Vaginal rejuvenation has been such a hot topic in both the aesthetic and women’s health arenas as of late, but there’s a lot of misinformation floating around, and Louisville, KY plastic surgeon Chet Mays, MD is setting the record straight. Though he’s board-certified to perform aesthetic surgery from head to toe, he specializes in vaginal rejuvenation procedures for women of all ages. “These are very popular procedures, and I’m the only one in the office who does them, so people come from hours away because they found me online,” he says. Here’s what you should know if you’re considering a procedure.
Let’s start with nonsurgical options. What should everyone know about?
“We’ve shifted our technology into more laser therapy as opposed to heat therapy using radio frequency. Now we use something called Sciton DiVa, which uses an ablative and nonablative laser that goes into the vagina and causes a thermal sloughing of the tissue to generate collagen and elastin and tightening of the vagina. It’s mainly for vaginal canal rejuvenation, and it’s much quicker than previous treatments—only three to five minutes compared to 30 minutes.”
Does it work on patients of all ages?
“It’s for younger and older women—all of the above. For younger women, they enjoy it after vaginal births—we recommend waiting three to six months after delivery—or some incontinence because it can improve vaginal tightness. For older women, it can stimulate some new cell growth to remedy some of the dryness they experience after menopause.”
Let’s switch to the surgical side. What is the difference between a labiaplasty and a vaginoplasty?
“A vaginoplasty is more for tightening, say they had a tear, which caused an episiotomy and a delivery that caused some stretching. Sometimes the OBGYN will close the tear and sometimes they don’t and just let them heal secondarily, which can cause a lot of laxity on the posterior wall of the vagina. With this technique, I go in surgically and tighten the vaginal canal, and patients can sort of pick how tight they want it based on their discussions with me—there are different levels of tightness that can be done within reason. Some patients have had multiple kids and are unhappy with their vaginal laxity and how it impacts their intimacy with their partner.
A labiaplasty is more of a comfort procedure, because either the labia minora or majora is hanging too low and they don’t like the way it looks or feels in tight-fitting yoga pants or bikinis. Or they’re having discomfort during intercourse and the labia gets caught, which causes pain. A labiaplasty is more cosmetic, whereas a vaginoplasty is more functional.”
Is a vaginoplasty covered by insurance then?
“No. Unfortunately, even women who have had bad, bad tears from vaginal delivery and have no stability in the vagina are still not covered. These are all considered cosmetic procedures.”
What type of anesthesia is required for both procedures?
“A labiaplasty can be done under local anesthesia in the operating room and they don’t have to go to sleep. I just numb the area with lidocaine and do the procedure. Whereas with vaginoplasty, it has to be done under general anesthesia because I can’t get the patient comfortable enough without it. Most individuals enjoy taking a quick nap because of the positioning and comfort of the area.”
What is the recovery like?
“Anything we do surgically for the vagina, it’s six weeks of taking it easy, nothing in the vagina. The first few weeks, the patient will be swollen and sore and may have some difficulty walking and feel some burning from the friction. You don’t want to sit for prolonged periods of time because you can get swelling in the area, so standing is good. No sitting on bikes or any kind of direct pressure is very important. All of the stitches do dissolve in six to eight weeks, so there’s nothing we need to remove. Once you get past six weeks, there are no restrictions.”
Could these procedures be done as part of a “Mommy Makeover” too?
“Of course. Mommy Makeovers classically combine procedures for the breast and abdomen, but mine often include those plus vaginal rejuvenation. Having a medispa here, I can do surgery to remove extra tissue of the labia and then send them over to get tightening with the DiVa in six months. It’s great having all the surgical and nonsurgical options under one roof.”
How do you get patients to feel comfortable talking about these things?
“I get it, it’s a sensitive subject, and I’m a male and all the patients dealing with this are female, but by the time they reach the consultation chair, they’re almost mentally committed to the procedure because it’s a very humbling experience for them. They’ve reached that point that they’re past feeling embarrassed for the most part. Just like any other procedure, they show me what bothers them and I listen to their concerns, and then I talk about the treatment plan. I look at it as body art and I’m here to do what the patient is asking for within reason to make them feel better and meet their goals. I take it very seriously like everything else that I do.”
What about before-and-after images? I imagine this area is treated differently than other body part, and patients shouldn’t expect to get a book of before-and-after images like they would for a breast augmentation or rhinoplasty.
“Exactly. Everyone’s body is very different when it comes to this area. I don’t do before-and-afters for these procedures; I never have and I’ve been doing them for more than five years now. It’s more of a discussion, and maybe sketching for the patient on paper, as opposed to taking exposed photos of the patient. No one has ever asked me to see before-and-afters either. However, when it comes to labiaplasty, I ask them if they have any pictures of a labia they’ve seen that they want theirs to look like, so I can help guide them down the surgical pathway.”