Vaginoplasty & labiaplasty. I am very loose and my husband also told me so; what do I do? (Photos)

I am 51 and gave birth to 3 large babies. I am very loose and my husband also told me so. I used to be very tight before birth. I want to be very small again, remove some skin covering my clit. I never feel anything during sex, and make the lips as small as possible. Any suggestions after viewing my photos. I want my vagina to look like a teen.

Doctor Answers 9

Do I need Vaginoplasty and Labiaplasty?

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Dear Jenjen,

Childbirth causes changes in bladder, bowel and sexual function as well as causes appearance changes to the perineum. Depending on the symptoms you have and your anatomy on exam, the best procedure(s) can be determined for you.  Vaginoplasty is not a one-fit-all procedure and involves tightening the vaginal wall (s) and restoring the muscular structure of the perineum.  The most common symptoms are reduced or no sensation for one or both partners, air that moves in and out causing gas-like noises and partner fall out in the middle of sex due to the weak muscles at the vaginal opening.  Constipation and hemorrhoids can worsen after childbirth due to the damaged back wall muscles.

A Labiaplasty and Vaginoplasty can be performed at the same time by an experienced cosmetic gynecologic surgeon or uro-gynecologist.  Be sure to do your homework to find someone who has done hundreds or more of these procedures, see lots of before and after pictures and discuss how s/he addresses post-op complications when they occur.

Please visit the link below for more information on vaginal rejuvenation procedures.

I hope this information is helpful and best of luck in achieving greater sexual satisfaction!


Troy R. Hailparn, MD, FACOG

Cosmetic Gynecology Center of San Antonio

San Antonio OB/GYN
5.0 out of 5 stars 37 reviews

Vaginoplasty Options

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Candidates of Vaginal Rejuvenation or Vaginoplasty surgery are women who desire a more youthful appearance and function of the vulva and vaginal area.  For some women, the effects of childbirth, aging, trauma, and/or genetics, causes their vaginal tissue and muscles to become stretched, which results in loss of strength and tone in the vaginal area. This may result in decreased intimacy and sexual satisfaction. In some cases, the laxity of tissues can be visible. 

The lining of the vagina can be reduced, removing excess and redundant mucosa decreasing the diameter of the canal. The muscle ring, pubococcygeus, at the entrance or introitus can be tightened.  These procedures along with exercises such as Kegles can help keep the muscle tone in this area. Aesthetic Vaginoplasty, in many cases, can increase friction during intercourse, giving women more control of vaginal muscles, increasing sexual satisfaction, while also creating a more attractive and appealing appearance to the vaginal area.

The best thing is to schedule consultation with a board certified plastic surgeon to discuss the options of the vaginoplasty or other vaginal reconstructive or rejuvenation surgery that may help achieve your desired results.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Vaginoplasty after child birth

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it is not uncommon to be all stretched out after childbirth especially with multiple deliveries of large babies.  So vaginoplasty would definitely correct the looseness and improve your sex life again.  Often I find my patients can use a vaginoplasty with a perineorrhaphy at the same time.  If you combined co2 fractional laser to the labia majora then you would get a smoother looking external genitalia as well if you were seeking that aesthetics. Best of luck!

Wide & loose & droopy after 3 children!

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YES, this is possible. I can see from your photos that you have significant loss of pelvic floor supports, as well as both intra-vaginal and perineal (opening) laxity. This sensation of a "...wide & smooth vagina...) can be changed!

