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Vaginoplasty / vaginal surgery

Sexual stimulation depends on many factors: how attractive your partner is, your own physical and mental state, age, time of day, place, atmosphere etc. From a purely anatomical viewpoint, sexual stimulation means friction. Too strong and it hurts, too weak and it has no effect. This principle forms the basis of all our treatments.

It is not difficult to understand that when you are giving birth, the passage of the baby’s head through the vaginal canal overstretches the vagina and has an impact on the surrounding pelvic muscles. Even though the overstretched tissues recover to a certain extent, a changed anatomical situation remains in most cases: a widened vagina with slack pelvic floor muscles. Hormonal changes throughout life may be another reason why the vagina is no longer as tight as it was some years ago.

And what is the result of these physical changes? Women and their partners experience less sensation while having sex. The previous intense stimulation is no longer there. There may also be symptoms of urinary incontinence – the involuntary loss of urine during physical activities. This is distressing not only for the woman concerned, but also for her partner - and it is not uncommon for it to lead to a breakdown of the relationship.

The first point of contact is usually the gynaecologist, but, in the course of our many years of specialised activities, we have often heard from women seeking help that their gynaecologists do not offer any specific treatment and often trivialise the problems with the attitude that it is merely the price that women pay for having children and has to be accepted as such. This is simply not true, as there are indeed treatment options, which are very effective and can restore the anatomy to what it was before giving birth, or even better than before, and once again establish the basis for an optimal sexual stimulation.

More than 4500 women have decided to get help from our clinic in Munich. Female genital surgery (including vaginoplasty) has been our specialty since 1995. We have developed our own surgical techniques that today rank among the highest international standards.

Basics of the surgery (vaginoplasty)

Anatomically speaking, the vagina is like a tube and forms the counterpart to the penis. Even though the length of the penis can be increased (which does not actually do much for sexual stimulation), it is not yet possible to increase its diameter. So, the only possible option is to narrow the vagina. However, as the lining of the vagina is very stretchable (an important aspect when giving birth), merely narrowing the vagina and removing some of the tissue would not be enough on its own. It would simply result in the same situation happening again a few months later. Decisive for success is that the surrounding muscles – the pelvic floor muscles – are also tightened in this procedure, in order to apply more pressure from outside the vagina. This prevents further overstretching of the vaginal lining. Additionally padding the vaginal wall with the patient’s own fatty tissue reinforces this effect.


Cross-section of the vagina with surrounding pelvic floor muscles (red)
and the connective tissue layer (white) below the vagina.


Removal of a segment at the posterior and anterior vaginal wall
across the entire length of the vagina.

Narrowing the vagina canal, tightening of the connective tissue layer (fascia), tightening
of pelvic floor muscles, filling with fat tissue (yellow)


Video: Operation Technique


The individual steps for tightening the vagina (vaginal rejuvenation)

1. Narrowing the vaginal canal. Some of the lining is removed from the posterior wall of the vagina; tissue can also be taken from the anterior wall, if the vagina is very lax and there is urinary incontinence. Simply removing this excess tissue does not have a lasting effect, however, as the lining is very stretchable and the vagina would soon widen again.

2. Tightening the pelvic floor muscles and fascia that surround the vagina. This step provides support and firmness around the vagina to make it as snug as it was in younger years. This is the decisive step for sustained treatment success.

3. Padding and thickening the vaginal wall with the body’s own fatty tissue. This padding narrows the vagina even further: a soft padding without additional incisions or scars. The fat is taken from the outer aspect of the thigh, specially prepared and then injected under the lining all around the circumference of the middle section of the vagina using a fine needle. This part of the vagina is the most sensitive.

This procedure makes it possible to achieve the ideal anatomical conditions for perfect sexual stimulation. It is the maximum variant of medical feasibility and is extremely successful and effective. We can proudly say that every patient so far has been highly satisfied with the results of this operation.

Vaginal narrowing with autologous fat injections alone

Narrowing the vagina by padding the vaginal wall with the body’s own fatty tissue is a very elegant method that requires no incisions and leaves no scars. However, the extent to which the vagina can be narrowed with this treatment is somewhat limited: only 20-30%. It is the method of choice for women, who have not yet had children, but still want improved stimulation. This variant is not very successful after childbirth, as it is not possible to adequately compensate the overstretching of the vaginal tissue that has occurred. Narrowing the vagina by about 20% is usually not enough to achieve a tangible difference.

