Fotona SMOOTH: How the Vaginal Laser Works and What It Treats

Fotona SMOOTH is the laser behind several of the most widely offered vaginal laser treatments in the UK, including IntimaLase and IncontiLase. You may also see it called FotonaSmooth, the Fotona vaginal laser or the Er:YAG vaginal laser. All describe the same technology: an erbium laser fired in a special non-ablative mode that warms the vaginal tissue rather than removing it.

This guide explains what Fotona SMOOTH is, how the SMOOTH mode works, which treatments use it and what each one is for, what treatment involves, and what the research shows about results and side effects. At Centre for Surgery, all four of our Fotona vaginal laser treatments use this technology. If you are comparing it with other options, our guide to non-surgical vaginal rejuvenation sets out the alternatives, and our article on whether vaginal laser is safe covers the trial evidence in depth.

What Is Fotona SMOOTH?

Fotona is a laser manufacturer, and SMOOTH is the name of a pulse mode on its erbium:YAG (Er:YAG) lasers. The FotonaSmooth gynaecology platform uses that mode with vaginal handpieces designed to treat the vaginal walls and opening. The same SMOOTH technology is used outside gynaecology, for example in Fotona NightLase laser snoring treatment, where it heats the tissue at the back of the mouth, and as one of the steps in Fotona 4D facial treatment, described in our article on whether Fotona 4D can tighten skin without surgery.

In gynaecology, Fotona SMOOTH is used for four main concerns: vaginal laxity, stress urinary incontinence, mild pelvic organ prolapse, and vaginal dryness and atrophy after menopause.

How Does the Fotona SMOOTH Mode Work?

The Er:YAG laser emits light at a wavelength that water absorbs very strongly. In its usual ablative mode, used for skin resurfacing, that energy vaporises a thin layer of tissue. Our article on erbium vs CO2 laser resurfacing explains the difference in skin.

The SMOOTH mode changes how the energy is delivered. Instead of one strong pulse, it fires a rapid sequence of low-energy pulses. Each pulse is too weak to vaporise tissue, but together they build up heat in the surface of the vaginal lining, which then spreads into the deeper connective tissue. The aim is a controlled thermal effect only, without breaking the surface. According to the developers, this heating causes collagen fibres to contract and starts a remodelling process in which new collagen is laid down over the following weeks, with the intention of firming and thickening the vaginal wall^[1]. That description comes from authors employed by the manufacturer, and whether the tissue change translates into improvement women can feel is what the independent trials described below have tested.

Er:YAG vs CO2 vaginal laser

The other common vaginal laser is the fractional CO2 laser, sold under brands such as MonaLisa Touch and FemiLift. It works differently: it makes columns of microscopic wounds in the lining, and the healing response is meant to rebuild the tissue. The SMOOTH Er:YAG mode does not make wounds.

The best-known trial of CO2 laser, a 2021 double-blind study of 85 postmenopausal women, found no significant difference from sham treatment in vaginal symptoms at 12 months^[4]. That result does not automatically apply to the Er:YAG laser, but neither laser type can be assumed to work simply because it is a laser.

Which Treatments Use Fotona SMOOTH?

At Centre for Surgery, Fotona SMOOTH is used in four separate protocols, each aimed at a different problem and a different part of the vagina:

• IntimaLase treats the whole vaginal canal and opening for mild vaginal laxity, usually in three sessions four to six weeks apart. Our article on the benefits of IntimaLase covers what to expect.
• IncontiLase concentrates on the front vaginal wall beneath the urethra and the bladder neck, for mild to moderate stress urinary incontinence, usually in two sessions a month apart.
• ProlapLase treats the prolapsed areas and the whole vaginal surface for mild to moderate prolapse, usually in three to five monthly sessions.
• RenovaLase treats the vaginal lining for dryness and atrophy after menopause, usually in three monthly sessions.

Some women combine treatments in one course, for example IntimaLase with IncontiLase where laxity and leaks occur together.

Who Is a Good Candidate for Fotona SMOOTH?

Fotona SMOOTH treatment may suit adult women who:

• have mild vaginal laxity, mild to moderate stress incontinence, mild prolapse or vaginal dryness;
• would prefer to avoid or delay surgery, or cannot use vaginal oestrogen;
• have tried, or are willing to continue, pelvic floor exercises;
• are not pregnant or trying to conceive;
• have a current normal cervical smear result and no active infection.

It is not the right treatment for marked laxity caused by separated muscle, a wide vaginal opening after a tear, more than mild prolapse, or enlarged labia. For those, surgery such as vaginoplasty, perineoplasty or labiaplasty is more appropriate. Our guide to the different types of vaginal rejuvenation explains which treatment fits which concern.

What Happens During a Fotona SMOOTH Treatment?

• Consultation: a medical history and examination, confirmation of your smear status, and a written treatment plan.
• Preparation: none in particular. No fasting is needed and you can take your usual medicines.
• Treatment: you lie on a couch as for a smear test. A smooth applicator is placed in the vagina and the laser is fired through it as it is moved along the vaginal walls. Sessions take about 15 to 30 minutes for IntimaLase, IncontiLase and RenovaLase, and 30 to 45 minutes for ProlapLase.
• Afterwards: you can dress and return to work immediately. Avoid sex for 72 hours. A watery discharge or mild swelling is common for a day or two.
• Follow-up: your clinician reviews progress between sessions. A yearly maintenance session may be recommended after the first course.

Our guide to when you can have sex after laser vaginal tightening covers aftercare in more detail.

Is Fotona SMOOTH Painful?

