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Desirial is a hyaluronic acid dermal filler that has been developed for treating female vulvo-vaginal conditions, such as vaginal atrophy and dryness by non-surgical vaginal rejuvenation treatment.
Many of us are often afraid to talk about so called “embarrassing areas”; hence why one of the least talked about areas of cosmetic surgery is that available for the female genitalia or vagina.
All women are born with differently shaped genitalia, and with the effects of childbirth and age on top, many can suffer from problems and defects with their genitalia that can make them feel very self conscious and unhappy, often affecting relationships with sexual partners.
Such problems include;
There are now a range of surgical options available which can address and hopefully resolve these problems.
According to statistics from the American Society of Plastic Surgeons (ASPS), who started tracking statistics for vaginal surgery for the first time in 2005; 1,030 vaginal rejuvenation procedures were performed in 2006 in the USA, a rise of 30% on their 2005 figures. ASPS stopped gathering data for this procedure after 2006.
The American Society for Aesthetic Plastic Surgery (ASAPS) also started collating statistics on this procedure as late as 2007 and currently shows that 12,756 labiaplasty (excluding vaginal rejuvenation) were performed in 2018 in the U.S., an increase of 18.3% on 2017 figures, and a rise of 52.9% when compared to 2014 numbers.
No official figures are yet available for the UK, but vaginal surgery is becoming increasingly popular and more available in this country too.
Non-surgical options are also available to address vaginal atrophy (loss of skin elasticity and volume in the outer labial folds) using hyaluronic acid based dermal filler products such as Desirial. This improves concerns such as vaginal dryness. This page of treatment information will however focus on the surgical solutions for vaginal concerns.
If you are considering vaginal surgery; the following information will give you a basic understanding of the procedures. It can't answer all your questions, since a lot depends on the individual patient. Please ask a practitioner about anything you don't understand.
Types of Surgery
The main types of vaginal surgery available in the UK are:
Labiaplasty or labia/lip reduction, sometimes also called vulvaplasty, where the labia minora or inner vaginal lips can be reduced in size and reshaped.
Vaginoplasty or vaginal rejuvenation/tightening, where the inner vagina walls and muscles can be reshaped and tightened to produce a more toned and tight vagina.
Hymenoplasty, or hymen repair/re-virgination, where a torn hymen is repaired or rebuilt to imply the virginal state of a women; this is most frequently done for religious, ethnic or cultural reasons with the utmost discretion.
Other less commonly practised procedures for vaginal enhancement include:
Hoodectomy, where the fold of skin or hood covering the clitoris, which can be large or elongated, is removed to expose more of the clitoris, with the aim of making it more sensitive. Currently only anecdotal evidence exists for any success with such a procedure.
Clitoropexy, where the position of the clitoris can be altered, such as repositioning a protruding clitoris.
(Note: these operations are not the same as female circumcision, practiced in some countries, which removes the clitoris and is a very controversial subject).
G-Spot Augmentation is a non-surgical procedure using dermal filler products such as collagen and hyaluronic acid injected into the G-spot area, with the aim of increasing the likelihood and intensity of the female orgasm. This technique is marketed under various names including G-Delight and G-Shot™.
And liposuction or fat transfer to the labia majora (outer lips) or pubic mound, to either reduce or enlarge these areas for a better aesthetic appearance.
For the purposes of this Treatment FAQ, we will only concentrate on the commonly performed procedures of labiaplasty, vaginoplasty and hymenoplasty.
Your first discussion with a surgeon should clearly set out your expectations and whether the operation can give you the results you desire.
Careful discussions regarding the reasons for wanting vaginal surgery and your suitability for this type of surgery are very important at this stage. Make sure that you obtain as much information as is necessary to enable you to make a fully informed choice and make sure you receive satisfactory answers to all your questions.
A medical history should also be taken to make sure that there are no reasons why you shouldn’t have this operation. You would normally be asked to sign a consent form which means that you have understood the potential benefits and risks associated with vaginal surgery.
Photographs will also be taken by the practitioner as a "before and after" comparison at a later date.
The surgeon may also wish to write to your G.P. giving details of the operation so that if there are any problems associated with surgery in the short or long-term your doctor is aware of the procedure and can help you to recover.
Vaginal surgery is usually performed under a general anaesthetic. In some cases an alternative using a local anaesthetic and sedation can also be performed.
Please take into account that a general anaesthetic carries more potential risks – this should be clearly explained by the surgeon before you make any decisions about the anaesthetic. Types of anaesthesia available should always be discussed with your surgeon.