This procedure is clearly less invasive than the previously described method of vaginal rejuvenation with surgery to tighten the pelvic floor muscles. It can be performed under a local anaesthetic as day surgery. Subsequent care is straightforward. Sexual intercourse should be avoided for two weeks.

Video: Vaginal rejuvenation by injection of autologous fat

Additional information is available on all our procedures. We are happy to offer you personalised advice. Click on the link to request more information.

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Further information

Before surgery

You should come for a preliminary examination and initial consultation, when the procedure will be explained to you, at least 14 days before the operation. We will then give you all the relevant documents, which you should read at your leisure and bring with you, duly signed, on the day of your operation

Vaginoplasty with tightening of the pelvic floor muscles is carried out under a general anaesthetic and requires a two-day hospital stay. Do not take any blood thinners such as aspirin or cardio aspirin (ASA 100) for 14 days before surgery. You should see your general practitioner for a pre-anaesthesia check with a full blood count, coagulation tests, and an ECG not more than 14 days before surgery and bring the results with you.

This procedure is always carried out on a Tuesday. You should come to the clinic (Iatros-Klinik, Nymphenburgerstrasse 1, Munich, Germany, between 8 am and 5 pm on the day before (Monday) for the consultation with the anaesthetist. You do not need to make an appointment, as long as you arrive within the time frame stated. After this, it would be good if you then stopped by at the practice, so that we can once again talk you through the important points and clear up any questions you might still have.

Please make sure that you drink enough fluid the day before the procedure, but avoid any bulky food – just eat soups or yoghurt, so that your digestive tract is not too full.

Make sure that you have picked up the medications that we prescribed. You will need them once you leave hospital.

No particular preparation is needed if you are having the injection of fatty tissue alone. You also do not need to be fasting, as the procedure will be carried out under local anaesthetic in the practice.

After surgery

There is usually a burning sensation and mild pain the first night after surgery. However, these symptoms will have improved or disappeared completely by the next day. There is often a feeling of pressure, which usually resolves within a few days, but may last a little longer.

You will have a catheter to drain the urine from your bladder for the first 24 hours. A pack inserted into the vagina immediately after the operation will be removed the following morning.

Take the antibiotic as instructed in the package leaflet until you finish the prescribed course. Take the painkillers as you need them, usually for the first three days after the operation. Whilst you are in hospital, you will be given the necessary medication, and you should continue to take the antibiotic and painkillers for 2-3 days after surgery.

After the operation, you should drink plenty of water and follow a diet that gives you soft stools. You can take a shower on the second day after vaginal rejuvenation, but use only clear water at body temperature without any soap during the first week. You can have a camomile hip bath after three days and we recommend them. The sutures are absorbable and do not need to be removed.

The operation will not affect your daily life for very long. The initial swelling and any possible slight bruising will disappear after a few days. Any residual swelling will resolve slowly over the next few months.

In the first two weeks after surgery, we recommend that you do not use tampons during your period, but rather sanitary pads. Wait at least six weeks before having sex. Although the wounds will have closed by then, they are not yet very stable and mechanical strain or friction during sex could cause them to reopen. Sports such as horse riding, cycling or jogging may also cause mechanical strain or friction and should also be avoided for six weeks. Do not have a sauna for at least two months.
During this time, you should not perform any strenuous activities, lift any heavy weights or strain during bowel movements, so that you do not put excessive pressure on the pelvic floor muscles.

Vaginoplasty usually lasts a lifetime.

In total, you will visit us on three occasions. The first time is for the preliminary examination and consultation, when we will provide you with the information about the operation. The second visit is for the operation itself. You will have a general anaesthetic and a short hospital stay. The third appointment is for your follow-up examination.

How many appointments do I need?

For inpatient operations (vaginoplasty, pelvic floor muscle tightening), you will need three appointments: consultation/preliminary examination, surgery and a follow-up examination about six weeks after the operation. The initial consultation and the surgical procedure cannot take place on the same day. There should be an interval of at least 7-14 days, so that you can take your time to think about the operation.

For day surgery (padding with autologous fat), you will also need a total of three appointments: consultation/preliminary examination, surgery and a follow-up examination the morning after the procedure. The initial consultation and the surgical procedure cannot take place on the same day. There has to be an interval of at least 24 hours between the first consultation and the scheduled surgery. An interval of 14 days is better, so that you can take your time to think about the operation. After the procedure, you should spend the night in Munich. We can help you to find a suitable hotel.

How can I get the necessary information?

