What is Perineoplasty?

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  • Written By: Donn Saylor
  • Edited By: John Allen
  • Last Modified Date: 16 October 2019
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A perineoplasty is an umbrella term used to describe several different surgical procedures that treat conditions of the vagina or anus. For many patients, a perineoplasty is done as a cosmetic surgery to restore the physical appearance of the vagina. Sometimes called a perineorrhaphy, perineoplasty has also been known to address issues of sexual dysfunction and enhance feelings of sexual pleasure.

The most common type of perineoplasty is conducted for purposes of perineum restoration. The perineum area between the vagina and the rectum, as well as the vagina itself, may become damaged due to childbirth, weight gain, or nerve problems. A perineoplasty for this purpose involves a tightening of the skin around the perineum, the removal of excess skin, and a close stitching-together of the essential muscles. Many women also have a vaginal surgery called a vaginoplasty around the same time; this process tightens the vaginal muscles and eliminates unneeded skin.

A perineoplasty can also be performed to treat issues relating to painful sexual intercourse or involuntary contractions of the vaginal muscles. This process is essentially the opposite of a vaginoplasty; the entry of the vagina is surgically loosened. Genital warts can also be removed through this type of perineoplasty.


Most perineoplasty surgeries are conducted under general anesthesia. Typically, patients are only in the hospital for the day and are not required to stay overnight. General recovery time is four to six weeks.

After perineoplasty, a patient may be advised to do pelvic exercises to aid the healing process. A patient is commonly encouraged to avoid sexual intercourse for the initial duration of healing, at least four weeks. Other recommendations might include refraining from heavy lifting, using pads — not tampons — to help control any normal discharge, and waiting at least one week before returning to work.

As with any surgery, perineoplasty has risks, though the procedures are considered exceptionally safe and effective. Infection and unusually heavy bleeding are among the most serious risks of the surgeries. If one of these conditions should develop, they can usually be treated easily.

Some types of perineoplasty are available as laser surgeries; perineum restoration, for example, can be done via laser technology. The outcome of the surgery is the same — a tightening of the muscles in the region — but the process utilizes lasers and requires no incision. A typical laser perineoplasty is done in a single 45-minute treatment. Recovery times and precautions generally remain the same as with more traditional approaches.


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Post 4

I have recurring vaginal tears (well mostly just in one place) at the base of my vagina (or the fourchette I think it's called) every time I have sexual intercourse. I use plenty of lubricant so that is not the issue. The lubricant actually helps it tear less but it doesn't fix the issue completely. My doctor wants to remove that band of skin (the fourchette). Is this what the opposite of a vaginoplasty is? I am very upset by this situation. I can't have sex normally, without a lot of discomfort during and after, and it takes a few days to a week to heal up, and I am very nervous to have any surgery for fear it will make it worse. Can anyone help me? Thanks!

Post 3

@medicchristy- Thank you so much for the information. Since I read your response, I called a local plastic surgeon and he referred me to another surgeon who specializes in those types of procedures. I am scheduled for a preliminary visit in a couple of weeks. Again, thanks for the informative and sensitive response.

Post 2

@stormyknight- First of all, congratulations on the tremendous weight loss! I am glad that you are comfortable enough to talk about your situation. I know it's not exactly an icebreaker so you've definitely found the right place!

It sounds like you are interested in the same surgery that my sister-in-law had. She had gastric bypass surgery last year and had the same extra vaginal skin that you are describing. She is only 23 years old and she just didn't want to look that way forever. Of course, my brother told her she was beautiful anyway! She just wasn't comfortable with herself.

She had a procedure done that was called a labiaplasty majora, which is a type of perineoplasty

discussed in the article. I will try to word this as tasteful as I can so to not offend anyone reading this. Her labia majora had become extremely droopy since her weight loss. She was embarrassed when she wore a bathing suit because it was kind of “odd” looking.

She said it is the best thing she has done since she lost the weight. She looks more proportioned and feels great about herself. The unfortunate part is that insurance doesn’t cover it. They said that unless it was a vaginal reconstruction due to injury then it would be considered a cosmetic procedure and it cost her about $6000.00.

Post 1

I am so glad I found this site. I have looked for discussion forums to ask certain questions and they tend to be vulgar. This site is very tactful.

I had weight loss surgery two years ago and lost a little over 100 pounds. I'm a bit embarrassed to talk about this but I'm going to go ahead and ask. Has anyone ever heard of having extra vaginal skin removed? I know that sounds weird but since I lost the weight, it seems as though I lost some down there too. The skin around my vaginal area is now droopy and not very attractive looking.

I know you can have plastic surgery to remove extra skin after weight loss but I didn't know if this area could be worked on as well.

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