Hello, my friend from Sanger... Yours is a great educational question! There is a big difference between the sexually-enhancing and aesthetic surgery, "perineorrhaphy and perineoplasty" and a "simple" Posterior Repair" (aka "Posterior Colporrhaphy.") A Posterior Repair (what you had) is performed by either a general Gynecologist or Urogynecologist and is ONLY for defacatory dysfunction (trouble with pooping and/or problems with a big hernia ("bulge") in the vaginal canal.) A properly performed vaginoplasty or perineorrhaphy/perineoplasty is an entirely more complex operation, performed usually by a specially trained "Cosmetic Gynecologist," wherein the old adynamic scar tissue from previous childbirth(s) is entirely removed from the area under the skin of the outer vagina and vaginal opening, and this "defect" is then filled by carefully reapproximating the bulbocavernosis, bulbospongiosis, transverse perinealis musculature, and frequently the base of the perineal membrane to "re-build" and bulk-up the outer vagina, vaginal opening, and perineum to produce vaginal tightening (and therefore more pressure during lovemaking against the G-spot and internal clitoris for increased orgasmic function, tightness & sexual pleasure, in addition to very aesthetically re-designing the opening and perineum. And, yes, this can be accomplished even in a woman who has had a previous "Posterior Repair" at the hands of a general/ or Uro-Gyn. I personally have performed around 250 vaginal reconstructions/perinieorrhaphy/perineoplasties, several of which were in patients who had had previous "hernia repairs..." RealSelf's Web reference and the video below may help. In California you have several choices of Cosmetic Gynecologists skilled in this work, including Dr. David Ghozland in L.A., Dr. Peter Castillo in San Jose, and myself in Sacramento, among others. Look carefully at websites for experience, training, and "before and after" photos. If possible, look for a surgeon who is experienced in doing this surgery under safer, less-expensive "local" anesthesia, which leads to both stronger results and an easier recovery. Steer clear of those surgeons who seem to have flashy, self-hyping type of websites, frequently with untruthful and unethical marketing ploys..! Very best wishes for success, and increasing youir knowledge of your personal choices... Michael P Goodman, MD, FACOG, IF, AAACS. Sacramento, CA, USA