The "holy grail" is "...the Right procedure on the Right patient for the Right reasons." Each vulvo-vaginal aesthetic surgical procedure, in my opinion, should be designed for the individual patient. If there is significant vaginal floor laxity, a RF or Laser tightening won't do the job, and you most likely would do best with a pelvic floor tightening consisting of a modified posterior colporrhaphy ("posterior repair") + "vaginoplasty" (procedure approximating the levator and other perineal muscles, and re-approximating the fibrous fascial layer of the vaginal floor,) plus an aesthetic perineorrhaphy/perineoplasty, well elevating and supporting the perineal body at the opening of the vagina. The best person to perform your surgery will be an experienced Gynecologist or Urogynecologist who has been additionally trained (and can prove it with a certificate, or evidence that he or she has performed at least 10 (personally, I've performed >125 )pelvic floor repairs for the specific reason of sexually-improving vaginal tightening, which is a different operation than the "standard" posterior repair for prolapse.) Most plastic surgeons do not operate within the vagina, but a select few do so- ask.  Better to travel to find the right person, than to settle locally and be dissatisfied.  I have operated on women from > 20 different states, and 5 foreign countries; an informed consumer will travel to find "...the best."  HOWEVER, there very well may be a fine surgeon close to you; make sure (s)he is well experienced and specifically trained in vaginal tightening procedures for enhancement of sexual pleasure, not just a general Gyn who knows basic vaginal floor repairs... Cost will vary widely, and you need to be a savvy consumer. The "ideal" (hard to find) is a doc who is experienced and can perform surgery under a local anesthetic (yes!! this is definitely feasible), eliminating the extra cost and recovery generated by being in a hospital, and/or having a general or spinal anesthetic. Also VERY important is inclusion of pelvic floor physical therapy and/or intra-vaginal devices to enable you to exercise and strengthen the muscles of the pelvic floor after surgery. (Stay away from docs who don't mention this crucial aspect of ongoing success...) In our center in Davis, CA, near Sacramento in Northern California, the "out-the-door" fee is $7250, less any applicable discounts. (e.g., we presently give a $300 discount for RealSelf referrals...) This includes all consults, surgery, facility, anesthesia, all followup care, supplies, an APEX(tm) pelvic training device, and a session with a pelvic floor physical therapist, if desired. Adding a labiaplasty/hood reduction would be an additional $2000-2500.Feel free to click on the link below for in-depth information. Also, while you are on the site, click on the header, "Genital Plastic Procedures" for more educational info and short videos; if you wish, we can send you a PDF of my latest (Amazon) book, "You Want to Do WHAT? WHERE...?

Best wishes,

Michael P Goodman, MD

Davis, CA, USA

Your vaginal supports are visibly damaged. You need pelvic reconstruction AND vaginoplasty at minimum.

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Childbirth has damaged your vaginal supports. You've got a sagging bladder (cystocele), a sagging posterior vaginal wall (rectocele), and a gaping vagina with an attenuated (thinned out) perineum. These are only the visible problems. A pelvic exam would be needed for a full assessment. Nonetheless, you will require pelvic reconstruction and vaginoplasty at minimum to achieve adequate and long lasting vaginal tightening. Forget about the wish pics. They're completely unrealistic. You will not look anything like a young skinny blond who never had kids. You will have a tighter vagina that can feel the friction of the penis during sex. 

Pregnancies and vaginal changes

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There is no question that there are vaginal and labial changes that occur as a result of both hormonal changes in pregnancy and subsequent vaginal delivery of babies.  The degree to which women are affected differs from person to person and is further affected by the number of pregnancies, any injuries at the time of the delivery, the size of the baby(s), and the quality of repairs performed at that time.The aesthetic changes have more to do with excess labial growth and presence of stretched skin. The functional aspects have more to do with various degrees of loss of pelvic muscle strength due to stretching or injury during the delivery. Both concerns can be addressed in one operation; meaning that the aesthetic and functional aspects can be improved.  Dr. B

Ramin Behmand, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 44 reviews

When you're too 'loose'

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and you've done the Kegel exercises, you should see a urogynecologist for a thorough evaluation as your pelvic floor and adjacent tissues could be simply shot.  Get your vault repaired (assuming it is needed) and then you can work on the aesthetics with the labiaplasty... or see if you can get surgeons to work together so you can have it both at the same time so you only have one recovery.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Vaginoplasty and labiaplasty

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Because your presentation involves both functional and aesthetic issues, Your primary problem may be related to pelvic supporting structures.  The first step is professional and comprehensive evaluation.  See a uro-gynecologist in your area.  That doctor will learn more about your situation, examine you carefully, and will offer solutions.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

What surgery do I need?

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Vaginal births damage the vagina.  This causes looseness and pelvic organ prolapse.  Prolapse is when the organs surrounding the vagina drop through the vagina.  This can include the bladder, bowels, rectum and uterus. You may have some degree of prolapse in addition to to the looseness.  Evaluation for correction of this will be part of your surgical evaluation.  You can be made tighter in the surgical process.

Your labia minora or inner lips are a bit elongated compared to the labia majora - or outer lips.  Your anatomy is normal but if you want the appearance changed to the other photos you show then a labiaplasty can be performed.  I could not see from the images the extra skin over your clitoris but a reduction of this skin is commonly performed at the time of labiaplasty.  This is a clitoral hood reduction.

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.