Perineoplasty

Perineoplasty is designed to reconstruct the perineum to help support the vagina and pelvic floor musculature. The perineum is the area located between the vagina and the anus. The structure of the perineum can be disrupted by childbirth, traumatic injury, significant weight loss and the natural ageing process. These factors can result in the vaginal opening enlarging and appearing widened.

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Perineoplasty surgery is designed to tighten the perineal area and narrow the vaginal opening. Areas of scar tissue which has occurred as a result of childbirth or trauma can be effectively reconstructed. The procedure can effectively improve both the appearance of the perineum and improve its function for a significant boost in self-confidence.

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Dr Paraskevi Dimitriadi is a specialist cosmetic gynaecologist and has trained at some of the world’s leading hospitals in all aspects of cosmetic gynaecology. Dr Dimitriadi continues to practice in a major London teaching hospital. She takes an active interest in research into cosmetic gynaecology and lectures both nationally and internationally on a range of topics in cosmetic gynaecology. She is a full member of the European Society of Aesthetic Gynaecology (ESAG).

Dr Dimitriadi is known for her caring, patient-centred approach, supporting all her patients and she always strives to optimise patient outcomes at stages of the patient journey. As a female surgeon, Dr Dimitriadi understands her patient’s most delicate needs and preferences,  which allows her to create a personalised and bespoke treatment plan to meet the patient’s goals. She is regarded as one of the top gynaecological surgeons in London by her peers and brings years of experience to each and every procedure she performs. Dr Dimitriadi brings together her expertise across both surgical and non-surgical gynaecological treatments.

Most women who choose to have perineoplasty do so to narrow the vaginal opening by getting rid of loose skin. A wide vaginal opening may result in reduced stimulation during intercourse and may affect the ability to achieve sexual climax. Damage to the perineal muscles may also be present from childbirth and may cause urinary incontinence.

Reasons to have a perineoplasty include:

• Wide vaginal opening with loose skin
• Reduced sensation during sexual intercourse
• Excessive and painful scar tissue after uncontrolled tearing during vaginal delivery or after an episiotomy
• Vaginal pain and discomfort with persistent irritation
• Reduced self-confidence
• Reduced sexual drive
• Urinary incontinence
• Faecal incontinence

Does perineoplasty tighten the vagina?

Perineoplasty, also known as perineorrhaphy, is a surgical procedure that repairs and tightens the perineum, which is the area of skin and muscle located between the vaginal opening and the anus. While perineoplasty can improve the appearance and functionality of the perineum, it is not specifically designed to tighten the vagina.

Vaginoplasty, on the other hand, is a surgical procedure that specifically tightens the vagina. It is typically performed for women who have experienced significant vaginal laxity, which can occur as a result of natural ageing, childbirth, hormonal changes, or other medical conditions.

In some cases, a combination of perineoplasty and vaginoplasty may be performed to achieve optimal results. This will depend on the individual needs and goals of the patient and should be discussed with a qualified plastic surgeon who specializes in genital surgery.

It’s important to keep in mind that while perineoplasty and vaginoplasty can have benefits, they are not without risks, and the procedures may not be right for everyone. It’s important to carefully consider your goals and expectations and to discuss your concerns with your surgeon, to ensure that you make an informed decision about whether perineoplasty or vaginoplasty is the right choice for you.

Childbirth is the most common cause of damage to the perineum. When women have vaginal childbirth, the soft tissues of the vagina canal must stretch significantly to accommodate the unrestricted passage of the baby to the outside world. Multiple childbirths significantly increase the risk of developing vaginal laxity and a wide vaginal opening.

During a traumatic vaginal delivery, the soft tissues of the vagina matey in an uncontrolled fashion or an episiotomy may be required to facilitate childbirth. In both cases, women are more likely to develop scar tissue which may be painful and tender. Women may also notice a reduction in sensation and discomfort during sexual intercourse.

