About the Perineoplasty Procedure
Perineoplasty is a surgery that is designed to either tighten or loosen the perineal
muscles of the vagina. Perineoplasty is also sometimes called perineorraphy.
According to Los Angeles urologist Dr. Michael Safir, “The most common type of perineoplasty
we perform is a tightening perineoplasty.” Many women who have had difficult vaginal
deliveries suffer from torn or weakened perineal muscles. Women who have gained
weight may also find that their perineum has stretched and the muscles have loosened.
Some women may also elect to have perineoplasty because they find their muscles
have become lax as they’ve gotten older. By undergoing a tightening perineoplasty
procedure, these women are able to have their perineum tightened, restoring their
Often, perineal damage is accompanied by some type of pelvic prolapse. Because Dr.
Safir specializes in pelvic floor reconstruction, he can perform pelvic prolapse
surgery to correct cystocele (bladder prolapse) or rectocele (rectal prolapse) at
the same time as the perineoplasty procedure.
Many patients have perineoplasty as part of a total vaginal restoration. Total vaginal
restoration comprises several different procedures designed to address both aesthetic
and functional concerns. These procedures include labiaplasty,
vaginoplasty, and perineoplasty.
Another type of perineoplasty is designed to loosen the perineal muscles of the vagina. Women who experience painful intercourse – a condition called dyspareunia - due to an overly tight vaginal entry find that this type of perineoplasty surgery allows them to enjoy intercourse, whereas before it had always been a painful ordeal.
The Perineoplasty Procedure
As there are multiple types of perineoplasty, the exact procedure will vary according to your needs.
Sedatives and pain relievers are administered to reduce anxiety
- Drugs are administered to reduce anxiety and pain before the procedure begins.
- Local anesthetic is injected into the area.
- Dr. Safir then performs the perineoplasty by making an incision, and possibly removing
and scar tissue from the perineal muscles in the posterior wall of the vagina.
- After the procedure is completed, the area is carefully sutured to make sure it
- The entire procedure is usually completed in under an hour
If the perineoplasty is being performed as part of a total vaginal restoration,
or in addition to other pelvic floor repairs, such as correction of pelvic prolapse,
these will be performed concurrently, and the procedure will take longer.