Identity and self-esteem are closely linked to a person’s perception of their genitals. Self-esteem can be damaged if a person feels inadequate when compared to a perceived ideal. A normal man might complain about his penis being too small, or a woman might complain about the unattractive appearance of her genitals. These complaints can develop after comparisons with what is seen in pictures or videos, media attention, or comments from friends or partners.

Increased awareness has resulted in a significant demand for aesthetic genital surgery. Recently, new techniques have been developed to improve the appearance of both male and female genitals. It can be said that a noticeable aesthetic improvement in genital appearance is now more possible. Surgery in this area requires extreme attention to detail and meticulous surgical technique.

Vaginal Tightening (Vaginoplasty)

Vaginal widening can occur in many women as they age and after interventions such as pregnancy and vaginal delivery. Vaginal widening can affect both the couple’s sex life and increase the frequency of vaginal infections, as well as complaints such as vaginal gas. Therefore, many women seek medical help for vaginal tightening.

What is Vaginal Tightening?

Vaginal tightening surgeries are referred to as “vaginoplasty” in medical literature. Vaginoplasty, or “surgical vaginal tightening,” is among the most preferred surgeries in the field of aesthetic surgery, alongside labiaplasty. Vaginal tightening surgeries are reconstructive surgeries and are performed by plastic and reconstructive surgeons.

Why Does the Vagina Widen?

The vagina is a structure composed of connective tissue and muscle tissue. The main component of connective tissue is collagen. Due to factors such as aging, vaginal births, pregnancy, abortions, and similar interventions, this connective and muscle tissue can be affected, leading to vaginal widening.

The most common cause of vaginal widening is having given birth vaginally. Difficult births, in particular, can cause tears in the muscle and connective tissue of the vagina, leading to permanent vaginal widening. On the other hand, vaginal widening can also occur after births that were planned vaginally but were converted to cesarean section because the baby could not descend into the pelvic floor.

While the most common cause of vaginal widening is childbirth, sometimes women who have never given birth, or even been pregnant, can experience complaints related to vaginal widening. These women have genetically weak connective tissue structures, resulting in increased elasticity of the vaginal connective tissue. This, combined with lubrication during sexual intercourse, can cause a feeling of looseness and relaxation in the vagina.

Vaginal Rejuvenation (Renewal, Vaginal Rejuvenation)

Vaginal rejuvenation is a broad term. The need for vaginal rejuvenation arises not only from widening but also from the loss of the vagina’s elastic and rugal structure due to aging and, especially, the decrease in hormonal levels during menopause.

All procedures performed to restore the vagina to its former structure can be called ‘vaginal rejuvenation’ or ‘vaginal renewal’ procedures.

Vaginal renewal procedures can be performed in two ways: surgically (vaginoplasty) or with laser vaginal rejuvenation (LVR).

While vaginal tightening can be performed surgically in various ways, the most commonly used method in practice is the classic posterior repair operation. As a result, the desired degree of vaginal tightening is achieved.

Laser vaginal rejuvenation utilizes the thermal (heat) effect of the laser. This effect provides a degree of vaginal tightening, increased blood flow and therefore sensitivity, and tissue regeneration.

What is Vaginoplasty?

Surgeries performed to restore the tightness of a widened vagina are called ‘vaginal tightening surgery’ or ‘vaginoplasty operation’.

In medical literature, the organ where sexual intercourse takes place is called the vagina, and the aesthetic operation performed on the vagina is called vaginoplasty. In common parlance, the vagina is referred to as the “womb”. The average length of the vagina is approximately 8-9 cm.

The vagina, which utilizes its expansion capacity to the maximum during vaginal delivery, may not fully return to its original state after childbirth. Especially in difficult deliveries and in cases of delivering a large baby, the muscle and connective tissue of the vagina suffer significant damage, resulting in permanent vaginal widening. This widening can cause problems for the individual or during sexual intercourse with their partner, leading them to seek ways to restore their vagina to its former state.