If you make a decision to go ahead with vaginal surgery, the actual procedure may take place in an outpatient surgical clinic where you can go home the same day, but most surgeons and patients prefer a hospital setting where you can recover overnight.
Any vaginal surgery should not be performed at the same time as a woman has her menstrual period, so timing of the operation should be arranged around your monthly cycle.
The labiaplasty operation usually takes about 1 - 2 hours, and is normally treated as a day case, meaning that you are discharged to go home a few hours after your surgery is completed. There may be cases where an overnight stay is required.
The surgery can be performed in two ways, either by reducing the excess tissue along the edges of the labia by simply trimming along the inner folds until the labia no longer protrude, or by cutting out a ‘V’ shaped wedge of tissue from the underneath of the labia, the edges of which are then sewn back together. This method leaves the front of the labia unchanged, making the evidence of surgery less noticeable.
Surgeons nowadays tend to use dissolvable stitches in this area to aid healing and reduce pain and discomfort. Some surgeons also use a laser rather than a scalpel for cutting to reduce bleeding in the area, as the laser cauterises blood vessels as it cuts.
The vaginoplasty operation usually takes about 1 - 2 hours, and is treated as a day case, meaning that you are discharged to go home a few hours after your surgery is completed. There may be cases where an overnight stay is required.
The surgery is designed to tighten the vagina and is done by joining together the stretched muscle at the back of the vagina and therefore shortening it, using dissolvable stitches, and then removing excess vaginal lining (vaginal mucosa) and tightening the surrounding soft tissues. This procedure may also be done using a laser. The resulting decrease in the size of the vaginal cavity creates more friction during sexual intercourse, often described as giving a woman back the vagina she had before she had children. The G-spot is not affected by this procedure.
The hymen is a membrane that partially obstructs the vaginal opening, and is believed by most scientists to have no known anatomical function whatsoever, but is simply a remnant from the development of the foetus into a girl in the womb. There are arguments that it serves as an infection barrier to the vagina in infancy but this is simply a hypothesis.
Although the hymen can be easily broken in early youth through sporting activities or tampon use, it is historically associated with a sign of virginity, and consequently is considered to break and bleed on the first experience of penetrative sexual intercourse; (although medically this is not always the case as hymens come in all shapes and sizes which may not always bleed when torn).
This belief of virginal status prior to marriage through the possession of an intact hymen is still practiced in many countries and through many religious belief systems. Therefore in circumstances where a woman has torn her hymen naturally but wishes to prove her virginal status on her wedding night, an operation to repair it may be seen as a credible option.
If you have already had sexual intercourse and are therefore no longer a virgin, hymen repair does not “make you a virgin again” despite it often being marketed as a re-virgination procedure. Such operations have been utilised as a psychological help in child rape cases though.
The hymenoplasty operation usually takes about ½ - 1½ hours, and is almost always treated as a day case, performed under local anaesthesia, meaning that you are discharged to go home a few hours after your surgery is completed. This is often the preferred option for the patient as they are unlikely to have told any friends or family that they are having the operation, due to the cultural sensitivity of it, so cannot afford to be missed for a night. There may be cases though where an overnight stay is required.
The type of hymenoplasty procedure will depend on how much remaining tissue is available to the surgeon.
In a simple hymenoplasty the surgeon can piece together the remnants of hymen, pulling it together and closing the tear with dissolvable stitches so that it covers the vaginal entrance once more. The restored hymen is not very strong or designed to last long, and due to a lack of blood supply in the area will not heal properly in most cases. It is therefore normally recommended that the procedure is performed ideally 3 to 7 days (or certainly less than one month) prior to the wedding night or first sexual intercourse experience.
Alternatively, tissue from the vaginal wall can be used to create a hymen across the vaginal opening if not enough fragments of the hymen exist.
If there is simply not enough tissue and your hymen cannot be restored, a biomaterial or hymen implant can be inserted instead to act as a hymen which will tear through on penetration. It is not easy to notice that this material is not a real hymen.
Due to the way in which the hymen repair is surgical done, it is very likely that upon the act of penetrative sex, there will be pain and some bleeding.
Following labiaplasty you should expect some slight bleeding for the first 24 hours with discomfort and swelling at its worst in the first 72 hours, disappearing after about 2 - 3 weeks. Bruising in the area should be minimal. The incisions should heal quickly without scarring, making them unnoticeable. As dissolvable stitches are usually used there is also no need for these to be removed. You should be up and about and resuming normal activities within 48 - 72 hours, expect to be off work for up to 7 days. Full healing takes approximately 6 weeks.
