First the tsunami of round the clock feedings, sleepless nights and endless diaper changes and then somewhere through the newborn storm comes the realization that not everything on your body went back into pre-pregnancy position. In fact for some moms, a little surgical restoration may be required. Dr. Rothbart – who was famously flown to Namibia to deliver Brad Pitt and Angelina Jolie’s baby Shiloh in 2006 – gave Breezy the scoop on vaginal repair.
Do all OBs perform Vaginal Rejuvenation?
Not all OBs perform vaginal rejuvenation. Some have special training to do so, and some, while qualified, simply choose not to for various reasons.
Does insurance cover the cost?
Unless there is a medical reason to undergo the rejuvenation (bladder weakening, rectal dysfunction, prolapse of the vagina or uterus etc), insurance will usually not cover the cost.
If so, what are the other pros of having your Dr. perform the surgery vs. a plastic surgeon?
Depending on the particular procedure being performed, often times a well-trained gynecologist does this procedure more often and is therefore better qualified. That being said, a plastic surgeon who has special training in this procedure may have better and newer techniques to apply. On the other hand, some plastic surgeons do this only rarely and in that case it is best left to more experienced hands.
What’s involved in the procedure?
It depends on what is exactly being done, if vaginal laxity “not tight” is the problem, then the procedure involves vaginal surgical incisions, and removal of redundant or excess tissue, then repairing with sutures to give the vaginal walls support. If the procedure involves other aesthetic changes with the vulva or labia, then the unwanted tissue is excised and delicately remodeled to the patients’ request.
How many visits does it require?
Usually a consultation and exam in the office, and then the procedure is performed in the hospital or surgical center on an outpatient basis, meaning, the patient usually will go home that same day.
Are women awake during the procedure?
Women are not awake during the procedure.
Is it safe?
As a surgical procedure, it is very safe and very little blood loss. That being said, there are inherent risks with any surgery, including but not limited to pain, infection, bleeding, blood clots, and poor wound healing. Though rare, these risks, and others, do exist, and need to be discussed and understood prior to any elective surgery.
Is it correct that a woman should be done having children before getting the procedure?
Though not definitively mandatory, it is always better if a woman has completed childbearing prior to any vaginal reconstructive surgery, as childbirth, and pregnancy alone, can alter or sometime even undo the reconstruction completely. The exception to this is labioplasty, where the labia are trimmed and shortened. Though this too may be affected by childbirth, labial irregularities can be pronounced and for a young girl may very adversely affect her quality of life and her sex life.
Under what circumstances would you recommend vaginal rejuvenation?
If a patient is finished with childbearing and her discontent with the appearance or function of her vulva/labia/vagina is affecting her quality of life to a point where the risks of elective surgery are outweighed by her unhappiness, than she would be a great candidate for the procedure.
When would you NOT recommend a woman have it performed?
If a woman is young, hasn’t thought the procedure through, has no real anatomic defect or is a poor surgical candidate.
Are their alternatives for a woman who has given birth to have her vagina “restored” to pre-baby form?
In the 21st century, women have become very aware of the affects of a vaginal delivery on the tone and function thereafter, and some are opting for an elective caesarean section to “preserve the pelvic floor”. Whether or not this is the right thing to do is a very hotly debated topic, and should be personalized between patient and physician. The other thing that can be done post delivery is Kegel exercises.
Can Kegels achieve the same effect?
Kegel exercises very much can have the same effect and can do wonders in restoring tone and function. They can also help to thwart urinary incontinence and other bladder laxity issues.
How often should a woman being doing Kegels? Once a day? Once a week?
Kegels should be/can be done everyday, around 3-5 times a day.
What’s the proper way to do a Kegel?
The best way to describe the correct movement and find the pelvic muscles used for a Kegel exercise is to stop the flow of urine. If you succeed, this is the basic move. Once the muscles are identified, then empty bladder and sit or lie down. Contract the pelvic floor muscles. Hold the contraction for three seconds then relax for three seconds. Repeat ten times. Once the three-second muscle contractions are perfected, try it for four seconds at a time, alternating muscle contractions with a four second rest period. Work up to keeping the muscles contracted for ten seconds at a time and relaxing for ten seconds between contractions.
Jason A. Rothbart, M.D. is an Obstetrician/Gynecologist in Los Angeles. He attended college at the University of California at Davis, and medical school at The Chicago Medical School. He was trained in obstetrics and gynecology at the University of Southern California in the Los Angeles County Medical Center. He is back home practicing minutes from where he grew up, and has a wonderful practice with all ages, and is currently on the surgical and obstetric staff at Cedars-Sinai Medical Center.
Breezy Tip: Do your Kegels during every day tasks such as being stuck at a stoplight, doing dishes, watching TV or while reading your Breezy Mama for the day (You’re doing them right now, aren’t you?).