The process of correction of sagging and deformities in the female external genital organs due to giving birth or aging is called Vaginoplasty.
Why does the vagina sag?
Vaginal sagging occurs because of two important reasons.
The first is pregnancy. During pregnancy, hormones cause a high level of blood supply and growth in the external genital organs. The muscles around the vagina relax and prepare for childbirth. After childbirth, growth and relaxation in these tissues return to their original form but sometimes not entirely. At birth, due to ruptures and enlargements in the mucous membranes and muscle tissue, a partial sagging occurs both in the inner part of the vagina and in the labia minora and Majora.
Secondly, with aging, a loss of elasticity of the tissues and a loss of subcutaneous adipose tissue causes relaxation and sagging in the vaginal tissues. At the same time, the relaxation of the connective tissues surrounding the vagina can not get back to its original form as in pregnancy and after birth. Elongation in the collagen and mucosa causes sagging with age.
The vagina is a tube system that connects the internal genital system to the outside. It has 3 important functions. The first one is being a canal that transmits the sperm to the uterus by taking the penis inside. It also acts as a channel for the child to exit from the uterus during childbirth. It is also a tubular organ in which the intrauterine blood and tissues during the menstrual cycle are cast out. The inside of the vagina is covered with mucous wrapped with glands. This structure secretes fluid during sexual intercourse and provides the formation of slipperiness. Under the mucosa is a structure that we call fibromuscular. This structure has a certain tone and tension. It can expand during intercourse and childbirth. The vagina has a rich structure both from veins and arteries. As with hormonal effects, the blood supply increases; with the age, blood drainage decreases and causes dryness in the vagina. Also, the vagina and the surrounding tissues are surrounded by rich sensory nerves.
What are the results achieved with vaginoplasty?
The surgery process depends on the condition of the deformity in the vagina. It varies from patient to patient.
Firstly, if there is an enlargement due to the tearing of the mucosa and muscles in the inner tissue of the vagina, which happens mostly with births, the procedure will be to narrow the mucosa and muscle and connective tissue in the vagina. Thus the tube in the enlarged vagina is narrowed and tried to be normalized.
The vaginoplasty is also performed to treat the Labia minora, which is at the outward opening mouth of the vagina, and the labia majora. These usually have sagging in the labia minora and the skin tissue surrounding the clitoris, which we call the clitoral hood. These sags are normalized by shortening both the labia minora and the skin tissue around the clitoris.
Thirdly, by using vaginoplasty, the labia majora is intervened, and if there is excess skin tissue, it is removed and if it is missing fat tissue some fat injections can be made.
Finally, a color change in the vagina, a darker color, may occur. This usually occurs in overhanging labia minora. More natural color is obtained by removing this area and fat injections.
How is vaginoplasty performed?
Although the vaginoplasty process varies from patient to patient, it is examined under three main headings. The first is the tubular part of the vagina tissue from the entrance to the cervix. The stretch here can cause two problems. The first is an excess of the mucosa. This excess tissue is caused by giving birth and age. This excess mucous tissue needs to be removed and sutured. Secondly, and more importantly, ruptures due to tearing and stretching occur in the muscles surrounding the vagina after giving birth. Due to this slack, the vagina loses its old tone. After we remove the excess of the mucosa, we tighten the muscles here, just like in the abdomen, with the help of stitches.
The second procedure we do in vaginoplasty is a procedure called labioplasty.
Labioplasty is the process of reshaping the small lips and the clitoris and its surrounding tissues. The process we do is to shorten the excessive tissue in the labia minora. It is also the process of shaping the area with the help of sutures after the mucosa on the labia minora is stripped and removed, leaving the tissue inside. When we move to the upper region, excess skin tissue around the clitoris can Cover the clitoris. After leaving both the excessive and sagging skin tissue to cover the clitoris with a sufficient amount, the remaining excess is removed. If necessary, this process is completed by lifting the clitorial region that hangs downwards.
The region where we last intervene in vaginoplasty is the labia majora region. There may rarely be excess skin in the labia majora. Excess skin is removed to preserve the usual shape of this region. However, more tonus loss occurs. So there is a decrease in fat and ligament tissue. This occurs with weight loss and aging. By filling these areas with fat grafts, we can achieve a certain tone and plumpness.
The vagina that has been darkened, by intervention in both the labia minora and the labia majora, is returned to its normal color.
The postoperative recovery period after vaginoplasty
If three processes are performed together in the vaginoplasty, the total healing period is one week if we have created a narrowing in the vagina tissue. However, if we have performed only the Labiaplasty, recovery is completed in 3-4 days. After vaginoplasty, you can return to daily life on the third or fourth day. After Labiaplasty, the patient can easily return to daily life 1 day after the surgery.
What are the risks of the surgery?
A large complication in vaginoplasty usually does not happen. There are risks of anesthesia that can occur in every surgery. Labioplasty can be performed under local or general anesthesia. Infection and bleeding are other complications. These complications can be seen from time to time, but these are complications that can eventually be controlled.
Is the result of the surgery permanent?
Vaginoplasty and labiaplasty procedures are permanent procedures. There is no short-term deterioration and deformation. However, with aging and giving more birth, the vagina mucosa gradually begins to deform over time.
What is the difference between vaginoplasty and labioplasty?
In vaginoplasty, both the inside of the vagina and the external genital organs are intervened as a whole. In labiaplasty, only the external genital organs and the clitoral area are intervened.
The surgery is performed on the same day as the patient arrives at the hospital. The preoperative tests are made and the patients get ready for the anesthesia before the surgery. After the surgery, it is necessary to stay for one day in the hospital. It is recommended to stay in Turkey for 2 days for labioplasty patients and 3 days for vaginoplasty patients. However, for patients that work could be allowed to travel after 1 day in labioplasty and 2 days in vaginoplasty.
Patients are very easy to take care of after surgery. It is enough just to pay attention to the rules of hygiene and apply an ointment with antibiotics on the wound once a day.
The stitches used in both applications are stitches that can be absorbed. These are absorbed or fall off spontaneously within 1-2 weeks. Recovery is completed within 1 week. Sexual intercourse should be avoided until 6 weeks after labioplasty and 3 weeks in vaginoplasty.