Almost all of the cosmetic surgeries are outpatient. Labiaplasty and vaginoplasty cases are typically finished within an hour. If a repair of the bladder, rectum or bowel is needed then a 23 hour overnight stay may be needed. If a hysterectomy is needed than it is typical to stay one to two days. Placement of a sling to help with incontinence does not prolong the hospital stay. Many patients feel the pain involved is similar to the discomfort AFTER a baby has been born. They are somewhat sore but not in agony. Pain control is excellent in the large majority of cases.

Labiaplasty is the cosmetic reshaping of the inner folds of tissue, called the labia minora, or smaller inner lips of the vagina. Various instruments are used such as pinpoint cautery, Yag lasers, fine scissors, or a knife. The edges are then sewn together with delicate absorbable sutures. A vaginoplasty (commonly referred to as vaginal rejuvenation) is when a diamond shaped section of tissue is excised from the inside of the vagina and brought down to the outside of the vagina. Often times a small triangular area is also excised from the perineum (the area right below the vaginal opening). This is called a perineoplasty or perineorrhaphy. The size of the tissues removed rarely are larger than a domino block. If needed, sutures that bundle loose muscles together are used to narrow the vaginal opening.

Surgery can trim excessively large labia minora, it can also reduce a labia majora. We can also trim the excess bulge of skin in the vagina and tighten the entrance to the vagina. We can make the whole vagina tighter by excising this loose vaginal skin. Surgery alone will not improve the tone of your vaginal muscles. You need pelvic floor exercising for that similar to Kegels exercises. Surgery can also add support to your fallen bladder, rectum, bowel, or vagina. Many women tell us that they are happy to be able to wear jeans, bathing suits, and form-fitting outfits again because the rubbing and irritation have disappeared.

The procedure is usually done in the operating room or surgery center. If a simple labiaplasty or vaginoplasty is performed then the option of performing the surgery in the office under local anesthesia and oral and injectible medication can be considered. We tailor the surgery to the patient,s projected pain tolerance, anxiety level, and health status.

You can have a short nap or be fully awake. General anesthesia is also common anesthetic used because of the patientes desire not to know or feel anything. Then there is the spinal or epidural anesthetic that allows you to be awake. This is ideal for those who have a fear of going to sleep or have other major medical problems. Sedation and use of local anesthetics is the least invasive of anesthetic options. Many choose this so that recovery is almost immediate and the down time is minimal. If the case involves bladder, rectum, or bowel repair of if a hysterectomy is performed then general anesthesia is the standard.

In rare cases, long-term complications may occur after vaginal rejuvenation. Again, many of these complications can occur with any major surgery. Among the long-term complications that sometimes occur after vaginal rejuvenation are:

• Long-term or permanent loss of sensation
• Uncomfortable or painful intercourse
• Dissatisfaction with the results of the surgery
• Serious infection or tissue necrosis
• Loss of sensation is relatively rare, and usually only occurs at the sites of the incision. If the surgery has made your vagina too tight or the opening too small, uncomfortable intercourse could result.

Perhaps the most common long-term complication of vaginal rejuvenation is dissatisfaction with the results. This is common with most cosmetic surgery procedures, and can be addressed through revision surgery. Be sure to communicate your goals for the surgery to your cosmetic surgeon during your pre-surgery consultations. The more thorough and honest your communication is with your doctor before surgery, the more likely he is to provide you with the results you desire.

Serious infection can be avoided by closely following post-operative instructions and using the full course of antibiotics provided by your doctor. Post-surgery hygiene is also important in preventing infection. Tissue necrosis, though it is extremely serious, is rare. This condition, in which tissue dies and must be amputated, is more common among smokers. Smoking reduces the amount of oxygen that is delivered to body tissues, making it more difficult for a smoker to heal effectively after surgery. Surgeons recommend smoking cessation at least two weeks before major surgery of any kind.