Published: Sep 10, 2016, edited: Jun 13, 2019 by Dr. Zelmanovich (Gynecologist in NYC), Manhattan Women's Health & Wellness


Perinioplasty Surgery ProcedurePerinioplasty is a plastic surgery procedure done to correct a damaged, dysfunctional or distorted opening of your vagina. You might develop a lax or stretched vaginal opening if you’ve had a difficult childbirth or a tear in your vagina while giving birth. Perineal scars usually occur following childbirth, and they are necessary and helpful for your recovery from the delivery, but scar tissue is inflexible and can lead to pain during intercourse moving forward.

Perinioplasty is designed to produce a more natural and tightened vagina. It does not tighten the vagina canal. Instead, the procedure often is performed at the same time as a vaginoplasty, which tightens the vagina floor. The perenioplasty only tightens the skin at the opening of your vagina that can cause:

  • The penis to slip out during sex
  • Irritation by rubbing on loose clothing
  • Diminished sexual pleasure
  • Self-consciousness

Are You a Candidate?

The perineum is the area between your vagina and rectum that is visible. Tears during childbirth are very common in the perineum. During the approximately 30-minute procedure, your surgeon can:

  • Remove excess skin and skin tags
  • Sew the underlying muscles to tighten them up
  • Give your vagina a snugger feel
  • Resurface the tissue to make it look as it did before you had a baby

The best candidates for perinioplasty benefits are women in generally good health who:

  • Have had a vaginal birth
  • Experience looseness during sex
  • Have itching
  • Have decreased sexual stimulation
  • Have changes in their bowel movements
  • Have not had a baby, but because of the pressure from excess weight, the vagina has stretched
  • Are embarrassed by vaginal flatus
  • Were born with an unusually wide vaginal opening
  • Have tried and failed to tighten the vagina with Kegel exercises

Preparing for the Procedure

Once you’ve decided that you want to pursue the benefits of a perinioplasty and have been advised of the process, your gynecologist, Dr. Zelmanovich in Midtown Manhattan may prescribe intra-vaginal estrogen if you haven’t yet undergone menopause. The healing capacity of your vagina is strengthened with this hormonal therapy that many gynecologists prescribe for a two or three months prior to the actual procedure.

Then you can expect to:

  • Make necessary arrangements for your recovery so you can have a ride home from the office, help at home and childcare for a few days if required
  • Prepare in the weeks leading up to the surgery by stopping cigarette smoking if you’re a smoker and keeping up with aerobic activity
  • Eat a diet high in proteins and carbohydrates to get your body in peak shape for surgery
  • Take oral antibiotics for a few days leading up to the procedure

How Laser Perineoplasty Is Performed

The procedure is done in a specialized gynecology in NYC center on an outpatient basis. You’re given a local anesthesia and mild sedation, so you’ll need to have someone available to drive you home after the procedure.

  • Once you’re relaxed and sedated, a V-shaped incision is made in the posterior wall of your vagina using a pixel laser.
  • The laser allows your gynecologist Midtown NYC specialist, Dr. Zelmanovich to provide extremely precise and accurate incisions.
  • Any scar tissue is removed.
  • The underlying muscle and tissue then are brought back together.
  • The folds are sutured with dissolvable stitches.
  • After about an hour in a recovery setting, you can leave.

Recovery Process

You may experience some minor bleeding for a couple days, for which you can wear a sanitary pad. But you should be able to return to work within two or three days with minimal pain. Any pain you do feel can be best managed with over-the-counter medication such as Tylenol that doesn’t promote bleeding.

You may experience slight pain and pressure during the first two weeks after your surgery, but it will decrease over time. Chances are you’ll have better bowel movements than you’ve had for a while. You’ll be asked to refrain from sexual intercourse for about six weeks to give the area time to completely heal. Additionally, you must:

  • Keep your vagina clean and dry
  • Drink lots of water
  • Increase your fiber intake to prevent constipation
  • Let the stitches dissolve on their own in about two weeks
  • Return to all your normal exercise routines within about four weeks
  • Include vaginal exercises that you receive after your procedure

Potential Risks

Risks following perinioplasty surgery are minimal, but as with any type of surgical procedure, they do exist. The most likely culprits include:

  • Infection
  • Excessive bleeding
  • Constipation

A perinioplasty surgery is elective, so you need to weigh the risks with the benefits before proceeding. Other complications are rare, but can occur. They include such occurrences as:

  • Your vagina may not be as tight as you hoped.
  • Conversely, it may end up being too tight.
  • You may need to undergo a second procedure to make adjustments.
  • Your recovery may take longer than you expected.
  • The incision can open up during sex, especially if you don’t wait the recommended period of time.
  • An abscess or infection can appear, even if you take antibiotics.
  • Damage to your rectum may occur, and though this is extremely rare, a repair may be necessary, extending your recovery time.
  • A second opening, called a fistula, can appear, necessitating another surgery to close it. This is extremely rare.

The most modern surgical techniques include lasers to do the surgery. They reduce the odds that you’ll have any excessive bleeding. You can even take antibiotics before the operation to reduce the odds that you’ll develop an infection.

Do Your Part for a Quick Recovery

Of course, relying on the gynecology NYC expertise and precision of a talented surgeon is important to decrease the chances of adverse reactions. Finally, a healthy diet reduces constipation. High fiber diets consist primarily of fruits, vegetables, grains, cereal, legumes, nuts and seeds. For example:

  • One cup of cooked split peas equals 16.3 grams of fiber
  • One cup of black beans equal 15 grams of fiber
  • One cup cooked, whole wheat spaghetti gives you 6.3 total grams of fiber
  • One cup of raspberries equals 8 grams of fiber
  • One cup of boiled broccoli equals 5.1 grams of fiber


Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist in a specialized NYC gynecology facility can determine an accurate diagnosis and proper treatment.

Do you have questions about Perinioplasty Surgery Procedure? Would like to schedule an appointment with the top Midtown NYC GYN specialist, Dr. Anat Zelmanovich of Manhattan Women’s Health and Wellness, please contact our office for OBGYN consultation.

Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
51 East 25th Street, Ste 403, New York, NY 10010
(Between Madison Ave & Park Ave)
(212) 533-4575
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
983 Park Ave, Ste 1D, New York, NY 10028
(Between 83th & 84th Street)
(212) 427-8761
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Union Square OB/GYN)
55 W 17th St Ste 104, New York, NY 10011
(Between 5th & 6th Avenue)
(212) 378-9985
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class gynecologist in Midtown regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or our Gynecology NYC office today and schedule a consultation with a top Midtown OBGYN gynecologist.