Perineoplasty Perineum Surgery Orange County Perineoplasty Perineum Surgery Orange County

What is the Perineum?

The perineum is the area located between the vaginal opening and the anus. At the center of the perineum lies the perineal body, a complex structure made up of several muscles. The perineum plays an important role in several functions. It provides structural support for the opening of the vagina and contributes to the stability of the pelvic floor. From a sexual function perspective, it helps maintain the shape and tightness of the vaginal opening, thereby decreasing any gaping or the ability for air or water to enter freely into the vaginal canal.

Any changes to the perineum can influence the amount of vaginal tightness, affect comfort during intercourse, and impact the overall aesthetic appearance.

During vaginal birth, the perineum stretches significantly. Post-delivery changes may occur due to natural perineal tears or a surgical incision called an episiotomy during childbirth. These events can lead to separation of the pelvic floor muscles as well as the perineal body.

Patients will often come in complaining of a widened vaginal opening, referred to as a gap. This can lead to air entrapment, water entering the vagina while swimming or bathing, and a loss of tightness at the opening with reduced friction and sensation during intercourse. Additionally, there may be a visible scar that can lead not only to potential discomfort or pain but also to aesthetic imbalance.

When performing perineal surgery, the goal is to re-approximate the muscles of the perineal body and remove any excess tissue. The procedure specifically addresses stretched perineal tissue, gaping of the vaginal opening, and any scar tissue resulting from prior deliveries or episiotomy tears. It also restores the separation of the perineal body muscles and provides an overall more closed and refreshed aesthetic appearance.

What is the Perineoplasty Procedure?

This procedure is performed under local anesthesia in a beautiful, tranquil, and comfortable procedure room. The procedure typically takes approximately 30 to 45 minutes in total, and the sutures used are self-dissolving. We utilize radiofrequency energy for precision cutting while minimizing thermal effects associated with traditional lasers. Once any scar tissue is removed, the muscles of the perineum are re-approximated, and the tissues are carefully reconstructed using dissolvable sutures.

• Steps: scar tissue removal → muscle/tissue reapproximation → dissolvable stitches
• Benefit of CO2/Ellman: precision, minimal thermal damage, good hemostasis

When Can Perineoplasty Be Performed?

A perineoplasty is most commonly performed during vaginal tightening surgery, although it can also be done as a standalone procedure. It is performed in our office in a comfortable, pain-free environment, and patients typically return home within about one hour.

It can also be performed during a labiaplasty, and combining these procedures is common after childbirth or as part of a vaginal rejuvenation treatment plan.

Who is a Candidate?

Typical candidates for this procedure are women who experience symptoms of a widened vaginal opening, which may cause air entrapment, water entering the vagina, or aesthetic discomfort. It is also appropriate for women who have scar tissue secondary to an episiotomy or a perineal tear during childbirth.

Additional candidates include women who report decreased friction at the vaginal opening during intercourse, visible distortion of the perineum, discomfort during sexual activity, or a feeling of decreased support at the vaginal opening.

Recovery After Perineoplasty

As mentioned, the procedure is performed in our office under local anesthesia. After the procedure, the first 72 hours may involve swelling, mild bruising, and mild to moderate discomfort, along with light spotting or discharge. You will likely be prescribed over the counter pain medication to take as needed. 

Within the first one to two weeks, there is typically a significant decrease in swelling, and the sutures begin to dissolve. Patients can usually resume walking and normal daily activities during this time. Most patients return to work within two to three days, depending on the nature of their job. We recommend increasing your water and fiber intake to avoid constipation while you recover.

Strenuous activity, heavy lifting, and moderate exercise are generally restricted until after the second week. Most patients are cleared for intercourse at approximately six weeks.

Risks of Perineoplasty

As with any surgical procedure, there are potential risks, although serious complications are rare, especially when performed by an experienced surgeon, such as Dr. Ghozland.

It is important to maintain a high-fiber diet and adequate hydration after surgery to help prevent constipation, which can place strain on the surgical area during healing.

Your Perineoplasty, Performed by a Pioneer in Pelvic Reconstructive Surgery

Dr. David Ghozland is an OB/GYN in Orange County specializing in the latest, safest, and most effective techniques in pelvic reconstructive surgery including perineoplasty, vaginoplasty, and labiaplasty. He is recognized as a pioneer in the art and science of cosmetic gynecology, and his genuine concern for patients is reflected in his compassionate, attentive bedside manner.

“Honesty is the best policy.” — Dr. Ghozland believes every patient deserves to feel fully comfortable asking questions about their procedure, and that the highest level of care begins with transparency and trust.

Book Your Perineoplasty Perineum Surgery

Ready to feel more confident and comfortable? Dr. David Ghozland offers compassionate, expert care in a private, judgment-free environment. Whether you have questions or are ready to move forward, we are here to help.

Serving patients throughout Orange County and the greater Los Angeles area.