What surgeries would be best for my vagina? (Photo)

I am a 24 yo who is EXTREMELY insecure with herself sexually. I was in a very open relationship, we tried everything. We mainly fisted and I am scared i am to lose for a normal man. The labia skins hangs outside my lips and causes so much discomfort. What are the best surgery options? Should I get vaginalasty or vaginal rejuvenation & labiaplasty. Thanks in advance

Doctor Answers 10

The best procedure ?

Thank you for your question. Based on the images you provided, it appears that your labia minora and clitoral hood are enlarged and may need a surgical correction. The vaginal opening ( introitus) does not appear to be significantly distended or gapping without stretching ( not easy to assess since both labia are covering it). Why do you assume that you "might be to loose for a normal man" ? Why not to attempt to find out if this is indeed the case under other ( normal ) circumstances ? You might regain your self confidence with regards to your "distorted anatomy" and then determine if the vagina and or perineum require a surgical correction. You may also seek an in office consultation/examination by an experienced expert in this field to asses the anatomy and laxity of vaginal walls and/or perinenum. Best of luck and hope you will overcome your insecurities. 

Yvonne Wolny, MD

Chicago OB-GYN
5.0 out of 5 stars 3 reviews

Insecure about vagina

If your have vaginal loosening by fisting, then you can have vaginal tightening and no more fisting. Your labia are enlarged, but not massively enlarged. A labiaplasty must be performed by a surgeon with experience. One of the two most common techniques is the central wedge technique, which I invented in 1995 and published in the plastic surgery textbooks.  It is also known as the "V" or wedge technique. Gynecologists and most plastic surgeons perform a labioplasty very differently. They essentially trim the labia minora (inner vaginal lips) and leave a long suture line instead of the normal labial edge. Their technique is the same whether a scalpel or a laser is used. In contrast, the central wedge removes triangles of tissue and bring the normal edges together. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed.  If you have extra tissue on your clitoral hood, it can be reduced it at the same time. No matter the technique, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery.

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY

Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 21 reviews

What surgery should I get? I am insecure I am too loose for a normal man because we did "fisting."

I agree with the answers given already.  For the skin that is irritating on the out outside, a labiaplasty is the procedure to consider. For vaginal tightness, a perineoplasty and vaginoplasty are the procedures to tighten your body.  That said, you appear normal and fine - and if you can avoid surgery that is always the best.  Surgery causes significant discomfort and has risks.   An office based procedure called thermiva may help you tighten your body back up.  This is painless and mostly risk free.  I would tend towards that assuming you have not yet had children rather than proceed to surgery right away.   But physical exam will be essential to see how much you have "loosened up" as result of sexual practices.

 The two red flags presented by your questions are "extremely insecure" and "very open relationship."   I suspect that what you mean by extremely insecure about yourself sexually is that you feel you damaged your body by your sexual practices.  If this is the reason for your insecurity then surgery is a good option.  But I wouldn't do any "fisting" after surgical repair.  

But if you are insecure for other reasons - like not "loving or accepting yourself" which is a common and painful feeling then that is a different story because it calls into question the type of sexual partner you attracted into your life in the first place and the type of sexual practices you shared together.  Sexual intimacy that damages a woman's body is closer to abuse rather than intimacy.  Intimacy is about sharing yourself physically and emotionally and spiritually with another person in your life who can/may become your husband and father of your children.   You want to love yourself and protect yourself and nurture yourself and find someone who also will do that for you - that is the person who you can trust to appropriately love your children and stay with your during your struggles with pregnancy and motherhood.  And that person does not make you feel damaged and not good enough - but makes you feel stronger and more beautiful.  

Michael Litrel, MD, FPMRS, FACOG
Woodstock Urogynecologist
5.0 out of 5 stars 4 reviews

Vaginal tightening after dilation by fisting

...Depends on what you want to accomplish. You look pretty normal to me! (see: "...if it ain't broke don't fix it..."). If you feel your normal-appearing but robust sized labia BOTHER you, a labiaplasty would "fix" that. If your vagina has been expanded by fisting (sorta like the vagina/pelvic floor damage done by childbirth), then a surgical pelvic floor repair (vaginoplasty; probable also perineoplasty) may be for you. The important thing, all of the experts here will counsel you, is to place yourself in the hands of an EXPERT. The surgery you potentially seek (perineoplasty, vaginoplasty, labiaplasty) will cost ("out-the-door) ~ $8500-$10,000. If someone offers to do it for considerably less, I would question their skill & experience... Work also on your muscular strength, which may have been damaged by fisting. Also, nothing "wrong" with fisting, but if you continue after surgery, it will break down your repair.

