I am considering vaginal rejuvenation. Do I sound and/or look like a good candidate? (photo)

Vaginal Surgery

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 introituscan be
tightened.

At first you seem like a perfect candidate for vaginal rejuvenation - natural vaginal delivery, episiotomy scar, and self noted change in appearance.  However because your gynecologist said you were "normal and fell into the snugger side" a consult with a vaginoplasty specialist may be warranted to confirm these physical exam findings. Additionally, some women experience a change/diminution in their hormone milieu (namely estrogen and progesterone) after childbirth and this can effect the quality of their vaginal tissue lining and supporting musculature.  In this case, bio-identical hormone replacement will be necessary and likely an effective solution.  Glad to help.  

Lack of sensation means different things to different women. Some women are describing a lack of tightness during sex. Others have areas that have no feeling at all from nerve damage. Others are trying to explain arousal issues. Vaginal rejuvenation can reduce the caliber of the vaginal canal internally and the perineum externally. Frequently, both are tightened. These procedures work well when lack of sensation means lack of tightness during sex. A thorough pelvic exam at the time of your consultation should identify what lack of sensation means to you and direct you to an appropriate solution.

Thank you for your inquiry! We would love to meet with you in person to make sure you're a candidate for this procedure. Schedule a consultation with a Board-Certified Plastic Surgeon like myself to help you reach your goals and create a surgical plan for you!

Looking at your history and photos, it does not appear surgery would be the first option for you. A procedural treatment such as ThermiVa would increase the blood supply to that area as well as stimulate underlying collagen formation. Quite possibly that would get you to where you would like to be. Given time, if there is a particular site or band of tissue that is painful or is getting in the way with penetration, surgical intervention could easily be performed to reduce or removal the that problem spot. Also, if after ThermiVa there is still decreased sensation or pleasure secondary to some laxity within the vagina, VR can certainly help in that regard. Best to you.

Surgical vaginal rejuvenation is the gold standard for tightening the vaginal opening and canal in a patient with moderate to severe vaginal relaxation who has completed her childbearing. Visually you do not appear to have severe relaxation, although this would need to be confirmed on a physical exam. if you are planning on having more children, or if you only suffer from minor relaxation, you may better benefit from a vaginal CO2 laser treatment such as MonaLisa Touch, or a radio frequency laser such as Therimva. The best next step is to consult a specialist who is an expert in the field of all forms of vaginal rejuvenation. Cheers!

Based on the photos and your concerns, surgery is NOT indicated. It appears you are experiencing something called vaginismus, which is spasm of the vaginal muscles before penetration. This can lead to dyspareunia (pain with intercourse). The treatments are mostly directed at helping your muscles to relax before and during intercourse.The photos show an anatomically normal vulva with no indications for surgery.ThermiVa may be helpful in improving sensation in that area. It is a radiofrequency device that warms the tissues and helps to increase blood flow. It can also tighten the vaginal opening at least temporarily. I would try this before any invasive procedures.

An examination would be necessary to offer an opinion. In general most women complain of loosness, vaginal laxity, rather than being too snug following childbirth.

   Unfortunately, these concerns cannot be addressed without a physical exam.Kenneth Hughes, MDLos Angeles, CA

A treatment such as Geneveve by Vivive may be just the perfect solution for you.  By treating the tissue of the vaginal walls, thickening collagen, improving blood supply, etc., our patients have noticed increases in lubrication and  sensation as well as improvement of stress and urge incontinence.  I think it would be well worth you checking out and considering.  Good luck