Vaginoplasty operations are performed by many gynecologists and are known among gynecological surgeries as “posterior colporaphy” (back repair). The aim is to narrow the vagina and restore its former tightness.

In vaginoplasty and vaginal tightening surgeries, triangular tissue is removed through incisions made inside the vagina, and then narrowing is achieved with transverse sutures. The posterior wall of the vagina is narrowed along its entire length from the entrance. In some cases, if muscle damage and separation have also occurred, the pelvic muscles under the vaginal canal are also brought closer together to increase tightness.

What Problems Arise When the Vagina Widens?

Over time, the widening of the vagina can prevent it from fully gripping the penis during intercourse, resulting in less sexual satisfaction. Many couples, especially after vaginal births, complain that their sex life is no longer the same.

Vaginal Gas Leakage, Sounds During Intercourse

Vaginal births cause widening of the vagina, negatively impacting pleasure during intercourse for both male and female partners. Furthermore, unpleasant sounds during penetration due to vaginal widening can cause a loss of concentration in couples. Sounds coming from the vagina during intercourse are due to gas leakage and reduce pleasure during sex.

The inability of the vagina to fully grip the penis during intercourse, and these unpleasant sounds, negatively affect sexual pleasure and, over time, sexual desire. Couples whose sexual intercourse frequency gradually decreases may eventually move towards an asexual marriage or relationship.

Vaginal noises due to gas leakage can occur not only during intercourse but also during exercise, heavy lifting, and running. Therefore, it can negatively impact social life. For this reason, vaginal rejuvenation, tightening laser treatments, or surgical vaginal narrowing procedures may be preferred.

How Much Can the Vagina Be Tightened with Vaginoplasty?

The wider the vagina, the more it will be tightened. Therefore, for example, the vaginal tightening will differ between a woman who has never given birth and a woman who has given birth five times. Vaginal tightening operations narrow the vagina both internally and externally.

In some patients with excessive widening, internal tightening of up to 7-8 cm can be achieved. In this way, the length (depth) of the vagina is not reduced, while the entire canal is narrowed. In our clinic, the preferred method is complete narrowing of the vaginal canal.

The area where sexual pleasure is most intense in women is the vaginal entrance. This area contains sexually stimulating organs such as the clitoris and G-spot. The mechanical contact of the penis with these structures during entry positively affects pleasure and orgasm. Therefore, vaginal tightening operations provide many functional benefits.

Before starting a vaginoplasty operation, the vaginal entrance is measured practically by inserting a finger. Insertion of 1 or 2 fingers is considered normal, insertion of 3 fingers is considered moderate, and insertion of 4 or more fingers indicates advanced vaginal widening.

The goal of all operations is to reduce vaginal width to between 1 and 2 fingers. For example, reducing the width of a 4-finger opening to 2 fingers through vaginal narrowing indicates a 75% narrowing. This level of vaginal narrowing is quite satisfactory for couples.

Labioplasty

Labioplasty is the term given to the aesthetics of the inner and outer labia in the genital area. Sagging of the inner labia, and loss of the outer labia in women with fuller labia, often leads to many complaints. Labioplasty operations are extremely practical interventions with a quick recovery process that eliminate these complaints.

Where are the Inner Labia?

The inner labia are the small lips covered by the labia majora, which are part of the vulva. These small lips are called labium minora. In normal aesthetic appearance, they are covered by the labia majora.

What is Labioplasty?

The term labiaplasty can be used to describe the aesthetics of both labia, since there are two labia.

The labia majora, or large lips, lose their fullness over time. Various fillers or injections can be used to restore this fullness. Sometimes, there may also be excessive fullness in the labia majora or vulva. These complaints can be resolved with liposuction.

Another term for labiaplasty refers to the aesthetic intervention on the labia minora. Also called labia minora, these smaller lips can sometimes be larger than normal due to age or genetics from birth. If the labia minora sag and become prominent, they can be reduced in size with labiaplasty surgery.