The development of vaginal laxity or perineal damage may also be caused by the following:

• Significant weight loss or weight gain
• Traumatic injury to the vagina or perineum
• Ageing
• Genetics
• Strenuous exercise
• Pathology affecting the female genitalia such as malignancy
• Long-distance cycling or horseback riding

Perineoplasty, also known as perineorrhaphy, is a surgical procedure that repairs and tightens the perineum, which is the area of skin and muscle located between the vaginal opening and the anus. The goal of perineoplasty is to improve the appearance and functionality of the perineum after it has been stretched or damaged, typically as a result of childbirth.

The following is a detailed description of the perineoplasty procedure:

1. Anesthesia: Perineoplasty is typically performed under general anaesthesia or local anaesthesia with sedation, depending on the individual needs and preferences of the patient.
2. Incision: The surgeon will make a small incision in the perineum, usually along the midline. This incision allows the surgeon to access the underlying muscles and tissues.
3. Repair of muscles: The surgeon will then repair and tighten the underlying muscles and fascia to provide support to the perineum.
4. Suture closure: The skin will then be closed with sutures, which will help to restore the appearance and function of the perineum.
5. Recovery: After the procedure, the patient will need to rest and avoid any strenuous activities for several weeks. The patient will also need to attend follow-up appointments with the surgeon to monitor the healing process.

It’s important to keep in mind that perineoplasty is a delicate procedure that requires a skilled and experienced surgeon to achieve optimal results. The outcome will depend on the individual needs and goals of the patient, and should be discussed with a qualified cosmetic gynaecologist who specialises in genital surgery.

If you are considering perineoplasty, it’s important to carefully consider your goals and expectations, and to discuss your concerns with your surgeon, to ensure that you make an informed decision about whether perineoplasty is the right choice for you.

As with all types of cosmetic gynaecology procedures, it is important to take time out for adequate rest and recovery after perineoplasty to ensure your healing progresses smoothly and with minimal risk of complications occurring.

It is normal to develop bruising and swelling during the first few days after surgery. The application of cold packs can help to minimise swelling, and any discomfort can be effectively controlled with prescription painkillers. It may be useful to immerse the perineal area in shallow warm water for a pleasant soothing sensation in the first two weeks after surgery.

It is important to follow your surgeon’s post-operative instructions in full, including the following:

• Avoid inserting tampons into the vagina for a minimum of six weeks.
• Sexual intercourse should be avoided for six weeks.
• Strenuous exercise, including lifting heavy objects should be avoided for a minimum of four weeks.
• Make sure to keep well hydrated by drinking plenty of water and eating lots of green vegetables to prevent constipation.
• External sanitary pads are useful for absorbing any minor vaginal bleeding.
• The area of surgery should be kept clean and dry and you should avoid rubbing the area after washing. Patting the area dry is the preferred technique.
• Your surgeon uses dissolvable stitches which do not need to be removed at your postoperative check-up appointments.

Once your recovery is complete after perineoplasty surgery, your surgeon may recommend Kegel exercises to increase pelvic floor strength. The best types of exercises will be shown to you, which you can be carried out at home.

RELATED: What is recovery like after vaginoplasty surgery?

As with any type of surgical procedure, perineoplasty carries certain risks and complications and your surgeon will discuss this at your consultation. Recognised risks of perineoplasty surgery include:

• Painful sexual intercourse or dyspareunia
• Bleeding
• Wound infection
• Constipation
• Inadequate amount of tightening sufficient to increase vaginal sensitivity

Although these risks are rare, by choosing to have your procedure at Centre for Surgery, our surgeons are trained to manage any potential complications of perineal repair and the risk of complications occurring can be minimised by following your surgeon’s postoperative instructions in full.

Perineoplasty surgery is not available on the NHS and is not covered by most private medical insurance policies. Patients would have to pay privately to have the procedure carried out.

RELATED: How much does vaginal rejuvenation cost?

Perineoplasty prices will depend on whether the procedure is performed alone or combined with vaginoplasty or another cosmetic gynaecology procedure such as labioplasty. The procedure can be carried out under a local anaesthetic or general anaesthetic, with prices under general anaesthetic costing more.

Are perineoplasty and vaginoplasty the same?