Perineoplasty - is it possible to loosen the area with another surgery?

Question

Hello ! I recently had a Perineoplasty along with Vaginal tightening , the perineum muscles are too tight and am wondering if it is possible to loosen the area with another surgery , my husband and I are having issues with penetration and also noticed the area is now very dry (no natural lubrication) like before the surgery . Can you please give insight and would loosening the muscles be another major procedure ? Thank you

Michelle Jones Singer, MD · Answer

Using vaginal dilators works well with stretching the perineum. The key is to be consistent. Your cosmetic surgeon will inform you on the brand of vaginal dilators they prefer and the use of them.  Another option is having the perineoplasty loosened (reversed) to allow for better penetration. This has to be done by a qualified surgeon. This procedure is short and the recovery is not as involved as the original perineoplasty.

Mark N. Scheinberg, MD · Answer

Thank you for your question It is rare that the muscles are what is interfering with penetration. It is usually the skin fold at the perineal- vaginal junction This can be easily and inexpensively opened by making a small v shaped excision at the “posterior orifice” which should allow easy penetration Moisture comes from vaginal vascular supply. When removing vaginal tissue there is less area to supply moisture. That might be improved with radio frequency or laser treatments which treat dryness or by use of lubricants Just an added note: surgery should not sew muscles but the surrounding tough tissue layer called fascia to bring the muscles into position

Marco A. Pelosi III, MD, FACOG, FACS · Answer

The perineum can sometimes be loosened with vaginal dilators and botox injections. If there is thick scarring, however, these won't work and you will need surgery. It's called a reverse perineoplasty, it's not major surgery and the recovery is mild. If done properly, it works great and looks great. If done wrong, it will look weird. That's why I recommend that you set up a virtual consult with an expert and travel if you must.

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Jesuis1,
The solution to your problem depends on how long ago you had your surgery and what your examination is like. It may be that the perineal skin was aproximated so that your opening is too small for easy penetration. If this is the case you may require a revision. If your suregry was recent then you may need more time. The dryness in the area may be due to scar tissue or other age related factors.
In all, I don't have enough information to help you too much.
Go to the link below to assess my expertise in this surgical specialty as well see hundreds of B/A photos of these procedures. From that link you may schedule a virtual consult 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 vaginal surgery.
Best of luck,

Susan Mikaelian, MD · Answer

Hello Jesuis1, I am wondering how long ago your surgery was as it may just take time as this area is healing for the elasticity and moisture to come back. If the surgery was several months ago and there is scarring at the opening or inside the opening then this would need surgical release. This is not a major procedure, it is easily performed in the outpatient setting and would significantly relieve your symptoms. Hope this helps!

Perineoplasty - is it possible to loosen the area with another surgery?

Answers (7)

Answer: Issues with penetration and dryness may not be solved by loosening muscles

Answer: Issues with penetration and dryness may not be solved by loosening muscles

Answer: Reverse Perineoplasty

Answer: Reverse Perineoplasty

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Everything you need to know about Perineoplasty

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Perineoplasty - is it possible to loosen the area with another surgery?

Answers (7)

Answer: Issues with penetration and dryness may not be solved by loosening muscles

Answer: Issues with penetration and dryness may not be solved by loosening muscles

Answer: Reverse Perineoplasty

Answer: Reverse Perineoplasty

Browse related questions

Recommended reading

Everything you need to know about Perineoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.