The perineum is the area between the vaginal opening and the anus, with a length ranging from half a centimeter to 5 cm. Its medical term is "Perineum." During childbirth, an incision is made with scissors on the right or left side of the perineum, the area between the vagina and the anus, with the intention of facilitating the baby's head to exit more easily and preventing irregular tears in the mother. This incision is called an "episiotomy incision" or "birth incision." After a normal delivery, poorly healed or later infected episiotomy scars can cause various physical and psychological discomforts for women.
In addition, irregularities in the perineal area can occur due to infections, burns, skin diseases, and many other causes. For these reasons, women may seek perineal surgery. The aim of "perineal aesthetics" is to improve the healing of scars in this area and provide a more aesthetically pleasing appearance.
Today, with the return to natural birth processes, unless extreme conditions occur, the mediolateral episiotomy is considered a surgical practice that should be left in the past, according to our clinic's perspective. We no longer perform mediolateral episiotomy in any of our deliveries, and as a result, vaginal births after aesthetic surgeries become a safer decision in terms of perineal aesthetics.
If there are unresolved scars in the perineum, it can lead to painful intercourse and a decrease in the quality of sexual relations. With perineoplasty, these complaints can be alleviated, and it has a positive effect on sexual life. The angle at the vaginal entrance is corrected, and clitoral G-spot stimulation during intercourse is enhanced. Perineal aesthetics provides an aesthetically pleasing genital appearance. The surgery mainly removes scar tissue, unsightly swelling, and unwanted skin, then tightens or loosens the perineal muscles and the vagina. An additional benefit of perineoplasty is that by making these adjustments, the surgery helps the woman regain her self-confidence and physically increases sexual pleasure levels. In other words, it boosts the individual’s confidence, making them happier, and has a positive impact on their sexual life.
Furthermore, excessive weight gain and loss, and obesity, can put strain on the perineum. These conditions can also cause the specific muscles in these areas to stretch, losing their elasticity. Operations to remove birth scars are often performed simultaneously with vaginal tightening surgeries. Therefore, patients can seek both surgeries at the same time. In some cases, these procedures can also be combined with labiaplasty and clitoral aesthetic surgeries.
The results of perineoplasty surgeries are highly satisfactory. The perineoplasty technique can also be used for treatments of vaginal looseness, vaginismus (involuntary contractions of the vagina during attempted intercourse), vulvar vestibulitis (severe pain during penis or tampon insertion), genital warts, incontinence (involuntary urinary leakage), vaginal stenosis (narrowing of the vagina usually caused by cancer treatment), dyspareunia (pain during intercourse due to a small vaginal opening), cystocele (the bladder bulging into the vagina), rectocele (the rectum bulging into the vagina), and other related conditions.
It is desirable for the perineum to be smooth, long, light-colored, and taut. The improvement of the appearance of the perineal area, the removal of scars if present, and the removal of skin folds (excess tissue) between the vagina and the anus are included in the scope of "perineal aesthetics" (Perineoplasty). These procedures are performed for both cosmetic and functional purposes. While the cosmetic goal is to improve the aesthetic appearance of the genital area, the functional goal is to alleviate issues such as pain or discomfort during sexual intercourse.
If only perineoplasty is performed, the procedure can be done under local anesthesia and typically lasts about 45 minutes. The skin and subcutaneous tissue in this area are removed in a diamond shape. The surgery is completed by suturing the area with new stitches. In this way, scar tissue resembling burn tissue is removed, and the area is covered with healthy-looking skin tissue, resulting in a very good and aesthetically pleasing appearance. In some cases, treatments such as carbon dioxide laser or subcutaneous fat injections may be applied to areas of the perineum that appear sunken. Depending on the size of the sunken area, 2 to 5 cc of fat taken from another area of the body, such as the abdomen or thighs, may be injected into the perineum to achieve aesthetic improvement. Subcutaneous fat injections can also be used to enlarge and add volume to the labia majora, especially in cases of sunken and sagging tissue. If the perineal repair is not done well and healthily, tissue collapse or poorly healed, rough-looking stitch marks (scar formation) may occur. Poor healing of the perineum and the formation of adhesions or band-like barriers in this area can make sexual intercourse painful, distressing, and undesirable.
The greatest benefits of perineoplasty are helping to increase the individual's self-confidence and providing physical and psychological relief. After surgery, patients should avoid sexual intercourse for one month. It is also recommended to refrain from strenuous activities such as cycling, horseback riding, heavy lifting, or stretching during this period.
Tampons should not be used during menstruation.
Many patients are able to return to work within a few days. Pain and discomfort are generally minimal to moderate. They can be treated with over-the-counter pain relievers or prescribed medications from the doctor. Minor bleeding and a small amount of discharge are normal after surgery. As a result of the anesthesia used during the surgery, it is possible to experience dizziness or nausea for one or two days, but this usually resolves or disappears completely within about 48 hours.
It is important for the patient to keep the incision area clean and dry. The stitches will dissolve on their own within about two weeks.
To prevent or relieve constipation after surgery, it is important to drink plenty of water, eat a probiotic-rich diet, and increase fiber intake during this period. The risk of major complications after surgery is low, but perineoplasty can still result in complications in rare cases. If excessive bleeding, signs of infection, or foul-smelling vaginal discharge occur, it is important to contact the surgeon who performed the procedure.
We invite you to our clinic for a free initial consultation, where we can explain the perineoplasty procedure, its costs, and the process you will go through in detail.
