Frequently Asked Questions
- What is the difference between Vaginal Rejuvenation Surgery (VRS) and Virginal Restoration?
Vaginal rejuvenation surgery (VRS) is a general term covering any type of modification to the external genitalia and vagina
which changes the appearance or size of the vulva and vagina. VRS modifies the vulva (external genitalia) and a portion of
the vagina restoring it to a "pre-vaginal delivery" size. In most cases it involves a simple excision of excess tissue either
using a surgical knife with suture closure or lasers. Because of its simplicity, vaginal rejuvenation surgery causes very
little pain and recovery time is short.
In contrast, Virginal Restoration is a surgery which extensively modifies the external genitalia, the vagina, and the pelvic
muscles underneath the vagina. Unlike simple vaginal modification surgery, Virginal Restoration is designed to restore the
vagina to a virginal size. Because of its complexity, it causes a much higher level of discomfort than simple vaginal modification
surgery and the recovery time is longer.
- If I needed vaginal rejuvenation surgery, why didn't my gynecologist say anything during my last examination?
Vaginal Rejuvenation Surgery and Virginal Restoration are considered cosmetic surgeries. Once a woman becomes sexually active and
especially after having children, a woman may demonstrate an increase in the size and a decrease in the "tightness" of her vagina. This
is an absolutely normal and expected change. Unless you have a medically indicated condition such as a cystocele or rectocele, your
doctor may not advise you that you have a problem.
However, changes could have occurred to your body which would embarrass you if you knew all the details. What if your doctor is able to insert
3 or 4 fingers into your vagina without producing pain. Would you think this is normal? Probably not.
Many women suffer from this degree of vaginal relaxation without knowing their true condition. Why? Because vaginal relaxation is not a medical problem; it is a
cosmetic problem. Therefore, your gynecologist will probably inform you that your physical exam is normal.
Further, only a few gynecologists perform elective cosmetic surgery so surgical correction of vaginal relaxation would not be discussed with you during
In order to get a better understanding of your condition, you should ask your gynecologist, "Doctor, how relaxed is my vagina?"
- How long will vaginal rejuvenation or virginal restoration last?
There is no set length of time for either one of these procedures to last.
In terms of changing the external appearance of the vagina or the vulva, cosmetic surgery can be permanent. However, if you are hoping to prevent
vaginal relaxation from occurring again, the better choice would be Virginal Restoration.
Since Virginal Restoration incorporates the external genital muscles as well as the internal pelvic muscles, it is expected to last longer
than simple vaginal modification surgery. Further, you are not expected to "relax" any wider than the diameter of the penis of your sexual partner. You
are also expected to maintain a level of virginal "tightness" for many years.
I began performing this type of surgery five years ago. To date, all patients have maintained their 12 week postoperative vaginal size.
- Why would anyone want to be a virgin again?
Most people who are afraid of having Virginal Restoration are concerned about the pain and discomfort associated with losing their
Following Virginal Restoration you are expected to experience pain and even bleeding for the initial 4-6 sexual experiences after your
However, after this initial period of discomfort, you are expected to experience even more pleasure with your renewed level of "tightness"
as compared to simple vaginal modification.
To date, none who have undergone Virgin Restoration have regretted their decision and all have stated that they would undergo the surgery
again. All have felt that the rewards were worth the initial period of discomfort.
- I was thinking of having laser Vaginal Rejuvenation™. Can Vaginal Restoration be done with lasers?
No. Laser Vaginal Rejuvenation™ falls under the category of Simple Vaginal Rejuvenation. Lasers are specifically used to penetrate
only a few millimeters below a tissue surface allowing the surgeon to cut and cauterize (stop bleeding using heat) at the same time. Because it
is a minimally invasive procedure, lasers allow for generally minor modifications to the vulva and vagina with minimal amount of discomfort and
Although lasers can be used as part of the surgery, Virginal Restoration requires heavy absorbable sutures which are used to create a
supporting foundation around the vagina to prevent it from stretching out again. This foundation are the muscles of the external genitalia,
as well as, the muscles of the pelvic floor (levator ani).
Virginal Restoration "wraps" the muscles of the external genitalia and pelvic floor around the vaginal opening and the length of the
vagina in order to prevent the vagina from stretching back to its previous size. This is the major difference between simple vaginal
modification including the use of lasers and Virginal Restoration. Modification and re-approximation of the pelvic floor muscles cannot be
done using only lasers. This is why Virginal Restoration is more difficult to perform; is more uncomfortable for the patient; and requires
a longer recovery time.
- Can any doctor perform Vaginal Rejuvenation Surgery or Virginal Restoration?
No. Very few doctors perform elective cosmetic surgery such as Vaginal Rejuvenation Surgery or Virginal Restoration. Although the majority of
OB/GYN doctors have been trained to perform the basic surgeries involved in vaginal rejuvenation, only a very few number are experienced in
actually performing these types of surgeries.
