Vaginoplasty to Decrease Laxity from Childbirth?

I would like to know if vaginoplasty would be a good option for me. 19 yrs ago, I had a difficult vaginal delivery. I was in labor for 56 hours, and pushed for over 6 hours. After delivery, I had over 200 stitches inside and outside of my vagina. I had another vaginal birth 3 years after that one, and then a C-section 12 years ago (she was stuck in the vagina canal).

I have never had a problem until now. I am in good shape: I'm slim and I exercise. I also do my Kegels. Recently, I feel "big" down there--really big. My husband and I have a great sex life until now. When I walk I feel like the air gets in there and like I said, I feel "big." Can someone please help me? I can't stop thinking about it and it's changing my sex life and drive. What do you think?

Doctor Answers 7

Who is a candidate for Vaginoplasty?


I have posted a comprehensive FAQ here about Vaginoplasty for you


As a woman’s body ages, it goes through a number of changes. Wrinkles develop and skin sags.Fat deposits increase and muscle mass may decrease.The vagina is no stranger to change either. While most young women have taut and stretchyvaginas, a number of women find that they lose vaginal tone and strength as they age. Some of this simply comes as a woman ages, and some of it comes from childbirth or simply because of the natural vaginal state. The severe strain put on the pelvis and the vagina inparticular can cause the vaginal opening to be stretched, and it can cause a loss of tone in the muscles which surround the vagina.Vaginal rejuvenation is a technique which is used to help increase the tone and tightness of the vagina. During a vaginal rejuvenation, the vaginal opening and walls will typically be tightened, and the surgeon will also help to rebuild and reinforce some of the surrounding supportive tissue. All of this helps to return the vagina to a younger, tighter state.Vaginal rejuvenation is not only a surgery designed to correct or perfect a physicalcondition, but it is also meant to boost the patient’s confidence and help them achieve abetter quality of life. After a vaginal rejuvenation, a patient should return soon to their normal activities. Vaginal rejuvenation is a surgery that with the proper care will not interfere with the patient’s quality of life and should show results in a very short time.

Reduced vaginal tone can be a contributing factor in a loss of sexual sensation andsatisfaction. During sexual intercourse, a certain amount of friction is needed to ensurethe ideal amount of pleasure for both partners. Oftentimes, a loose and weak vagina is unable to provide enough friction to give the woman or the man optimal pleasure. This can leave both partners with a feeling that sex isn’t as good as it once was, and this in turn can result in a lowered interest in sex and a lowered level of intimacy.Restoring tightnessto the vagina can increase sexual satisfaction for both partners.


Vaginal rejuvenation can solve problems with sexual sensitivity that are directly related to a lack of vaginal tone or stretching of the vaginal mucosa from childbirth or episiotomy. If the vaginal walls or opening have been stretched too much during childbirth, a vaginalrejuvenation can decrease their size. If a man feels like his wife’s vagina is just tooloose and the wife feels that his penis isn’t thick enough to fill her up, a vaginal rejuvenation may be able to help. A vaginal rejuvenation can also address issues where alack of vaginal tone is caused by weak vaginal and perineal muscles.

Vaginal rejuvenation cannot solve every problem relating to female sexual function and pleasure. It cannot solve sexual problems that stem from emotional or relationship issues.It is not a solution for sexual dysfunction or anorgasmia. It cannot solve a low interest insex, unless that low interest is an outgrowth of low sexual satisfaction due to vaginal relaxation. A vaginal rejuvenation only affects the vaginal introitus or opening. It does not typically address issues relating to the labia or the clitoris (for more information on how to address these issues, please see the Labiaplasty page). Similarly, a vaginal rejuvenation can’t solve incontinence issues that aren’t caused by weak pelvic muscles. It cannot solve urge incontinence, which is caused by overactive bladder muscles. It also cannot cure overflow incontinence, which occurs when the bladder doesn’t fully empty.