Fotona SMOOTH is not usually painful, and no anaesthetic or numbing cream is needed. The vaginal lining has relatively few pain fibres, so most women describe warmth rather than pain. Treatment near the entrance, which is more sensitive, can feel hotter, and the clinician can adjust the settings. After RenovaLase, a feeling like mild sunburn can last for up to 48 hours.

Does Fotona SMOOTH Work? What the Research Shows

The answer depends on what it is being used for.

Stress urinary incontinence

This is where the evidence for the Er:YAG laser is strongest, although it is still mixed. Two sham-controlled trials found more women improved after laser than after sham, and a third, double-blind trial of 144 women found no difference at six months. A 2026 meta-analysis of ten sham-controlled trials of energy-based devices ↗ found a modest, short-term improvement in incontinence symptom scores, with the strongest and most consistent effect for non-ablative Er:YAG laser^[5].

Vaginal laxity

A 2024 systematic review and meta-analysis of treatments for vaginal laxity ↗ found that sexual function improved after laser or radiofrequency in observational studies, but not when only randomised controlled trials were analysed^[6].

Vaginal dryness and atrophy

An early 2015 pilot study reported improvements in dryness and painful sex after three Er:YAG treatments, similar to vaginal estriol gel, but it had no sham group^[2]. A 2025 systematic review of energy-based treatments for menopausal symptoms concluded that the effects of Er:YAG laser are very uncertain^[3]. Vaginal oestrogen remains the first treatment, as our guide to treatment options for vaginal atrophy explains.

Pelvic organ prolapse

In a 2024 trial of 46 women with mild to moderate prolapse, Er:YAG laser and pelvic floor exercises improved symptoms to a similar extent, but the effect was not durable, and half the laser group asked for further treatment by two years^[7]. In a smaller 2020 trial of women with more advanced (stage 2 or 3) prolapse, laser did not improve prolapse stage or symptoms compared with no treatment^[8]. That is why ProlapLase is offered only for milder prolapse.

Fotona SMOOTH Side Effects and Safety

In trials, side effects have mostly been mild and short-lived, and systematic reviews report no serious adverse events^[3][5]. The usual effects are warmth or discomfort during treatment, a watery discharge, mild swelling or spotting for a day or two, and occasional urinary symptoms. In 2018 the US FDA warned about energy-based devices marketed for “vaginal rejuvenation”, and NICE’s guidance on transvaginal laser for stress urinary incontinence ↗ and urogenital atrophy ↗ found no short-term safety concerns but inadequate long-term evidence. Treatment should therefore be given by a trained clinical team after an examination, and only on healthy tissue.

Fotona SMOOTH at Centre for Surgery

Centre for Surgery is a CQC-regulated private hospital at 95–97 Baker Street, offering all four Fotona SMOOTH vaginal treatments under one roof. Every patient has a face-to-face consultation and examination with a GMC-registered clinician first, so that the cause of symptoms is clear and laser is only recommended where it is likely to help. If pelvic floor physiotherapy, vaginal oestrogen or surgery would serve you better, we will say so, and surgery is available at the same hospital, where the surgeon who assesses you performs your operation. The consultation fee is £100, redeemable against treatment, and finance is available.

Frequently Asked Questions

Fotona Vaginal Laser in London

If you are considering Fotona SMOOTH treatment, a consultation will establish whether laser is likely to help, which protocol suits you, and what the alternatives are. Find out more about vaginal laser treatment in London at Centre for Surgery.

Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation

References

1. Vizintin Z, Lukac M, Kazic M, Tettamanti M. Erbium laser in gynecology. Climacteric 2015;18 Suppl 1:4–8. doi:10.3109/13697137.2015.1078668 ↗
2. Gambacciani M, Levancini M, Cervigni M. Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause. Climacteric 2015;18(5):757–763. doi:10.3109/13697137.2015.1045485 ↗
3. Zerzan NL, Greer N, Ullman KE, et al. Energy-based interventions for genitourinary syndrome of menopause: a systematic review of randomized controlled trials and prospective observational studies. Menopause 2025;32(2):176–183. doi:10.1097/GME.0000000000002465 ↗
4. Li FG, Maheux-Lacroix S, Deans R, et al. Effect of fractional carbon dioxide laser vs sham treatment on symptom severity in women with postmenopausal vaginal symptoms: a randomized clinical trial. JAMA 2021;326(14):1381–1389. doi:10.1001/jama.2021.14892 ↗
5. Lukanović D, Shah G, Matjašič M, Phillips C. The use of energy-based devices for the treatment of stress urinary incontinence: a systematic review and meta analysis of the randomised sham-controlled trials. International Urogynecology Journal 2026;37(9):2779–2790. doi:10.1007/s00192-026-06604-9 ↗
6. Pereira GMV, Cartwright R, Juliato CRT, Domoney C, Iglesia CB, Brito LGO. Treatment of women with vaginal laxity: systematic review with meta-analysis. The Journal of Sexual Medicine 2024;21(5):430–442. doi:10.1093/jsxmed/qdae028 ↗
7. Page AS, Borowski E, Bauters E, Housmans S, Van der Aa F, Deprest J. Vaginal erbium laser versus pelvic floor exercises for the treatment of pelvic organ prolapse: a randomised controlled trial. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2024;303:165–170. doi:10.1016/j.ejogrb.2024.10.042 ↗
8. Athanasiou S, Pitsouni E, Cardozo L, et al. Can pelvic organ prolapse in postmenopausal women be treated with laser therapy? Climacteric 2020;24(1):101–106. doi:10.1080/13697137.2020.1789092 ↗