Aging and vaginal deliveries (natural childbirth) are factors that cause the vaginal tissue to expand and lose its elasticity (this is technically known as vaginal laxity). The expansion of the vagina could be likened to the enlargement of the abdominal skin during pregnancy.
The excessive stretching of the vaginal tissues that occurs during natural (normal) childbirth can loosen and widen the muscles of the vagina. Many couples with vaginal laxity complain of a loss of sexual pleasure or an inability to enjoy sex as much as they used to.
Like all our organs, some changes occur in the genitals over time. These changes are usually accelerated by aging and childbirth. The most important changes due to aging are loss of “tightness”, straining, wrinkling, and sagging.
Aging occurs in both internal and external genitalia. The female internal genital organ is the vagina. If you think about it, you would realize that the vagina is exposed to many traumas throughout one’s life.
The following are reasons that could cause the vagina to age faster or lose its firmness: pressure traumas due to sexual intercourse, sneezing, coughing, weight-related pressures in obese and pregnant women, large and small cuts/tears when the baby's head or other limbs come out during childbirth, incisions made to the vagina to facilitate natural childbirth, cuts due to traumatic sexual relations, etc.
Fortunately, there is an important operation to restore the vagina and get rid of vaginal laxity. This operation is called 'vaginoplasty', which is also known as vaginal tightening surgery. Vaginoplasty is the aesthetic operation of this internal genital organ (i.e., the vagina). This procedure provides both aesthetic and functional benefits to the vagina.
Before having the vaginoplasty operation, you should thoroughly research the experience of the doctor who will perform the procedure. If possible, a rational approach before making a decision would be to schedule an in-person meeting where you will be able to see before and after photos of the previous operations.
Vaginal enlargement complaints are generally grouped under 3 headings as visual, emotional, and spouse-related complaints. The complaints of my patients suffering from vaginal laxity are as follows:
Appearance-related Complaints;
Emotion-related Complaints;
Sexual life concerns about her partner:
The vagina is covered with a thin layer called the mucous membrane. This is analogous to the cheek tissues within the mouth. Just as your cheek is not resistant to excessive stretching or scratching with a sharp object, the vagina also has a certain limit. For example, normal delivery can tear both the mucosa and the inner lining of the vagina, which is under the mucous membrane. In fact, with too much strain, separations may occur in the vaginal muscles. Usually, these vaginal parts do not heal on their own. Excess weight and pregnancy can cause damage to the vagina given that the applied pressure stretches the tissues. Again, tissue aging is one of the most damaging factors.
If you have the following complaints, vaginal tightening surgery is also necessary for you;
The vagina is a very elastic tissue. It is essentially the vaginal muscles that provide tightness to the vagina because they are the biggest supporting tissue of the vagina. They provide a tight tone and strength. There is also a genetic basis for the width (widening) of the vagina.
If the pelvic (vagina) muscles are strong, the vagina will remain tight even if you have a lot of intercourse, so there is no such number. If the vagina is genetically wider than normal, it would remain wide even after the first intercourse.
In a normal vagina, the vaginal opening is narrow, and the further part is wider. Although the width of the vagina varies from person to person, it is 4-6 cm on average. In addition, since the underlying normal tissue structure of the vagina is very elastic, it has a much greater expansion capacity. This is to allow for normal delivery.
The distance between the vagina and the uterus is approximately 10-12 cm, but this length may vary depending on height and genetics. In addition, due to the elasticity of the vagina structure, it can stretch and expand when necessary.
There are various types of the vagina, i.e., the external appearance of the vagina is variable. Additionally, the large and small lips (labia majora and minora) can change with time due to genetics, weight gain, waxing, congenital reasons, etc.
There is no ideal measure for how narrow the vagina should be. The ideal size completely depends on whether you and your partner enjoy sexual intercourse. It is obvious that there is a problem if you used to enjoy the relationship but no longer do.
When the vagina is forced, it can stretch a lot and when necessary, it can be opened as much as the diameter of a baby's head, that is, 10-12 cm. However, during this stretching, permanent tears/cuts may occur in the vaginal membrane (also known as the mucosal and vaginal fascia). Also, this stretching could lead to separations in the vaginal muscles.
