Let’s get one thing straight: I’m the last person to tell anyone what they should do with their bodies.

I’ve always been a “you do you, I’ll do me”-kinda gal. 

But when I see people spending thousands of dollars for procedures that the F.D.A. says “have serious risks and don’t have adequate evidence to support their use for these purposes”, I’m at least going to do some digging to see what’s up.

If you’ve read our Vaginal Tightening Guide, you know that our whole deal at Goh!ddess is to use what you already have available (a.k.a. your amazing anatomy) to improve things like sexual sensation, arousal, and pleasure overall.

You also know that we’re no fans of the term “tight” or “loose” - but because this is the current jargon, I’ll spare you the lecture, and get straight to the point.

In this article, I’m going to cover everything we know up to this day about Vaginal Tightening Surgery or how it’s also been called, Vaginal Rejuvenation Surgery. 

We’ll look at the different kinds of procedures being offered, the research (or, spoiler alert: lack thereof) behind them, and the risks and benefits associated with them.

Let’s begin.

Why Vaginal Rejuvenation, at all?

As we age, women lose collagen and elastin, which are two proteins that provide rigidity, structure and elasticity in the body.

Furthermore, pregnancy, childbirth, menopause and certain hormonal imbalances can also affect the vaginal tissue.

Vaginal tightening or vaginal rejuvenation procedures are treatments that claim to help fight the symptoms that come with vaginal laxity, such as:

• Lack of sensation during sex
  
  
• Pain during sex
  
  
• Urinary Incontinence
  
  

What isn’t discussed when talking about these solutions (and what we covered extensively in our Vaginal Tightening Guide) is that there’s another layer of the skin below the dermis and the subcutaneous tissue that you can work on at any age to fight all of these symptoms, naturally: the muscle layer.

But let’s continue with our topic at hand, and examine the different methods of Vaginal Rejuvenation surgery.

Understanding Vaginal Procedures

Before we get into the two main types of vaginal tightening procedures, it’s important to understand some other definitions and tightening methods, so that we’re all on the same page.

First off, we’re going to disregard the least researched of the vaginal tightening products, such as vaginal tightening creams, gels, pills, herbal remedies, and at home versions of vaginal tightening laser devices.

At best, these products will cost you up to a few hundred dollars and dry you out so you feel “tighter”. At worst, you can seriously hurt yourself or burn your precious vagina (yikes!).

So let’s look at the actual procedures now. The ones that go from hundreds to thousands of dollars.

What this isn’t: Vaginoplasty for Gender Affirmation

The term “vaginoplasty” refers to any type of surgical procedure that has the objective of constructing or repairing the vagina.

For example, a person undergoing gender affirmation surgery might have a vaginoplasty, in which surgeons may use the tissues from the penis and testicles to construct a vagina, clitoris (clitoroplasty) and labia (labiaplasty). 

On the other hand, women that have been born with congenital abnormalities that affect the natural development of the vagina might also undergo reconstruction surgery.

Or women who have suffered trauma, exposure to radiation, or other injuries might also need parts of their vaginas repaired, and this will also fall under the category of vaginoplasty.

These procedures are not the ones we’re referring to in this article. Our focus here is on the type of vaginoplasty that’s offered as a solution to vaginal laxity and lack of sexual sensation.  

What this isn’t: Other Vaginal Rejuvenation Procedures

The term vaginal rejuvenation can also mean a few things. 

Some women undergo procedures purely related to aesthetics.

In this article, we’re not referring to labiaplasty, which is a surgery intended to reduce or even out the size of the labia minora (the flaps of skin at either side of the vaginal opening).

And we’re also not referring to vulvoplasty, which is also a gender-affirming surgery, specifically designated to construct the outer part of the vagina (creating the clitoris, mons, labia, and urethral opening).

Vaginal Tightening Surgery (Vaginoplasty)

Vaginal tightening surgery, also known as posterior colporrhaphy, is a surgical procedure designed to tighten the vagina by bringing the separated muscles together, removing the extra mucosa skin from the back of the vagina, and repairing any damage done to the vaginal tissue.

Dr. Deal Elterman, a urologic surgeon and professor from the University of Toronto says of this method: "It's quite invasive, has a significant recovery and carries the highest risk, as it is a surgery".

This surgery can be done under local or general anesthesia, and the recovery time is generally between 2-3 weeks.

Some of the risks associated with this surgery include:

• Infections
• Blood loss
• Anesthesia-related complications
• Scarring
• Nerve damage that might cause permanent loss of sensation
• Vaginal fistula: an accidental opening between the vagina and other organs caused during surgery, that allows urine, gas or stool to pass through the vagina

The average cost of a vaginoplasty ranges between $6,000 and $9,000.

