Gaping vagina and enlarged clitoris - Is tightening an option? (photos)

You definitely have clitoral enlargement. A clitoral hood reduction will not resolve your issue, but will make you worse if a clitoris reduction is not also done. The clitoris will stick out more and be more obvious. A clitoropexy will not work, because your enlarged clitoris will pull out the sutures. Stopping the DHT gel will not make your clitoris change, so you need a clitoris reduction if you wish it smaller.

Very few surgeons perform a clitoris reduction, since it is technically challenging and is rarely taught. It is an intricate procedure, since the sensory nerves have to be carefully preserved. I have done over 60 reductions without any loss of sensation or orgasmic ability. The clitoral reduction reduces the glans or head and also removes the erectile tissue in the shaft. After surgery, the clitoris will not stick out much or increase with arousal. The surgery is not very uncomfortable. It takes up to 3 1/2 hours and includes clitoral hood reduction.

You vagina can also be surgically tightened at the same time.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NY

Thank you for your inquiry! Yes, a Vaginoplasty procedure can be performed to increase vaginal tightness and Labiaplasty to reduce clitoral hood. Both procedures can be combined and done together in one surgery. We would love to meet with you in person! Schedule a consultation with a Board-Certified Plastic Surgeon like myself to help you reach your goals and create a surgical plan for you!

hi, it can be done surgically as a combination of vaginoplasty, labiaplasty and clitoral hoodoplasty and it will be a good option for you. Why were you using DHT gel? With these operations, the clitoris does not shrink, but by filling the tongue and lips, the clitoris can be made to appear smaller and remain inside.

Thank you for your question The gaping can be repaired with a perineorrhaphy but I suspect that the vaginal canal might need to be narrowed if it feels too wide inside.Yes a reverse V hoodoplasty to trim down excess hood can be done at the same time

In regards to the enlarged clitoris (clitoromegaly), this is usually a sign of high testosterone levels. If you are not taking any testosterone, I would have labs drawn to make sure it is not abnormally high.
Regarding the gaping vagina, as a gynecologist with 25+ years experience, it looks normal to me when you are at rest.

You do have some gaping and you obviously can consider surgery as a definitive option. It is permanent but could restore your posterior pelvic floor, and tighten the opening.Before you go that route you could try a series of FOTONA G runner Prolaplase treatments- likely a series of 5 would be necessary 1 month in between combined with pelvic floor stimulation with either EMS intravaginal V tone or Emsella. You should have a consult with a surgical rejuvenation expert and also a consult with a laser rejuvenation doctor and then decide best route for you.

Hi Sammy, There's a lot of information that a clinician needs to gather before being able to advise the best and most suitable course of action. Laser vaginal rejuvenation may benefit but we would need to chat further to discuss your baby delivery history, gynae and medical history, and of course a full examination to feel the muscle tone, skin internally and externally. These give us a fuller picture to be able to advise. Surgery isn't always the first place to start, especially if you are considering having another baby in the future. A good clinic should have an initial telephone consultation with their patients to discuss these topics, which would help develop an initial assessment to explore your history and explain the treatment and how it works as well as suitability. Treatments should be ideally be carried out in a medical clinic by female clinicians with women's health backgrounds. It is worth remembering this procedure will require maintenance as we get older.

Thanks for your query. You have 2 separate questions:
#1- Yes, you would be an excellent candidate for a vaginal tightening procedure with a reconstruction of the perineum and perineal body (the vaginal opening). This is correctly termed a "vaginal reconstruction," aka "vaginoplasty + perineoplasty." This procedure should only be performed by a surgeon trained both is deep intra-vaginal surgical reconstruction (a Gynecologist or Urogynecologist) who has been additionally trarined in plastic work, who can "...make it look good" in addition to functioning properly. A Dermatologist or Cosmetic Surgeon or Plastic Surgeon has not had the requisite training to safely reconstruct both the vaginal floor, remove scar tisse from the opening, and fully reconstruct the vaginal opening. If you are lucky, you may be able to find a surgeon who has been trained to perform this work under "local" anesthesia, which is actually safer, gives better results, leads to an easier recovery, and is less expensive (there are only several such surgeons around; only those trained by either Dr. Alinsod or myself...) You're looking therefore for a "Cosmetic Gynecologist or "Cosmetic Urogynecologist..."
#2. The clitoral hood is a bit more difficult. Unfortunately, you took androgens without proper monitoring or information (a BIG mistake!), perhaps by a personal trainer who was "...practicing medicine without a license..." and- truly- should be prosecuted for his or her failure to either monitor you to avoid over-medication, and for failing to inform you that, while your clit may get slightly smaller after discontinuing the inappropriate medication, it will never get considerably smaller and that you will continue to have a "standout clitoris..." The only way to diminish the size is through an expensive and difficult operation called a "clitoropexy." Yes, there are several surgeons who safely perform this surgery, but it costs a LOT, and has a risk of loss of clitoral sensitivity.
So... what to do about the enlarged clitoral glans? I would suggest, if you decide against the clitoropexy, to find a surgeon who is savvy about different permutations of the "wedge" technique. A micro-mini wedge, performed bilaterally in the midportion of your "hoodie" over the glans would bring the hood down a bit over your clitoral glans, diminishing its prominence and probably hypersensitivity as well. I only mention this as an alternative. In my opinion, it may be best to "...leave well enough alone...

Regards,

Michael P Goodman, MD, FACOG, IF, AAACS
Davis, CA, USA

Hi Sammy. Hope you've having a great festive season.From the pictures it appear that the vaginal entrance is open. Part of the problem will be detachment of the perineal body muscles. Although not visible it is highly likely that you also have damage to the supports of the front and back walls of the vagina. Non-surgical treatment will not fix either of these if you suffer from symptoms such as reduced sensation during sexual intercourse. Non-surgical laser vaginal treatment does have some other benefits but if you want a tighter vagina and tighter vaginal entrance, there is no substitute for surgery.I would suggest that clitoral hood reduction should be avoided because of the risk of over-exposure of the clitoris resulting in irritation. If the size of the clitoris reduces in the future then you could then consider clitoral hood reduction only if you feel that it interferes with access to the clitoris or you are bothered by it's aesthetics.Best wishes on your journey.