The vagina does not ‘loosen’ during sexual intercourse that is not forced or where the vaginal muscles are not strained. Even if it will expand, the vagina will not shrink again by itself.
There are some exercises that help to tighten the vagina. You can see some benefits by doing exercises that work on your vagina muscles, but very few women see the benefits of such exercises. Given that the vaginal muscles are located in the first half of the vagina (while the inner half is not surrounded by muscles),vaginal tightening exercises could only go a long way.
In addition, even if these exercises have an effect, they do not work in very wide vaginas. It is worth noting that creams marketed as vaginal tightening creams have no proven benefits. Therefore, vaginoplasty is the only way to effectively narrow and tighten the vagina.
How is vaginal tightening surgery done? Vaginal tightening surgery and vaginal aesthetic surgery are sometimes used interchangeably. During this surgery, attention is given to 3 main factors, namely the vaginal muscles, the vaginal support membrane, and the vaginal mucosa (i.e., the thin layer that covers the vagina).
First of all, the excess and loosened vaginal mucosa is separated from the vaginal membrane and removed with a laser (or any other normal way) depending on the surgical procedure, then the separated vaginal muscles are contracted and strengthened. Subsequently, the deteriorated or weakened recto-vaginal fascia (or the vaginal membrane) is repaired.
The remaining strong vaginal mucosa is reattached with absorbable aesthetic sutures. Overall, this procedure brings the vagina back to its original shape and size, giving it renewed flexibility and firmness. The upshot of this is a significant increase in sexual pleasure. The medical names of vaginoplasty operations are known as "colporrhaphy anterior" (anterior repair) and "colporrhaphy posterior" (posterior repair). While "colporrhaphy anterior" (anterior repair) is performed for urinary-related complaints, "colporrhaphy posterior" (posterior repair) is performed for vaginal tightening.
It can be applied in laser surgeries and locally. It is a tool that is used for burning and cutting with heat increase in the area where the laser is applied. We also use it in vagina tightening labiaplasty surgeries.
LVT makes use of medical lasers for vaginal tightening/rejuvenation. Its working principle is to increase collagen synthesis by increasing the temperature in the area where it is applied. A probe is inserted into the vagina and the laser is applied to the vagina. However, laser vaginal tightening does not provide the expected effect given it does not lead to sufficient tightening, therefore, it falls short of patients’ satisfaction.
The effectiveness of LVT remains limited, especially in very wide vaginas (i.e., with high vaginal laxity). It is also observed that the results only last for 6 months before laxity/enlargement recurs. Complications are unforeseen and undesirable surgical side effects that may result from LVT, just as any surgical operation has the risk of complications. However, the risk of complications is greatly reduced when LVT is performed by experienced hands.
The vagina and its surrounding parts are under the field of obstetrics, and the branch that can perform the surgery best is the gynecology department. Vaginal aesthetic operations can be performed by obstetricians experienced in genital aesthetics.
The procedure is usually performed under general anesthesia and you need to start fasting (i.e., stay hungry and thirsty) about 6 hours before the surgery. Blood thinners such as aspirin should not be taken the week preceding the surgery.
Anatomically, the vagina has excellent blood circulation; therefore, there is no problem with recovery. You will also not have much pain after the operation, and you can be discharged on the same day; you don’t need to be admitted to the hospital. You can resume your work in the days following the operation. The average recovery period is 3 weeks. After about 45 days, you can have your first sexual intercourse.
This is one of the most frequently asked questions, given that vaginal laxity is a common problem among many women. Since operations of this nature are usually performed only once, it is very important to get positive results. That's why experience is more important than cost. Since the doctor's examination determines how much aesthetics each patient needs, the fees incurred by each procedure may be different.
In general, the fees requested by doctors who perform vaginoplasty vary, but they are budget-friendly. Due to ethical rules, it is not appropriate to give prices on the internet; however, do not hesitate to contact our clinic for detailed information on the cost and other concerns you may have.
Useful information about vaginal enlargement/laxity and other vaginal problems
Cells that give our skin color, called melanocytes, are abundantly present in the female genitalia. Waxing may darken and lighten the vagina from time to time due to sunlight and various chemicals.
