Vaginal rejuvenation: From traditional to novel techniques
Key Takeaways
The media and popular culture have cultivated a rising interest in vaginal procedures, ostensibly to improve sexual satisfaction.
Vaginal rejuvenation techniques have advanced from surgical knives to non-invasive lasers and sophisticated radiofrequency devices.
Clinicians may need to counteract patients’ beliefs that a perfect vagina is necessary for a fulfilling sex life, and to ensure that they are not yielding to a partner’s or society’s pressure to undergo vaginal rejuvenation.
Vaginal rejuvenation procedures have skyrocketed by 7.6 times from 2011 to 2021, according to The Aesthetic Society's National Databank Statistics.[] The popularity of vaginal rejuvenation treatments is growing, as more females attempt to counteract the effects of aging, childbirth, and menopause.
From surgical knives to non-invasive lasers and radiofrequency devices, vaginal rejuvenation techniques have come a long way.
What is vaginal rejuvenation?
Vaginal rejuvenation focuses on the vagina and pelvic floor, with the intention of improving vaginal appearance and function.
One of the main reasons for seeking vaginal rejuvenation is to improve sexual satisfaction.
Another popular reason is to treat concerns associated with an aging vagina. As women age, their vaginal tissue becomes lax and dehydrated, which can result in vaginal atrophy and dyspareunia (painful intercourse). Vaginal rejuvenation reportedly improves elasticity and lubrication, minimizing pain.
Vaginal rejuvenation procedures can help to repair and tighten vaginal laxity caused by childbirth. It is also indicated for some medical conditions, including incontinence or vaginal prolapse.
There are several different types of vaginal rejuvenation procedures, ranging from surgical to non-surgical, with each designed to address specific concerns or conditions.
Vaginal rejuvenation surgery
Vaginal rejuvenation surgery combines different procedures to reduce the size of the vaginal canal and opening. Gynecologic or plastic surgeons commonly perform the surgery.[]
These surgical techniques include
Vaginoplasty (tightening or repairing the vaginal canal)
Labiaplasty (reshaping the labia)
Vulvoplasty (reshaping the vulvar tissue)
Perineoplasty (removing excess tissue; tightening and strengthening the perineal muscles)
Monsplasty (removal of fatty tissue over the pubic bone)
Clitoral hood reduction
Most techniques are similar to those used in traditional colporrhaphy for correcting vaginal prolapse or pelvic floor defects.
The results of these surgeries are promising, but there is also a risk of complications, with rates from 2% to 3.77%, as reported in the International Journal of Women’s Dermatology.[] These can include painful sex, dryness, infection, constipation, bleeding, suture failure, and even perforation of the rectal mucosa.
Minimally invasive surgery
The review in the International Journal of Women’s Dermatology also discusses minimally invasive procedures that are used for some genitourinary symptoms.
Silicone threads
Silicone threads offer a gentler, dynamic approach to vaginal rejuvenation without causing tissue trauma. The procedure involves placing threads under the vaginal submucosa.
Gore-Mycromesh
Gore-Mycromesh is a biocompatible compound made of expanded polytetrafluoroethylene (ePTFE).
Non-surgical techniques
Energy-based devices
Energy-based devices utilize radiofrequency (RF) or laser energy—from sources such as carbon dioxide (CO2; 10,600 nm) and erbium-YAG (2940 nm)—to produce thermal-dependent changes in the vaginal tissue.[]The most commonly used RF devices work on focused electromagnetic waves that act via thermal remodeling. An advanced RF technique, transcutaneous temperature-controlled radiofrequency, also shows promising results.[]
All energy-based devices stimulate the production of collagen and elastin fibers, leading to increased elasticity, blood flow, high glycogen content, and lubrication.
These procedures are popular because they require minimal downtime and take as little as 8 to 30 minutes without anesthesia.
Although there isn't much long-term data on the safety and reliability of energy-based devices, according to current evidence, they improve vaginal laxity, sexual sensation, and symptoms of genitourinary syndrome of menopause.
Other non-invasive tools
Non-invasive alternatives include injectable volumizers like hyaluronic acid and platelet-rich plasma for vulvovaginal lipo-filling and G-spot amplification, as described in the International Journal of Women’s Dermatology review article. These procedures claim to improve laxity, dryness, and sexual pleasure. The results may last 3 to 5 months, but their effectiveness is unclear due to a lack of randomized controlled data.
Concerns hinder consensus
There are many concerns about the potential complications of vaginal rejuvenation.
Complications include perineal infection, fibrosis, tissue damage, pain, and sensory loss.
In 2020, the American College of Obstetricians and Gynecologists recommended that doctors inform their patients that there is no evidence supporting the efficacy or safety of these procedures.[]
Vaginal rejuvenation is also controversial since it isn’t considered to be an actual cosmetic surgery done to improve appearance or boost confidence—it isn’t quite like aesthetic procedures such as breast augmentation, liposuction, and facelifts.
The surgeons who perform vaginal rejuvenation procedures must inform their patients that there is little evidence to support their utility. The potential complications should be mentioned explicitly. Vaginal laxity, a prerequisite for surgery, is subjective and can have various causes. Women considering vaginal rejuvenation must be offered psychological and sexological counseling beforehand.
What this means for you
Before patients decide to undergo vaginal rejuvenation procedures, it can be worthwhile to help them understand that anatomic perfection is not necessary for sexual satisfaction and a healthy sex life. In making the decision, patients can be asked to carefully consider their motivations for wanting the procedure. They need to be honest with themselves and be clear that they are not making this decision based on pressure from a partner or societal expectations.