Following vaginoplasty you should expect some slight bleeding for the first 24 hours and to feel sore and swollen for several days, disappearing after about 2 - 3 weeks. Bed rest is advisable post-surgery as you will not be able to walk comfortably for a few days. Depending on the extent of surgery you can expect to be off work for 7 - 10 days. Full healing takes approximately 6 weeks.
Following hymenoplasty you should expect some slight bleeding for the first 48 - 72 hours.
Side Effects and Risks
Like all surgical procedures, there is always a possibility of complications or side effects and, although rare, these can include infection (such as urinary tract infections), a reaction to the anaesthesia, blood or fluid collection underneath the skin (haematoma), prolonged bleeding, nerve damage, and an irregular or a “lop-sided” appearance to the labia after the operation.
Following labiaplasty and vaginoplasty, urinating post-surgery may be difficult and somewhat painful, due to the burning/stinging sensation caused by the urine passing over the wound. This can be alleviated by either urinating in the shower, or by pouring a jug of lukewarm water over the area as one urinates in the toilet.
Following hymenoplasty the risk of infection is very low.
It is very important that you follow the advice of your surgeon carefully after vaginal surgery.
Post-surgery advice may include:
Who Can Do It
Only fully trained and qualified surgeons in the field of plastic surgery and gynaecology should perform vaginal surgery.
For more information about practitioner training, qualifications and relevant medical organisations please view the information contained within the Legislation section of the Consulting Room.
Find a specialist clinic for Platelet Rich Plasma (PRP) therapy for sexual rejuvenation in the UK and Ireland.
You will not be able to access these types of treatment via the National Health Service (NHS), unless there is an associated medical condition, such as leaking urine or stools due to abnormalities in the genital region, or where a prolapse of the uterus, bladder or intestines into the vagina has occurred. In correcting these problems, the desired surgical improvement to the vagina may therefore be achieved at the same time.
We would always recommend that you visit your General Practitioner before embarking upon a major procedure. As well as their advice and guidance they may also be able to refer you to a local NHS Hospital who can treat you in certain circumstances.
The NHS has set out the following guidelines on how to get cosmetic surgery through the NHS:
"To qualify for surgery on the NHS you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.
NHS reconstructive surgery is performed by plastic surgeons who have had extensive training and belong to the British Association of Plastic Reconstructive and Aesthetic Surgeons. Surgeons who carry out cosmetic surgery through the NHS also belong to the British Association of Aesthetic Plastic Surgeons.
To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have a consultation with a plastic surgeon and an assessment by a psychiatrist, or psychologist. It will then be decided whether there is enough social, psychological, or physical benefit to be gained to justify surgery."
Private costs for vaginal surgery range from £1,000 - £3,000 for labia reduction (labiaplasty), £2,500 - £4,500 for vaginal tightening/rejuvenation (vaginoplasty) and £1,700 - £3,000 for a hymen reconstruction (hymenoplasty).
Despite the media hype surrounding Designer Vaginas, vaginal surgery is not something to be taken lightly and like all surgery carries the potential risk of complications and unexpected outcomes.
Such surgery should really only be considered as a means of correcting or improving the genitalia where there is discomfort in day to day life, or a genuine problem, such as difficulty with sexual intercourse. It should not really be seen as a means of achieving an aesthetically perfect version of the vagina, as found in some magazine centre-folds, much like wanting your nose to look like that of your favourite celebrity is not a good reason for cosmetic rhinoplasty.
With more and more women prepared to discuss this sensitive area, and more surgeons available to perform such surgeries, vaginal procedures are indeed a growth area within the cosmetic surgery industry.
As well as discussions with your surgeon it is important to discuss your concerns, worries and expectations with your sexual partner, as it may be that despite your fears they like your genitalia just the way it is!
Before and After Pictures
Please note that results of cosmetic surgery vary enormously, depending upon both the patient and the skill of the individual surgeon, so outcomes for procedures will always be more variable than those for less invasive non-surgical treatments.
(All before and after photographs featured are real patients treated by highly experienced surgeons, your results may differ).
Vagina and labia before (left) and 6 weeks after (right) labiaplasty surgery.
Photographs courtesy of Consultant Plastic Surgeon, Mr Christopher Inglefield, BSc, MBBS, FRCS (Plast) at London Bridge Plastic Surgery.