An even smaller group of gynecologists are able to perform Virginal Restoration which requires an extensive knowledge of internal pelvic
anatomy and the modification of at least five surgical procedures including: anterior repair, posterior repair, labioplasty, perineoplasty,
hymenoplasty and overlapping sphincteroplasty.
If you are thinking of undergoing a Virginal Restoration it would be advisable for you find a gynecologist specially trained in pelvic
reconstructive surgery who also has experience in cosmetic gynecology.
Be careful with your choice of gynecologist or surgeon. I have consulted patients from both here and abroad who have claimed to have had
vaginal rejuvenation surgery or virginal restoration only to be told that they underwent surgeries that were not virginal
restoration or that would not last.
- Can you have Virginal Restoration without going down to a virginal size?
Yes. The vulva and size of the vagina can be modified based on the patient's wishes. In terms of this type of surgery, virginal size has been
defined as a 1.5cm diameter vaginal opening and length of vagina or approximately 1 finger diameter. This is the smallest recommended size.
Virginal Restoration which reduces the diameter of the vagina down to 1.5cm size is not recommended for patients who's sexual partner are
very large in size. These patients may prefer to undergo Virginal Restoration down to between 2-3cm instead.
The final decision on vaginal size will be made after discussing the requested sized as compared to the size of the penis of your sexual
- Is Vaginal Rejuvenation Surgery or Virginal Restoration covered by insurance?
No. Both vaginal rejuvenation surgery and virginal restoration are considered cosmetic procedures. However, if a medical
condition such as a cystocele, rectocele, vaginal prolapse, stress urinary incontinence or fetal incontinence is diagnosed on physical
examination, a portion of your expenses may be covered by your insurance.
- I have had premarital sex in the past but my fiancée does not know this. Can I have my hymen repaired or do you recommend Virginal Restoration?
Yes and No. Hymenoplasty or Hymenorrhapy is the reconstruction or repair of the hymen. Depending on the appearance of the hymen, a repair or
modification can be done either as an in-patient or out-patient procedure.
Virginal Restoration is generally recommended for a woman who has already completed her child-bearing years. It is not recommended for a
woman who plans on having children and delivering through the vagina.
It is also very important to understand that the presence of a reconstructed hymen means absolutely nothing if the vagina is relaxed from
repeated episodes of sexual activity or from having sex with a partner with a very large penis.
If your fiancée is not a virgin, he may be able to tell that you have had intercourse in the past if you suffer from vaginal relaxation.
Therefore, it is important to consider having simple vaginal modification along with your hymenoplasty.
I recommend that a hymenoplasty and simple vaginal modification be reserved for women of child-bearing years who plan on delivering their
I recommend Virginal Restoration for women who have completed child-bearing or who plan on delivering their children by Cesarean Section.
- I have heard that you can improve sexually stimulation with G-spot injections. Can you do this at the same time as Vaginal
Rejuvenation Surgery or Virginal Restoration?
Yes. The G-spot
(Gräfenberg spot) is a small area in the genital
area behind the mons pubis (pubic bone) and surrounding the urethra. It is named after the German gynecologist Ernst Gräfenberg. Stimulation
of this area has been credited for producing an increased intensity with orgasm or increasing the ability to have multiple orgasms.
In order to increase friction during sexual intercourse, some gynecologists have used injections of collagen to thicken this area.
G-spot injections can be used with or without vaginal rejuvenation or Virginal Restoration although the effect of the injection is
expected to be temporary.
Because of the degree of tightness, vaginal size reduction and stimulation are already expected with Virginal Restoration. Therefore,
G-spot collagen injections may not be necessary, although it is not contraindicated.
- Can you have Virginal Restoration right after having a baby?
No. Virginal Restoration requires making multiple lines of incision exposing the deeper tissue for repair. Since the pelvic and vaginal
tissues are supplied with an enormous amount of blood during pregnancy as compared to the non-pregnant state, it is possible to have a great
deal of bleeding during this surgery. This is why it is recommended to wait at least 6 weeks before having surgery.
However, it is possible to perform simple vaginal modification after the delivery of a baby. This surgery is called Postpartum Vaginal
Rejuvenation (PPVR). Unlike Virginal Restoration, Postpartum Vaginal Rejuvenation (PPVR) only modifies the external genitalia and a small
portion of the vagina; therefore, the risk of bleeding is much less than with Virginal Restoration.
Postpartum Vaginal Restoration (PPVR) is very similar to the repair of an episiotomy, which is a surgical incision made by an obstetrician
to enlarge the vaginal opening during the delivery of a baby.
It is important to understand that PPVR is not just the repair of an episiotomy. Nor is it is simply putting an "extra stitch" in the
vulva or vagina as is commonly asked by husbands or stated by some obstetricians.
The patient should also understand that PPVR is more complicated than an episiotomy and the level of pain will be much greater than with
the repair of an episiotomy.
*Women portrayed in photos on this page are not actual patients of First Choice OB/GYN Associates, PA.
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