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Under The Covers


Vaginal abnormalities can affect a woman both physically and psychologically, and can often inhibit their self-esteem and sexual pleasure. ‘There are a number of surgical options that can alleviate discomfort, pain and hygiene issues relating to the vagina – and in turn help to restore self-confidence and sexual satisfaction,’ says Sydney cosmetic surgeon Dr Colin Moore.

‘Women who seek vaginal surgery often notice changes to their vagina after giving birth or as a result of the ageing process,’ he continues. ‘Depending on the patient’s concerns, I work with the patient to decide on the most appropriate treatment option for total vaginal rejuvenation.’

After giving birth, some women experience stretched muscles and skin that can change the shape of the vagina significantly both internally and externally. Dr Moore says it’s important in such cases to treat the vagina in a holistic manner, tending to rough, loosened labial folds through a labiaplasty, and sling muscles through a vaginoplasty.

‘A vaginaplasty is a day procedure which involves tightening the sling muscles in the vagina by lifting the muscles, removing excess vaginal lining and reattaching the muscles,’ he says. ‘However, it’s important the patient knows that surgery will not make them 16 years old again – we can over-tighten stretched vaginal muscles and this can cause muscle cramps and spasms during intercourse. This is where an experienced surgeon’s experience is essential.’

A labioplasty involves excising and sealing excess, roughened tissue that can cause the labial folds to look asymmetrical or stretched. ‘Younger patients usually opt for labiaplasty alone to correct an uneven appearance of the labial folds,’ says Dr Moore. ‘Essentially, if a roughened edge is the issue, this needs to be removed. If not, we slightly reduce the edges of the labia minora back to the same level as the labia majora and often reduce excess skin covering the clitoral hood.’

Dr Moore explains that a labiaplasty procedure can be especially beneficial in improving vaginal hygiene for some women. ‘With large labia, urine can become trapped, allowing bacteria from the bowel to migrate and colonise in the urethra,’ he explains. ‘This can result in chronic urethral contamination or even cause infection to be flushed back into the bladder, causing bladder infections. For many women, labiaplasty can rectify this.’ Patients must refrain from penetrative sex for at least six weeks after a vaginoplasty and labiaplasty.

For women who are seeking to improve their sexual satisfaction, G-spot augmentation can provide a solution. However, Dr Moore believes this somewhat elusive pleasure source is an acquired phenomenon. ‘There is no question that the G-spot exists,’ he says. ‘It is part of the nervous complex of the clitoris and can trigger a powerful orgasm for women. However, the ability to experience a G-spot orgasm needs to be developed beforehand as augmentation of the area does not guarantee a G-spot orgasm – it merely intensifies the G-spot orgasm if it is already present, however weakly.’

The G-spot lies on the front wall of the vagina and can cause significant pelvic floor contraction during orgasm. ‘G-spot augmentation usually involves a transurethral injection of permanent filler into the middle layer of the vaginal wall, behind the G-spot, to make a G-spot orgasm more intense,’ says Dr Moore. After the procedure, sexual activity should be avoided for about 10 days if permanent filler has been used, or around six weeks in the case of dermal fat grafts.

All of the above procedures, performed individually or in combination, are usually carried out as day surgery under general anaesthetic. As with any surgery, there is a risk of possible complications, however when performed by an appropriately trained surgeon in an accredited operating theatre, these risks are minimal.

Prof Colin Moore