When Should Labia minora aesthetic surgery be performed?

The operation can be performed on individuals who are 18 years of age or older and who are visually or physically bothered by their labia minora.

Where are the labia majora located?

The labia majora are the outermost parts that are the first thing seen when looking at the genital area, covering the labia minora.

What is labia minora sagging?

Over time, the labia minora lose elasticity and become more visible than the labia majora. This creates a sagging appearance, sometimes referred to as vaginal prolapse. Normally, the labia majora should cover the labia minora.

Who is a candidate for labia minora surgery and why?

Labia minora surgery is performed on individuals who are 18 years of age or older and who are physically or visually bothered by their labia majora or labia minora.

Sagging labia minora can cause various physical problems in addition to visual discomfort. The main causes include:

recurrent infections,
irritation and swelling due to friction,
constant itching and discomfort,
pain,
asymmetry, and

dryness caused by friction during cycling or strenuous sports activities.

Furthermore, the labia becoming more prominent even through clothing, bikinis, leggings, or, in more advanced cases, jeans, is also a result of labial hypertrophy, meaning the enlargement and sagging of the labia minora.

In addition, over time, loss of elasticity and age can cause sagging, hollowing, wrinkling, and a reduction in size compared to what it should normally be in the labia majora. In such cases, labiaplasty can be performed with fat injection or filler injections to restore the labia majora to their former fullness and firmness.

Why Does the Labia Majora Sag?

The cause of sagging in the labia minora can be sudden weight loss, being excessively thin, or loss of elasticity with age, but it can also be due to genetic factors from birth, without any of these. In Turkey, genetic factors and congenital asymmetry or size are more prominent.

What to Consider Before Surgery?

Labiaplasty surgery is a short and practical procedure. However, like any intervention, there are important points to consider beforehand. As with any procedure, it’s necessary to inform the doctor if you are taking any medications regularly. Also, if you are taking blood thinners, you may need to stop taking them under your doctor’s supervision. Similarly, as with any operation, you may need to stop consuming herbal teas or food supplements with blood-thinning properties, such as onion and garlic extracts.

How is Labiaplasty Surgery Performed?

Labiaplasty surgery can be performed using local, general, or spinal anesthesia. Under local anesthesia, the area to be treated is numbed. In general anesthesia, the person is completely asleep, while in spinal anesthesia, the area below the waist is numbed, similar to a cesarean section. Regardless of the anesthesia method chosen, the person does not feel pain.

What are the Surgical Methods, and Which Technique is Best?

If a reduction and tightening of the labia minora is to be performed, the excess part is removed, and flap techniques are used to tighten the sagging while reducing the size of the labia. Generally, the scar is hidden underneath to prevent discomfort during intercourse.

In older methods of amputation, scar tissue remained on top, causing discomfort during intercourse; therefore, new flap techniques have been developed to eliminate this problem.

If labiaplasty is to be performed on the labia majora, it is first decided whether the fullness will be achieved with fat injection or synthetic fillers. If synthetic hyaluronic acid is preferred, it can be administered using pre-filled injection methods with a cannula, similar to filler applications.

These applications are generally temporary and need to be renewed at certain intervals, depending on the filler material chosen. If fat injection is decided upon, a sufficient amount of fat is taken from a pre-determined area using a syringe, following the principles of fat injection.

The processed fat is prepared as a filler. It is then applied to the labia using special cannulas. Fat injection has a 40% permanence rate. If necessary, it can be repeated for a few more sessions to add to the effect. Due to its permanence and lack of allergic reactions, fat injections are preferred in labia majora aesthetics.

In rare cases, even when fullness is achieved with filler injections, sagging may not be corrected. In such cases, an incision can be added to correct the sagging of the labia majora.

Sometimes, excessive fullness may also be seen in the vulva. In these types of cases, a short liposuction procedure can be added.