The vagina is normally odorless, but small tears/cuts in the vagina, menstrual periods, hormonal changes, and particularly infections cause the vagina to smell. In addition, the vagina is closed to the external environment and receives less air. Vagina odors can be different. A particularly rotten fish odor is caused by an infection called bacterial vaginosis. It is accompanied by a gray-white foamy discharge. Small bleeding from the cervix wound can also cause odor changes. These odors can be prevented with cause-oriented treatments.
The vagina is a tissue that usually has a slightly acidic environment. If an alkaline (basic) environment develops for various reasons, some infections may develop. For example, fungi develop in basic environments, so if you wash the inside of the vagina with soap, it will become basic and you will have a fungal infection. Fungi and various infections irritate the vagina and cervix. Even if you have dry intercourse without getting wet, the vagina will be irritated. There is always heightened irritation in a vagina with constant infection. In this case, the vagina is susceptible to trauma.
If you think you don't have vaginismus, the reason why you can't have intercourse is usually that you're not wet enough and you're not psychologically ready. In order for you to get wet enough, you need to be adequately stimulated sexually.
If you have not had intercourse before, the notion that you will experience a lot of pain during intercourse will prevent you from receiving sexual sensations. Therefore, it is important that you do not attempt to have sexual intercourse while feeling psychologically unready. Don't panic and don't limit your time just because you can't have intercourse; just think that things could eventually be normal. You can also use lubricating creams for easier sexual intercourse.
The vagina's best moisturizer is the vagina's secretions. The vaginal glands secrete an oily and dense fluid called mucus. This fluid particularly increases your sexual arousal. In addition, it reflects periodic hormonal differences. For instance, the estrogen hormone increases this secretion.
During your ovulation periods, this secretion and wetness are bound to increase. Again, other factors that cause vaginal dryness include beyond-normal exposure to the vaginal opening. In the special case of normal childbirth, due to the enlargement of the vagina, more air enters the vagina and causes vaginal dryness. In addition, vaginal dryness is common in women who have gone through menopause; this is because of the reduced production of estrogen.
If you have excessive vaginal dryness and you want to use moisturizing medication, you can use estrogen-containing creams under medical supervision.
It is common for one to refrain from the first sexual intercourse on the first night (wedding night) due to the excess pain that may result.
Some of the factors that can cause pain during sexual intercourse are as follows;
In such a situation, you must first be prepared psychologically. You should also get help from lubricants during sexual intercourse. If you cannot have intercourse despite these, you should apply to a gynecological specialist and have a gynecological examination.
Although the complaints of burning sensations in the vagina are mainly due to infections, they can also be due to irritation due to sexual intercourse.
The most common form of vaginal discharge is fungal discharge. Fungal discharges are white, gray discharges like milk curd. The cause is the Candida fungus. Green discharges are mostly due to Trichomonas infections. Trichomonas vaginalis is a "protozoan", that is, a sexually transmitted parasitic group of microorganisms, not a bacterium. It may also be accompanied by burning and itching, especially during urination. Bacterial vaginosis is also a type of vaginal discharge.
The reason for this is the overgrowth of a group of bacteria in the vaginal flora. To diagnose this condition, the whiff test will be positive. This vaginal discharge (Bacterial vaginosis) is in the form of gray-white flows, but it is not transmitted sexually. It can cause itching and burning sensation during urination.
Generally, in cases where the vagina is severely damaged, the vagina is nervously affected and numbness may occur. For example, it is possible that there will be numbness in a vagina that has been damaged during normal childbirth. Due to this numbness, one may lose sensation during sexual intercourse. The vagina may also become numb during prolonged and frequent sexual intercourse. Vaginal numbness is also found in diabetic patients.
During orgasm, the vagina can beat like a heart. This vagina is formed as a result of blood flow changes. In addition, the same feeling can be experienced in cases of damage or under inflammatory conditions.
DR. FATIH ADANACIOĞLUGynecology and Obstetrics Specialist
+90 545 938 1234
Vaginal Tightening and Marriage