than surgery anyway.  Hopefully your surgeon can offer you that since your results are not satisfactory.  

Woodstock Urogynecologist
5.0 out of 5 stars 3 reviews

It sounds like your vaginoplasty wasn't a full vaginoplasty

A properly-designed and well-executed vaginoplasty shouldn't loosen up unless you experience vaginal childbirth after your procedure. Your experience and now, your relative's same experience suggests that your doc might be skipping a few steps in the procedure and might not be an expert in vaginoplasty. Laser vaginal rejuvenation is a full vaginoplasty in which the surgical incisions are made with a laser instead of a scalpel. However, the tightening created with LVR has nothing to do with the laser and everything to do with suturing the right muscles in the right places and fixing any damaged pelvic supports using pelvic reconstruction techniques. I frequently revise vaginoplasties done elsewhere for symptoms similar to yours and can tell you that incompletely done work is unfortunately common, but it can be fixed with excellent results.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.6 out of 5 stars 24 reviews

Surgical vaginal rejuvenation longer last results than laser

Thanks for sharing.   I am sorry to hear of your experience but i promise you that vaginal rejuvenation surgery has better results with longer lasting success compared to radio frequency, or laser therapy.   

 Many surgeons who perform plastic surgery do not understand the normal and abnormal herniation of the vagina's internal anatomy. When a woman has a lack of friction with intercourse many surgeon will recommend a vaginal tightening i.e. vaginal rejuvenation by tightening the floor of the vagina and the opening.  Many times this is all that is needed.  Still other surgeons only tighten the opening of the vagina or the very distal 2-3 cm.   Do not make the mistake of letting some surgeon who doesn't really understand vaginal rejuvenation offer you an inferior surgery and then 6 month later your back in his/her office because the results are less then desirable.

What is vaginal rejuvenation?  As mentioned above 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.  This is why gynecologists or urogynecologist who have practices dedicated to pelvic floor reconstructions have a better funds knowledge and approach to vaginal tightening over other specialists who have not dedicated their professional careers to pelvic floor/vaginal reconstruction.

You can attempt a laser therapy which will not last ( compared to surgical vaginal rejuvenation) but realize that most likely you will need to undergo vaginal rejuvenation in the future.  Choose a surgeon with proven experience and results.  Choose a surgeon who will gave a guarantee ---- this doesn't mean a 100% chance of cure , it means the surgeon is giving sometype of recourse if the surgery does not meet your expectation.  My partner and I give a 1 year guarantee -- if you are not tight enough we will redo the surgery without a second surgical fee/bill.

Best of Luck

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 19 reviews

Looseness soon after Vaginoplasty

Thank you for sharing and sorry to hear of your short lived results. There are a number of reasons that could result in your experience, but I'm unable to make a conclusion, let alone make a negative comment about your surgeon, with such limited information. I would return to your surgeon for answers and to let him know of your results and that of your cousin. You should then seek out a second opinion from an experienced reconstructive and cosmetic vaginal surgeon. Below is a link with information on finding the best surgeon for you.

Laser Vaginal Resurfacing with the FemiLift is an excellent option in the right patient. You should hold off on this until you find a surgeon that can better guide you in your decision.

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

Do Not go back to the same surgeon who does not understand the concepts of vaginoplasty

There is no such thing recognized in legitimate vagino-plastic surgery terms as "...size 1; ...size 2, etc." This is something made up by your not legitimately trained surgeon. As someone who has performed > 150 true sexually mandated perineoplasty/vaginoplasties, I fully agree with my fellow RealSelf respondents that a legitimately performed vaginal tightening surgery will not "loosen" after a short period of resumption of intercourse. It will hold for a good while, can definitely hold longer if your surgeon carefully instructed you on post-op pelvic floor exercises, supplied you with the implements necessary to help with rejuvenating your pelvic floor muscles, and possibly referred you to a pelvic floor physical therapist to help in your muscular rejuvenation. A proper repair and a patient's continued participation in muscular P.T. will make a repair last many years. Poorly done repair and/or no P.T.-- failure is assured within a year.

So-called "non-invasive" technologies (laser or radiofrequency) have definite uses in the vagina, but GOOD TIGHTENING IS NOT ONE OF THEM! Any doc who offers you these technologies as a sole therapy for "vaginal tightening" is probably not skilled in the "gold standard" (surgical repair) and is just trying to pay for the $80,000+ machine that (s)he has just bought..! NO, "laser rejuvenation is NOT better.

Best wishes,

Michael P Goodman MD

Davis, CA, USA

Vaginoplasty: Surgery vs. Laser

Vaginoplasty surgery will have more noticeable and longer lasting benefit than rejuvenation by laser. During the surgery, the support along the vagina is used to elevate and restore the caliber of the vagina. Following surgery, vaginal rest is advised for 6 weeks while the area heals. Once intercourse is resumed, there is improvement in vaginal tightness during surgery. 

George Shashoua, MD
Austin Urogynecologist
4.9 out of 5 stars 37 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.