Vaginoplasty(vaginal rejuvenation)  is designed to remove extra mucosa, plicate (tighten)the underlying muscle and close the defect in a way that tightens the vaginal vault. A diamond shaped piece of perineum and internal vaginal mucosa is removed to allow tighteningof the underlying muscle and closure of the vaginal introitus (external opening).Typical tightness is to allow only two and one half finger breadths of space in the vaginal introitus (opening).The operation is outpatient and takes around 1.5 hours. It is typically well tolerated and healing is similar in time and length to a standard episiotomy performed at childbirth. This must be performed in a surgery center under general anesthesia. The average cost including anesthesia and facility fee is around $5500. It is less expensive if performed in combination with other procedures such as labiaplasty and clitoral unhooding (please see labiaplasty page).

I hope this helps,

Daniel A. Medalie, MD

Beachwood Plastic Surgeon
4.9 out of 5 stars 34 reviews

You may be a candidate for Vaginoplasty

The final decision can only be made after a complete examination

From the way you describe the "AIR GETTING THERE" you might be a good candidate for vaginoplasty with muscle repair or tightening.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

You need a surgical evalutation

You really need to see a surgeon to determine what your problem may be and what surgery (if any) can help you. From reading your story it is really unclear what is going on.

Kari L. Colen, MD
New York Plastic Surgeon
4.5 out of 5 stars 8 reviews

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The Long Lasting Results of Vaginal Rejuvenation vs Kegels

Many patients who have tried #kegels for years feel the results are not as successful as vaginal rejuvenation can be. Kegels will further maintain the results of the rejuvenation surgery and may continue to strengthen the vaginal floor.
Candidates of #VaginalRejuvenation 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. Additionally, 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.

Vaginoplasty can also be carried down to the area below the vulva and above the anus, the perineum.This area may be irregular from childbirth or previous trauma. It can be corrected with excision and closure to further enhance the region.
If necessary, this may be combined with a #Labiaplasty which is a surgical procedure that will reduce and/or reshape the #labia. Labia minora are the inner lips of the vagina that cover the female clitoris and vaginal opening. Women with excessively large labia may experience pain during sexual relations, feel discomfort during normal activities or while wearing tight clothing. Or, the labia may be asymmetric or may #hang below the labia majora (the outer lips of the vagina) which some women find this unattractive. At times the outer labia or labia majora may also be excessively large, uneven, or may be too small. The size may be increased with fat injections.

Candidates for treatment include women concerned about the appearance of their genitals, those who experience discomfort, pain or difficulty with sexual relations.The specific problems are noted below in each section. These problems may exist at birth or with growth and development. They can occur with childbirth or other trauma to the region. All of these issues can cause a woman great emotional distress that is often difficult to talk about with their partner, friends and even their doctor.
The best procedure approach will be discussed in more detail during your in-person one-on-one consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 106 reviews

Vaginoplasty For More Friction

From your description, you are probably a good candidate for a vaginoplasty procedure. Candidates of Vaginal Rejuvenation or Vaginoplasty surgery are women who desire a more youthful appearance and function of the vulvas 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 can lead to unsatisfying intimate contact and discomfort.
These surgeries are best performed by carefully selected Plastic Surgeons or Gynecologists. As this is not a very common procedure it is important that you choose a specialist who has significant experience in these procedures to get the best result with the least number of complications.
Intended ResultThe intended results of cosmetic labia and vaginal surgery are to return a youthful sensation and appearance to the labial and vaginal areas or in other cases, to remove physical and psychological discomfort.
The surgical procedure, 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.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
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Sudden Vaginal Laxity Years After Difficult Childbirth

Sometimes, vaginal muscles can compensate for damage to the pelvic floor suspension system that occurs during childbirth. With time, however, the stress and daily wear and tear is too much for these overworked muscles and they can suddenly weaken and give out. Vaginal laxity, bulging or dropping of the vaginal walls (cystocele, rectocele, uterine prolapse) may then become obvious and urinary leakage issues may also ensue. A thorough gynecologic exam will identify the extent of the problem. Vaginoplasty may the solution or simply part of a larger solution that also includes pelvic floor reconstruction. It's a complex situation and it requires expert assessment. Yes, it can be fixed.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.6 out of 5 stars 24 reviews

Sounds like you may need reconstructive surgery

There are many reasons for this and one may be generalized pelvic laxity and perhaps cytocoele, recotcoele or uterine prolapse.

You may want to discuss this with your gynecologist but you may need the expertise of a urogynecologist.

Given your history of obstetrical trauma, you would be a likely candidate for this condition and may need suspension or other procedures.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 79 reviews

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.