The perineum is the area between the vagina and anus. Many women choose to undergo a perineoplasty to address damage to the area caused by childbirth, traumatic injury or the natural ageing process. The procedure is designed to improve the appearance of the vaginal opening so that it appears less gaping. It can also be carried out to improve sexual function and enhance the quality of life. Surgery on the perineum is most commonly combined with a vaginoplasty to treat a loose vagina. Perineoplasty, also known as perineorrhaphy, involves surgical restoration of the muscles that form the opening to the vagina. Perineoplasty is often combined with pelvic floor repair to treat weakness of the vaginal walls causing the uterus, bladder, or rectum to bulge into the vagina. Surgery on the perineum can also help to restore the shape of the vagina to its pre-pregnancy condition or to repair damage caused by traumatic injury. Perineoplasty has the potential to give women the ability and improve their sexual satisfaction as well as enhance the cosmetic appearance of the vagina. Women can be assured that perineoplasty does not affect the ability to become pregnant and is not associated with an increased risk of complications during pregnancy. Perineoplasty is a type of designer vagina surgery.
Am I suitable for perineoplasty?
Women who may need perineoplasty often fall into one or more of the categories below:
- Difficulty with passing a bowel motion
- Pelvic organ prolapse
- Recurrent vaginal infections, including thrush
- Pain and discomfort during sexual intercourse
- Tenderness when touching the perineum
- Painful scar tissue
- Perineal weakness with a widening of the vaginal opening
Patients who are not suitable for the procedure include:
- Women who are pregnant
- Have an active vaginal infection
- Have pre-cancerous or cancerous changes which require further investigation and treatment
- Vascular conditions of the female genitalia
- Severe coagulation disorders may increase the risk of significant bleeding during and after the procedure.
How to prepare for perineoplasty surgery
Dr Dimitriadi will conduct a thorough clinical assessment to ensure you are fit and healthy for perineal plastic surgery. Patients with chronic medical conditions may require special clearance before having the surgery. In some cases, preoperative testing including blood tests, may be necessary but this will depend on your age and past medical history. Dr Dimitriadi can combine a perineoplasty with a vaginoplasty for comprehensive vaginal rejuvenation.
Dr Dimitriadi will also explain other alternative treatment options and the risks and benefits of perineoplasty surgery. The consultation serves as the ideal opportunity to ask any questions you may have about the proposed procedure. Patients should ideally be non-smokers or be willing to completely give up before having the operation at least four weeks beforehand. If you had the procedure under local anaesthetic, there would be no need to undergo preoperative fasting. For a general anaesthetic, you will need to fast for six hours for food and two hours for clear fluids only.
What does a perineoplasty involve?
Perineoplasty can be carried out under local anaesthetic alone but is most commonly carried out under a general anaesthetic using minimally invasive techniques to facilitate quick healing and less scarring. The surgeon will first inject a local anaesthetic into and around the perineum before removing excess skin and repairing the deeper muscles. The wound edges are then closed with dissolvable stitches, which do not need to be removed at post-operative appointments as they will dissolve on their own. Where carried out under a general anaesthetic or local anaesthetic, perineoplasty is a day case procedure and takes approximately one hour to perform. The procedure may take longer when combined with vaginal tightening surgery or a vaginoplasty. Once you are medically fit for discharge, our nursing team will explain the post-operative instructions to your responsible adult escort, who should look after you for the first 24 hours after your procedure whilst you are recovering from the effects of the anaesthetic.
Recovery after perineoplasty
Perineoplasty is an outpatient procedure which means patients can go home later the same day to recover in the comfort of their own homes. During the first few days after the procedure, it is normal to feel localised discomfort and a feeling of swelling and burning in the surgical area. Painkillers prescribed to you by your doctor will be able to control any pain symptoms easily. For approximately 7 to 10 days after perineoplasty, the perineum may appear swollen, although the skin usually goes on to heal without any complications with no noticeable scarring. Patients should avoid having sexual intercourse for six weeks after the procedure to ensure proper healing and minimise the risk of wound breakdown.
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Dr Dimitriadi is one of the most experienced cosmetic gynaecologists in London and strives to provide the very best medical care to all of her patients right from the first consultation until complete healing has taken place. Booking a consultation with Dr Dimitriadi is easy; call us on 020 7993 4849 and speak to one of our friendly and knowledgeable patient coordinators today, or you can fill out the contact form below.