Perineoplasty (Childbirth Scar Aesthetics)

First, let's define the perineal area: it is the region between the lower part of the vagina and the anus.

After a normally sized baby (1.4–1.6 kg) is delivered vaginally, it is completely natural for the vagina to become wider and show signs of wear.

This is caused by the loosening of the heavily stretched pelvic floor muscles during delivery.

As the number of deliveries increases, pelvic muscle tone decreases further, and vaginal width and laxity increase.

Vaginal laxity and deformation not only create tension for partners during intercourse, but can also directly affect pleasure, delaying or preventing orgasm for either partner.

Kegel exercises — training the pelvic floor muscles — when performed regularly and under a physician's guidance, can help restore tone to the muscles surrounding the urethra, vagina, and anus. Of course, this should not be thought of as a tightening procedure.

The muscles that start and stop urination — the ones you use to suddenly halt the flow of urine mid-stream — are the muscles that need to be engaged during Kegel exercises.

However, this should never be done while actually urinating, as it can cause infection. These muscles can be exercised while at rest.

Kegel exercises not only strengthen the pelvic muscles but can also help prevent urinary incontinence. However, results can vary depending on the condition of these muscles and the surrounding area.

Sexual activity can typically resume about six weeks after delivery.

Particularly during a woman's first delivery (at home or with a midwife), the perineal area can tear uncontrollably toward the anus, resulting in irregular birth-related tears. Sometimes these tears can be severe, extending deep into the vaginal canal.

However, in most hospital deliveries with a physician — particularly for first-time deliveries — the doctor makes a controlled incision in the perineal area.

This incision is called an episiotomy.

Scientifically, an episiotomy is a surgical incision made to the bulbocavernosus muscle in the perineum during the second stage of labor.

An episiotomy is performed in about 92% of women having their first hospital-based vaginal delivery.

Following an episiotomy during a normal delivery, scarring results from the rapid closure of the incision.

We can also refer to these marks as scar tissue.

This is exactly where perineoplasty comes in. It is a type of surgery that can be performed when childbirth-related widening and permanent scarring cause discomfort or other issues.

Beyond childbirth-related cases, this procedure can also be performed for perineal tissue that has suffered traumatic damage, or that is deformed or sagging due to genetic (hereditary) factors.