Already had posterior repair surgery. Can a perineoplasty be done separately?

Yes, you can have a perineoplasty done after a rectocele repair. It's a common request in my practice because many surgeons fail to include a perineoplasty with a rectocele repair. It's a shame because an expertly performed perineoplasty will add support to the rectocele repair and make it stronger. It will also reduce the caliber and improve the angle of perineum which improve sexual sensation. Be aware that there are other procedures that are also not usually done at the time of a rectocele repair that can improve sexual sensation - the most common of these is a levatorplasty - tightening of the internal vaginal muscles (the Kegel muscles). You might want to consider doing both of these procedures instead of simply a perineoplasty. If you're unsure or need more info and guidance, it would be most helpful to schedule a virtual consultation to discuss details.

It would have been preferable if you had had a perineorrhaophy at the same time as your rectocele repair. I'm not sure why this wasn't mentioned or performed at the same time. Yes, a perineoplasty can be performed following a rectocele repair. It's a regular request in my practice because many surgeons fail to combine a rectocele surgery with a perineoplasty. You do however have to wait about 4-6 months for healing of the previous procedure.

Hello.
The short answer is yes. Typically it is best to wait about 6 months to have the second procedure but it can be done and assuming there were no complications or issues with the posterior repair (and depending on its location) it would be a straight forward procedure. Please be aware that it is best to have it performed by a surgeon experienced specifically in aesthetic vagina surgery and or in perineoplasty. Best wishes to you. ~Dr. Poucher

It would have been best to have had a perineorrhaophy at the time of your rectocele repair. I'm not clear why this wouldn't have been suggested or performed at the same time. Perhaps your surgeon is not experienced in reconstructive and cosmetic vaginal surgery.
You will have to wait till you are healed from your rectocele repir before having additional surgery.
Go to the link below to see hundreds of before and after photos where you will find many examples of vaginoplasty at the time of pelvic repairs . From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

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