A perineoplasty is a procedure that repairs the perineum. The perineum is the bridge of skin and muscle between the vagina and the anus. The procedure is also called a perineorrhaphy or an introitoplasty.
The most common goal of a perineoplasty is to tighten the perineum when it's loose. Sometimes, the goal is to make the perineum looser if it's too tight - we call this a reverse perineoplasty or a Fenton procedure.
The most common goal of a perineoplasty is to tighten the perineum when it's loose. Sometimes, the goal is to make the perineum looser if it's too tight - we call this a reverse perineoplasty or a Fenton procedure.
From left to right, the images above depict the bulbocavernosus muscles & perineal body (blue), the relationship of the perineal muscles to the deeper levator muscles, and the transverse perineal muscles (superficial & deep). The perineal muscles are the collective term for the bulbocavernosus and transvese perineal muscles. The fusion point of the left and right sides of the perineal msucles is known as the perineal body. When the perineal body is thin or shortened, the most common cause is thinning or absence of left-right muscular connections in the midline. Perineorrhaphy corrects the anatomy and increases the distance between the anus and the vagina.
The video shows a typical perineoplasty step-by-step. Notice that it only tightens the muscles of the vaginal opening and a small amount of vaginal skin. This is the main reason why a perineoplasty works well for women who have no problems with loose muscles inside the vaginal canal. If the muscles inside the vaginal canal are loose, then a perineoplasty is not enough and a vaginoplasty is needed. Every vaginoplasty in our practice includes a perineoplasty. However, a perineoplasty alone, does not include a vaginoplasty. If you're not sure which procedure you need, Dr. Pelosi will be able to tell which procedure would be best for you during your consultation. If you want to learn more about vaginoplasty, see our Vaginoplasty page for complete details.
This video is from a lecture Dr Pelosi gave to gynecologists, urologists and plastic surgeons at a major conference. It covers the differences between a perineoplasty and a vaginoplasty and the important details that a doctor would need to know to choose the right operation. The presentation is called introitoplasty which is another word that means perineoplasty.
Frequently Asked Questions
Do I need a perineoplasty or a vaginoplasty?
It depends on what's loose. If the vaginal opening is loose and the vaginal canal is tight, then you would be an ideal candidate for a perineoplasty. If the vaginal canal is loose, then you would need a vaginoplasty. If you're not sure, Dr. Pelosi can tell instantly by examining you.
What happens if I get perineoplasty when the doctor recommends a vaginoplasty?
You will not be satisfied. The vaginal opening will be tight, but the inside will be loose and this will be obvious to you and your partner every time you have sex. You will then need to have a second operation to undergo a vaginoplasty if you want to feel tightness on the inside.
What happens if I have vaginal childbirth after a perineoplasty?
The perineoplasty will break and the vaginal opening will become as loose or looser than it was before your surgery.
When can I return to work after a perineoplasty?
You can return to work the next day after this procedure. However, you should stay out of the gym and avoid strenous physical activity for six weeks.
When can I have sex after a perineoplasty?
Most women can resume sex in six weeks. However, an exam by your surgeon is the best way to confirm this.
Can I have perineoplasty if I've had vaginal surgery before?
Yes. Many of our patients have had work done elsewhere and they can have this procedure done safely and effectively.
Do I need a perineoplasty or a vaginoplasty?
It depends on what's loose. If the vaginal opening is loose and the vaginal canal is tight, then you would be an ideal candidate for a perineoplasty. If the vaginal canal is loose, then you would need a vaginoplasty. If you're not sure, Dr. Pelosi can tell instantly by examining you.
What happens if I get perineoplasty when the doctor recommends a vaginoplasty?
You will not be satisfied. The vaginal opening will be tight, but the inside will be loose and this will be obvious to you and your partner every time you have sex. You will then need to have a second operation to undergo a vaginoplasty if you want to feel tightness on the inside.
What happens if I have vaginal childbirth after a perineoplasty?
The perineoplasty will break and the vaginal opening will become as loose or looser than it was before your surgery.
When can I return to work after a perineoplasty?
You can return to work the next day after this procedure. However, you should stay out of the gym and avoid strenous physical activity for six weeks.
When can I have sex after a perineoplasty?
Most women can resume sex in six weeks. However, an exam by your surgeon is the best way to confirm this.
Can I have perineoplasty if I've had vaginal surgery before?
Yes. Many of our patients have had work done elsewhere and they can have this procedure done safely and effectively.
