Perineoplasty: All You Need to Know

Having that loose skin near your private area can be embarrassing, particularly if you’re sexually intimate with your partner. It can lower your self-esteem and make you feel too conscious about how you look and how your partner may see you.

If that’s the case, perineoplasty can help end your problem. Before we get to that, it’s best to get a better understanding of your perineum first.

What is the perineum?

You can find your perineum between your vagina and anus. Even though it’s small, it has an important job in providing support for the organs and muscles in the area. It also plays a critical role in keeping the vagina tight.

There are a couple of things that can weaken or damage the perineum. 

One of the most common causes is childbirth.

During delivery, the vaginal and perineal muscles experience physical trauma. Even if an incision is made to help minimize the laceration, sloppy stitching can cause improper healing of the perineum. Heavy scarring and even pain can happen because of that.

Another factor that can cause damage to the perineum is obesity. The excess weight can stress out the structures that support your body. It can also stretch out your muscles, making them lose their elasticity.

Just imagine your mattress.

After sleeping on it night after night, the mattress wears out and its structure becomes concave. As this happens, it becomes inefficient in providing the support your body needs to rest and sleep comfortably.

Apart from obesity, losing too much weight can also be a problem with your perineum. As you rapidly lose weight due to an illness or going on a really strict diet, your muscles begin to droop.

What is perineoplasty?

Perineoplasty is the surgical reconstruction of the perineum and genital opening. Sometimes referred to as perineorrhaphy, it’s done for either medical or cosmetic purposes.

The procedure removes unwanted skin, scar tissues, and bulges in the area. It also loosens or tightens the vagina and perianal muscles. Most women have  it to boost their confidence as well as 

Who is it for?

Apart from the conditions mentioned above, perineoplasty is also recommended for women who are experiencing painful sexual intercourse due to a bacterial infection or vaginismus.

It’s a condition that causes involuntary contraction of the muscles of the vagina, causing pain with every penetration. 

Bacterial infections, particularly if caused by lichen sclerosus, can leave the genital area with itching and scarring. In some cases, it also makes it painful to defecate and urinate.

Women born with small vaginal introitus, a congenital condition, can also undergo perineoplasty. This condition makes the affected women more prone to having urinary problems, such as urinary tract infections. It may also cause painful sexual intercourse.

With perineoplasty, the tissues located at their vaginal opening and perineum can be surgically loosened. This way, they can attain the elasticity they need to have a better sexual experience.

Those with rigid perineal muscles can also benefit from perineoplasty since it can complicate childbirth. It typically happens right after an episiotomy is made and the muscles in the area become stiff right after the creation of the surgical incision.

Women who have this condition can undergo perineoplasty to prevent complications on future pregnancies and childbirth.

Other conditions that the procedure treats include:

• Incontinence
• Rectocele
• Cystocele
• Dyspareunia
• Genital warts removal
• Vaginal laxity that causes decreased sexual sensation

How is it performed?

Prior to the procedure, you will be positioned in a way that allows easy access to your perineum. To ensure that you remain comfortable throughout, you will be placed under local anesthesia.

Your doctor will create a V-shaped incision which will start from the top part of the vaginal floor. This incision will go through your vaginal mucosa and your perineum.

The cut will extend laterally on both sides of your vaginal opening and hymenal ring up to the top part of your anal area.

When it comes to the reconstruction part, your muscles will be carefully put back together. Your fascia will also be moved to conceal the reconstructed muscles. And in the process, any loose and excess skin and tissues will be removed.

During the procedure, a catheter will be inserted to help you urinate in the first few days after the operation. After careful assessment and after your doctor has determined that the right tightness or looseness is achieved, he’ close the surgical site properly. The area should look as normal as possible.

To ensure that, some doctors depend on laser technology while others prefer to use a scalpel as that allows them to be more precise.

Risks and Complications

Although perineoplasty isn’t that invasive, it still comes with risks.

On top of the list is an infection at the site of surgery. To address this, your doctor will need to start you on antibiotic therapy.

Inflammation and pain are also common after surgery. These effects should subside after a couple of days. If the pain is too intense for you, your doctor will give you pain relievers.

If the procedure isn’t done properly and with precision, you may experience leaking feces and urine. You may also experience abnormal vaginal discharge that may have a foul smell.

There’s also the possibility of having unsatisfactory results, like seeing more scarring. Most of these risks and complications are avoidable if you can find an experienced and skilled surgeon who will do your surgery.

Recovery period

One of the most important things to remember after your surgery is to refrain from having any sexual intercourse for about 6 weeks. You should also avoid engaging any strenuous activities like heavy lifting or bicycling. You are also discouraged from using tampons.

As for work, you should be able to get back to your normal routine after a couple of days. The pain should be minimal and can be relieved by over the counter pain medications.

To facilitate faster recovery and healing period, you need to keep the surgical site clean and dry. As for the stitches, they should dissolve in about 14 days. You need to increase your fluid and fiber intake to avoid constipation. Eat more fruits and vegetables high in fiber.

If those things don’t solve your constipation, you may see your doctor. He will prescribe medications to help make it easier for you to defecate.