What Is Vaginal Rejuvenation, Actually?

Whether due to staring at yourself on Zoom all day or feeling like the stress of the pandemic took a toll, you wouldn't be alone in researching a new skincare protocol or considering pricey aesthetic treatments like microneedling or injections like Botox. 

Unfortunately, the pressures on women to look perfect goes well beyond our faces. Surgical and non-surgical procedures referred to as vaginal rejuvenation, which aim to alter the appearance of the vulva and vagina and boost tightness and lubrication (to name a few of the purported benefits) are becoming increasingly common. 

According to ob-gyn Sherry Ross, M.D., author of she-ology and co-founder of URJA Intimates skincare, "Porn and social media has created vaginal insecurity which has helped move vaginal rejuvenation to the forefront."

Still, the term is a broad one which is used to refer to aesthetic treatments as well as female genital cosmetic surgery procedures that are done for postpartum or postmenopausal medical purposes. 

Here, what experts have to say about these procedures and how to know if they're right for you.

Just like every other part of our bodies, vulvas and vaginas vary in shape, size, color, etc., so there really is no "norm." Still, porn and social media are responsible for promoting an obsession with the "perfect vagina," says Dr. Ross. 

In turn, a range of "vaginal rejuvenation" procedures are popping up which aim to bolster the appearance of the vulva or address problems that might occur after giving birth or due to aging. Treatments purport to:

• Plump up the labia. 
• Remove skin discoloration of the labia.
• Improve elasticity of the labia.
• Make the entrance to the vagina tighter.
• Make the entire vaginal canal tighter.
• Reshape the size and shape of the labia.
• Augment the G-spot using fillers or fat to intensify orgasms.

Recently, energy-based treatments, which use light therapy, radio frequency, or a combination of the two to enhance collagen, blood vessels, tightness and lubrication of the vagina, have gained popularity, explains Dr. Alexis May Kimble, D.O., Medical Director of Kimble Center for Pelvic Wellness, double boarded in gynecology and female pelvic medicine. 

Radiofrequency, or RF, treatments (the brand names of RF devices are Geneveve by Viveve and ThermiVa) use electromagnetic waves to heat tissue and boost collagen production. CO2 laser treatment - delivered via devices like MonaLisa Touch, FemTouch, and FemiLift - heat the upper layers of the tissue to stimulate collagen.

It bears noting that the FDA has not cleared or approved any energy-based medical device for vaginal rejuvenation or vaginal cosmetic procedures or for the treatment of vaginal symptoms related to menopause, urinary incontinence, or sexual function. And these procedures aren't supported by the American College of Obstetrics and Gynecology (ACOG) either.

Still, Dr. Kimble adds that aesthetic procedures could bolster a patient's well-being by improving self-confidence.

It's possible to have abnormal labia, acknowledges Dr. Ross. But when that's the case for someone, there's no denying that the issue goes beyond concerns about aesthetics, as it'll affect everyday activities, she notes. 

"The most common symptom is the need to fold up their labia and push them into their vaginas in order to reduce the appearance of excess tissue or a bulge in their underwear or bathing suits," explains Dr. Ross. 

Other symptoms of abnormal labia include: 

• Labial pain. 
• Swelling. 
• Irritation. 
• Interference with athletics (like running, biking, horseback riding, swimming) or sexual activity. 

Childbirth can also lead to symptoms that might warrant intervention. "For women who have had a number of vaginal deliveries, the vaginal tissue can stretch and become enlarged," notes Dr. Ross. "The bladder and rectum can also become stretched leading to incontinence of urine and stool, and that can be horribly embarrassing and disruptive and cause social isolation. Avoiding intimacy and relationships is common for many of these women." 

The good news is that surgical correction can offer relief by addressing these symptoms. 

The primary procedure to repair such abnormal labia is called labiaplasty. "A trained plastic surgeon or gynecologist can perform this simple outpatient procedure, and the results can be life-changing," explains Dr. Ross. 

The surgery is usually a one-and-done procedure, and surgical fees can vary based on time, complexity, and location, explains Dr. Alexis Parcells, M.D., board-certified plastic surgeon, owner of Parcells Plastic Surgery and founder of SUNNIE Wrinkle Reducing Studio. You might incur additional fees for the surgical facility and anesthesia costs.

As with any surgery, there can be complications. The most commonly seen side effect of this procedure is painful scarring that can lead to discomfort during sex, says Dr. Ross.

Repairing the bladder, rectum, and the vagina is called anterior, posterior, and vaginal colporrhaphy. 

According to ACOG, other types of female genital cosmetic surgery include:

• Clitoral hood reduction, which makes the covering of the clitoris smaller.
• Vaginoplasty, which is marketed as a way to tighten the walls of the vagina.
• Perineoplasty, which is marketed as a way to strengthen the perineum (the area between the anus and the vulva).

In order to better understand which vaginal rejuvenation procedure - if any - is right for you, experts recommend taking the following steps.

Speak candidly to your health care provider.

Dr. Ross urges people to speak candidly to their gynecologist or board-certified plastic surgeon and maintain realistic expectations. You'll also want to prioritize a second and even third opinion from a trained, respected health care provider.

"You have to make sure you are getting advice and treatment by a medical doctor who is licensed and who can support the claims they are proposing," she notes.

Consider your "why."

Unless there are specific medical reasons to undergo surgery, Dr. Ross cautions against it. "Undergoing procedures for vaginal rejuvenation is potentially very dangerous and could lead to vaginal scarring, painful intercourse, infections, vaginal burns, and cause more harm than good," she warns. 

Bottom line: While there are some symptoms that might warrant intervention, your "why" should never be because you (or your partner) think your vulva and vagina should look like the most popular porn star's, Dr. Ross says. "Don't ever feel pressured to change your vulva or vagina for someone else."