Perinioplasty



What is Perinioplasty?

Perinioplasty is a plastic surgery procedure done to correct a damaged, dysfunctional or distorted opening of the vagina. You might develop a lax or stretched. The vaginal opening may become lax or stretched during childbirth. Perineal scarring may also occur following childbirth, and this scar tissue may be inflexible and can lead to pain during intercourse moving forward.

Perinioplasty is designed to produce a more natural and tightened vagina. It does not tighten the vagina canal. Instead, the procedure often is performed at the same time as a vaginoplasty, which tightens the vagina floor. The perenioplasty only tightens the skin at the opening of the vagina that can cause:
  • The penis to slip out during sex
  • Irritation by rubbing on loose clothing
  • Diminished sexual pleasure
  • Self-consciousness

The perineum is the area between your vagina and rectum that is visible. Tears during childbirth are very common in the perineum. During the approximately 30-minute procedure, the surgeon can:
  • Remove excess skin and skin tags
  • Sew the underlying muscles to tighten them up
  • Give the vagina a snugger feel
  • Resurface the tissue

The best candidates for perinioplasty benefits are women in generally good health who:
  • Have had a vaginal birth
  • Experience looseness during sex
  • Have itching
  • Have decreased sexual stimulation
  • Have changes in their bowel movements
  • Have not had a baby, but because of the pressure from excess weight, the vagina has stretched
  • Are embarrassed by vaginal flatus
  • Were born with an unusually wide vaginal opening
  • Have tried and failed to tighten the vagina with Kegel exercises

Potential Risks of Perinioplasty

Risks following perinioplasty surgery are minimal, but as with any type of surgical procedure, they do exist. The most likely culprits include:
  • Infection
  • Excessive bleeding
  • Constipation

A perinioplasty surgery is elective, so the risks versus the benefits should be considered before proceeding. Other complications are rare, but can occur. They include such occurrences as:
  • The vagina may not be as tight as hoped.
  • Conversely, it may end up being too tight.
  • A second procedure may be needed to make adjustments.
  • Recovery may take longer than expected.
  • The incision can open up during sex, especially if women don’t wait the recommended period of time.
  • An abscess or infection can appear, even if antibiotics are taken.
  • Damage to the rectum may occur, and though this is extremely rare, a repair may be necessary, extending recovery time.
  • A second opening, called a fistula, can appear, necessitating another surgery to close it. This is extremely rare.
Preparing for the Procedure

Once a women has decided to pursue the benefits of a perinioplasty and have been advised of the process, the doctor may prescribe intra-vaginal estrogen if menopause has not occurred. The healing capacity of the vagina is strengthened with this hormonal therapy that many doctors prescribe for a two or three months prior to the actual procedure.
Then the patient is expected to:
  • Make necessary arrangements for recovery including a ride home from the office, help at home and childcare for a few days if required
  • Prepare in the weeks leading up to the surgery by stopping smoking and keeping up with aerobic activity
  • Take oral antibiotics for a few days leading up to the procedure
How the Perineoplasty Is Performed

The procedure is done in a specialized outpatient surgery center on an outpatient basis. The patient given a local anesthesia and mild sedation or general anesthesia. Once the patient is sedated or asleep, a V-shaped incision is made in the posterior wall of your vagina.
  • Any scar tissue is removed.
  • The underlying muscle and tissue then are brought back together.
  • The folds are sutured with dissolvable stitches.
  • After about an hour in a recovery setting, patients are discharged home.
Recovery Process

Patients may experience some minor bleeding for a couple days, for which a sanitary pad can be worn. Patients should be able to return to work within two or three days with minimal pain. Any pain felt can be best managed with over-the-counter medication such as Tylenol that doesn’t promote bleeding.

Slight pain and pressure during the first two weeks after your surgery is normal, but it will decrease over time. Chances are patients will have better bowel movements than previously. Sexual intercourse should be refrained from for about six weeks to give the area time to completely heal. Additionally:
  • Keep the vagina clean and dry
  • Drink lots of water
  • Increase fiber intake to prevent constipation
  • Let the stitches dissolve on their own in about two weeks
  • Return to normal exercise routines within about four weeks
  • Include vaginal exercises as advised by the surgeon






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