Laser & Radiofrequency Treatment

New technology has emerged in this field. Specifically, two non-invasive, non-surgical  procedures that claim to not only tighten the vagina, but stimulate collagen production and blood flow in the region.

We’re talking about CO2 Laser and radiofrequency procedures.

In laser treatment, the process works through ablation. This means the laser creates tiny cuts in the vaginal tissue to stimulate the body’s healing response, increasing collagen and thickening the skin over time. 

Radiofrequency treatments, on the other hand, are more recent, and work by applying deep penetrating heat to stimulate collagen production. They also claim to improve ​​muscle tone, blood flow and sensation.

In mid-2018 laser therapy treatments, which have been performed for longer than radiofrequency came under scrutiny when the FDA issued a statement deeming them “a dangerous procedure with no proven benefit”.

These treatments generally cost anywhere from $1,000-$6,000, and sometimes more than one session is required, depending on the individual case.

Both these kinds of treatments don’t take longer than 30 minutes to perform, according to Dr.Ali from AMAE Med Spa.

What Does Science Say About Vaginal Tightening Procedures

It’s hard to make a logical decision when it seems that most of the articles supporting certain treatments are coincidentally written by the companies offering these treatments, right? 

(I realize the irony of this - at the end of the day I do have a program on advanced pelvic floor training, but also many free resources on how you can do it on your own.)

So how do you go about making an unbiased decision? Well, a good place to start is by looking at the scientific literature.

Just like I laid out a bunch of articles supporting pelvic floor training for the purposes of preventing incontinence and enhancing libido, pleasure, and orgasms, I’m going to do the same for the aforementioned treatments.

Some general rules to assess the significance of research is by looking at the number of participants, the randomization of such participants (both for the intervention and the control group), whether the research has been peer reviewed, and the impact factor of the journal where it’s been published (how many times it’s been cited by other articles).

For vaginal tightening surgery, these are the three most relevant studies to date:

This paper from 2019 looked at the 30 women who underwent posterior vaginoplasty with perineoplasty technique with the authors of the study.

Based on the author’s experience, posterior vaginoplasty with perineoplasty has demonstrated high patient satisfaction with no complications. The paper doesn’t mention the methods used to determine the patient’s satisfaction with the treatment or looks at a control group to contrast the evidence.

This study from 2013 aimed to determine the effectiveness of vaginal tightening surgery by having 79 women suffering with vaginal laxity answering a questionnaire which contained Female Sexual Function Index (FSFI) questions both before the procedure, and then 6 months after the procedure. The scores for libido, arousal, orgasm and satisfaction domain were significantly improved after the surgery, but a high level of dyspareunia (pain during sex) and low vaginal lubrication were also noted.

In this study from 2009, 40 women underwent cosmetic vaginal tightening from July of 2005 to January of 2007. With regard to vaginal sensitivity after 6 months, 2 patients (5%) did not notice any improvement, 16 (40%) noticed some improvement, and 22 (55%) noticed a significant improvement.

With regard to complications, there were two cases of localized infection (5%) that required treatment. One patient experienced vaginal bleeding on the fourth postoperative day.

Researchers noted that it is not possible to predict how long the results of the vaginal tightening will last, and it may be safe to assume that the results will not be permanent, as with any rejuvenating procedure. 

The Verdict

While I absolutely applaud your drive for looking through the research yourself (fellow nerd here! Let me know if you ever want to check out my fanfiction..) the person most qualified to advise you on your current situation is going to be a urogynecologist.

They’ll be able to assess what’s happening down there depending on your symptoms and determine whether your muscles are in fact too weak and could use some strengthening.

Issues like urinary incontinence, painful sex, or constipation can all be symptoms of a hypertonic pelvic floor. This is a condition where the muscles in your lower pelvis are locked and unable to relax. 

As you can imagine, tightening them even more is only going to make the problem worse. Depending on the severity of your situation, a doctor might recommend some stretching exercises, or they might manually help you loosen your muscles.

Now, if your doctor does in fact conclude that your problem is a weak pelvic floor, before you rush and spend thousands of dollars on surgeries and laser beams, consider that you might already have all the tools you need to improve your situation already inside of you.

Pompoir is the practice of advanced pelvic floor training, where students learn how to squeeze, pull, tilt, lock, milk, whip, suck, and twist using their vaginas - this in turn increases their pleasure, boosts their libido, and enhances their orgasms. 

If you’d like to join a structured, step-by-step (and science-based!) program on how to master all of these techniques, we’ll be waiting for you at The Oh!lympus Program.