Best wishes,

Michael P Goodman, MD

Davis, CA, USA


You are definitely a candidate for a labiaplasty. Most women want the most aesthetically beautiful genital area they can have, thus I created my technique of doing labiaplasty called the True Labiaplasty. I recently presented my technique at the American Academy of Cosmetic Surgery.

There are many types of labiaplasty procedures. I personally prefer my method of doing labiaplasty procedures using a modified posterior wedge technique. It can give you very good symmetry of the labia and it excises excess tissue around the clitoris (i.e. prepuce and clitoral hood) when needed.

It looks the best aesthetically, and postoperatively patients experience less pain, in my experience. In addition, many patients have more satisfying sex since the sensitive thin delicate labial edges are left intact. You can learn more on the link below.  Details are on my website on the link below. Your concerns are exactly the reason why I developed my technique. Good luck.

Robert L. True, MD
Grapevine OB/GYN
4.9 out of 5 stars 9 reviews

Labiaplasty and Perineoplasty

if you're concerned about the appearance and tightness of your vagina, these two procedures could help you. The labiaplasty to reduce the size of the inner labia, and a perineoplasty to tighten the vagina. See the video above for a tightening procedure explained. 

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 200 reviews

For women who like fisting, vaginal rejuvenation starts with no more fisting

If fisting is your thing, keep fisting. If vaginal tightening and a rejuvenated labial appearance are your goals, however, you need to stop fisting. There is no procedure that will withstand repeated fisting and yield a tight vagina. Vaginoplasty (surgical vaginal tightening) with any pelvic reconstruction that might be necessary is the gold standard for vaginal tightening - strong and permanent if you keep anything fist-sized or larger out of there. I would recommend reducing the labia and clitoral hood to streamline the outer appearance. The back end would be contoured by the vaginoplasty at the same time.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.7 out of 5 stars 26 reviews


Dear TGS:

I am sorry to hear of your anxiety and insecurity.  I do agree with Dr Aguirre with surgery for the external area and I would agree that a labiaplasty and some type of clitoral hood reduction might be needed.  I do NOT know if you need a clitorapexy as I can't see the location of your cltioris.  That decision would be made at the time of examination.

As for the interior I feel that you will need a surgical vaginoplasty instead of a laser FemiLift or Radiofrequency procedure such as ThermiVa.   Why?  Though the above two procedures are definitely not surgery and and less invasive.........you have given me much information in your short one paragraph above.  Any woman engaging in fisting by a man  most likely has  muscular relaxation which is so severe that she will not respond to laser or radio frequency.  The only exception might be if you were taking amyl nitrate prior to fisting. As you may or may not know amy nitrate is a common drug used for this type of sexual behavior and it is a muscle relaxant which allows for people to engage in fisting with less discomfort.  Based upon my education, experience and knowledge of women and performing 1000s of vaginal rejuvenation in my career I believe a surgical vaginal rejuvenation will serve you better.  If upon examination I feel differently I would correct my stance on surgery and recommend a less invasive surgery.

Please choose a surgeon wisely, someone who has experience, expertise, a great reputation for attaining great results.  My partner and I have a 90% rate of success of with vaginal rejuvenation, if the surgery is not successful in the first year , I will repeat the surgery without charging you a surgeons fee for retightening. ( my guarantee to you).  Best of luck with your care.

John R Miklos MD

Atlanta ~ Beverly Hills ~ Dubai

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 20 reviews

Insecure about myself - Sexually


Sorry to hear about how self-conscious you are about yourself. Many women with your labia minora size and shape are self-conscious and choose to have cosmetic surgery. You are an excellent candidate for Labiaplasty with Clitoral hood reduction and Clitoropexy. This would create a natural, clean and more youthful appearance. This is done as an outpatient procedure under local anesthesia to ensure privacy and eliminate hospital and anesthesiologist fees.

It doesn't appear that you've had vaginal deliveries. If this is the case then I would not recommend a vaginoplasty. I would however recommend non-surgical Laser Vaginal Tightening with FemiLift. This will help you feel tighter and respond better sexually without the risks or downtime associated with vaginal surgery. We often perform FemiLift treatment on the same day as Labiaplasty. If orgasms are difficult to achieve then you could have an O-Shot as well.  All these procedures are easy to recover from and leave you empowered with your new look and feel. See link below to view an extensive photo gallery and read reviews from many women.

Best of luck

Oscar A. Aguirre, MD
Aguirre Specialty Care - Pelvic Surgery & Intimate Aesthetics®

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 34 reviews

What surgeries would be best for my vagina?

Thank you for your photos, it is best to get total Genital beautification   I suspect that what you mean by extremely insecure about yourself sexually is that you feel you damaged your body by your sexual practices.  If this is the reason for your insecurity then surgery is a good option.  But I wouldn't do any "fisting" after surgical repair.  

Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 90 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.