You can request more information or make an appointment for a consultation here free of charge and without obligation. We have also set up an advisory phone line for you. Call us on +49 (0)89 24 22 39 22 for free non-binding personalised advice on the surgery you would like.

Which phase of the menstrual cycle is best for the procedure?

The phase of your menstrual cycle is not relevant to the operation; that is to say, surgery can still go ahead during your period. Don’t use tampons for two weeks after surgery, however, just sanitary pads.

What are the risks?

There are no serious risks or complications associated with vaginoplasty. Severe pain is not to be expected, although there may be a slight to moderate sensation of pressure on the perineum (beneath the pelvic floor), which disappears rapidly. You should drink a large glass of water every day, especially before breakfast, in order to keep your stools soft. Once the catheter has been removed the day after the operation, you should be able to pass urine on your own. If there is a great deal of swelling, it may be difficult for you to pass urine and the catheter will be left in a little longer. However, this happens only very rarely.

What is important for healing?

The most important thing you can do to aid the healing process is to follow your doctor’s instructions implicitly. We are, of course, available to answer your questions at any time after the operation. Avoid strenuous activities such as lifting heavy weights and straining during a bowel movement (after pelvic floor surgery).

How long must I wait before having sex?

After a vaginoplasty with pelvic floor muscle tightening, wait at least six weeks before having sex again. Although the wounds will have closed by then, they aren’t very stable and could reopen, if subjected to mechanical strain or friction.

When the vagina has been narrowed by fat injections alone, you can resume sexual intercourse after two weeks.

How soon can I take a shower?

You can take a shower on the second day after vaginal rejuvenation, but use only clear water at body temperature without any soap during the first week. You can have a camomile hip bath after three days.

When can I take up sports again?

Avoid mechanical strain and lifting heavy objects for six weeks, that is to say, avoid sports such as horse riding, cycling, weight training or jogging during this time.

Will I have any severe pain?

Even with the large number of patients we have already treated, we have not had a single case of prolonged postoperative pain. As a rule, patients experience a mild feeling of pressure on the perineum the first night after vaginoplasty. However, this symptom will have already improved or disappeared completely by the next day. Furthermore, you will be given sufficient painkillers, so there should not be any problem.

So far, none of our patients has ever reported pain during intercourse.

Should I expect a loss of sensation?

Disorders of sensation or sexually stimulated sensation are not to be expected.

Do the stitches have to be removed?

No, because we use absorbable sutures.

What does surgery cost?

The fee for vaginal rejuvenation with pelvic floor surgery is EUR 7800, plus the costs of the anaesthetic and inpatient stay. The fees must be paid before the operation. Vaginal rejuvenation by injecting autologous fat costs EUR 2500.

An advance payment of EUR 500 is required for the firm reservation of an operation date.

How certain are the chances of success?

A study by MASTERS and JOHNSON showed that sexual gratification for the female is directly proportional to the amount of the frictional forces generated during intercourse, as we mentioned previously.

The aim of the operation is to correct an existing widening of the vagina and achieve an anatomical situation corresponding to that of a young woman before childbirth. Experience shows that this greatly improves and increases sexual sensitivity during intercourse, not only for the woman, but also for the man, making passionate sex possible again for both. As with any medical treatment, there is, of course, never a 100% guarantee of success.
Treatment of any incontinence is carried out in collaboration with the gynaecologist and is usually very successful.

Which treatment is the right one for me?

The type of operation that is best for you can only be determined after a physical examination. The examination will assess how slack the vagina is. After a vaginal birth, the tissues are usually so overstretched that fat injections alone are generally not sufficient.

If the aim is only a slight narrowing of the vagina, injecting the body’s own fat beneath the vaginal wall may have the desired effect. A wide vagina requires tightening of the vaginal wall together with tightening of the pelvic floor muscles. If there are also symptoms of incontinence (involuntary loss of urine), it is necessary to tighten the pelvic floor and lift the base of the bladder.

How can I get the necessary information?

You can request more information or make an appointment for a consultation here free of charge and without obligation. We have also set up an advisory phone line for you. Call us on +49 (0)89 24 22 39 22 for free non-binding personalised advice on the surgery you would like.

What happens if I can’t make it to my appointments?

If you can’t make it to your initial consultation, please let us know immediately on: 
+49 (0)89 24 22 39 22 or at .

Any questions?

If you have any questions that we have not yet answered, please let us know and we will do our best to answer them as quickly as possible.

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