The Facts of Life, and Vaginal Tightening
Susan, a 32-year-old mother in Temecula, Calif., sought treatment
for urinary incontinence that began after the birth of her
children. What she got was an unexpected surprise: better
sex.
"My urinary incontinence wasn't severe," she says. "But they say in
time it can become severe. My surgeon said he could re-tighten my
pelvic muscles and inner walls to solve the problem, and he
did."
What Susan didn't know was that the surgery would add new spark to
her lovemaking as well. "My husband and I had great sex before, but
now it's magnificently great," she explains. "Everything's so much
tighter. I can really feel the difference. It's like I'm starting
all over again."
Susan is among a growing number of women who are discovering the
benefits of surgeries designed to improve sexual function.
"After childbirth, the vagina may become stretched," says Dr. Jane
E. Norton, a plastic surgeon in Palm Desert, Calif. "And men get
smaller as they age due to less testosterone in their systems,
which can affect the size of their erections and their stamina as
well. By tightening the vagina, this can enhance pleasure for both
the woman and the man."
With childbirth -- and aging -- pelvic muscles relax and the
internal and external diameters of the vagina increase. Difficult
deliveries can cause serious stretches, tears, and rips -- and
generalized weakening of pelvic supports.
It's a price that some women must pay for the reproductive burden
of bearing children. If the vagina loses its tone and strength, if
the pelvic muscles get too loose, even Olympic-caliber regimens of
Kegel exercises won't help much. And sexual pleasure during
intercourse may be diminished. In short, a woman won't feel as much
sexually. Neither will her male partner.
Gynecologists have long performed surgeries to repair damage caused
by labor or trauma. But now, doctors are adapting their surgical
techniques to deliver what many patients want: enhanced sex. Los
Angeles ob-gyn Dr. David L. Matlock calls the procedure "laser
vaginal rejuvenation." The procedure provides a tighter, more
resilient vagina, physiologically optimized for lovemaking.
Some women aren't waiting for bladder leakage or pelvic pain before
going in for vaginal tune-ups -- they're doing it because they want
better sex. Others are doing it to gain greater self-confidence
before dating anew after divorce. Still others want a piece of that
elusive fountain of youth and are willing to put themselves under
the knife or laser -- and pay out of their own pockets -- to get
it. In this regard, it's not that different from plastic surgeries
like liposuction or breast augmentation.
Dr. Matlock says he does about 25 laser vaginal rejuvenations a
month. The surgery costs between $3,500 and $8,000, depending on
the specific procedures performed. This includes surgeon's fees,
fees for the surgery center, surgical assistant, anesthesia, and
pre-op and post-op consultations. It's an outpatient procedure that
takes about an hour. Within a couple of weeks of the surgery, women
can resume most normal activities; sex is not advised until six
weeks have passed.
To many people, the whole concept may seem foreign. In fact, such
surgeries have gone on without much fanfare in the Middle East and
Asia for many years. But it's not a topic that many American
ob-gyns will broach with their patients. And the scientific
literature in this area is sketchy at best.
The American College of Obstetricians and Gynecologists, which
represents nearly 39,000 physicians, doesn't have an official
position on female sexual enhancement surgery. Neither does the
American Medical Women's Association, with some 10,000 women
physicians of all medical specialties as members. The American
Association of Sex Educators, Counselors and Therapists doesn't
have an official position, either.
If these medical organizations have nothing definitive to say about
the surgery, imagine how baffled the average doctor is about
it.
"This is about quality of life," emphasizes Dr. Matlock. He points
out that Viagra and other drugs represent only the beginning of a
shift away from treatments exclusively for disease toward those
designed to enhance well-being, vitality, and yes, even sex.
"These procedures are available to women who want them," says Dr.
Norton. "You shouldn't be embarrassed. Sex -- and the joy it can
bring -- is a big part of life."
But, say some sex therapists, the procedure shouldn't be considered
a sexual panacea. They point out that having a reconstructed vagina
will not reconstruct faltering relationships.
"I would be highly suspicious of a quick fix, especially when it's
an invasive procedure that carries with it risks that are involved
with any type of surgery," says Dennis P. Sugrue, a licensed
clinical psychologist and certified sex therapist in Bloomfield
Hills, Mich., who is president-elect of the American Association of
Sex Educators, Counselors and Therapists.
"The causes of sexual dissatisfaction sometimes can be very
complex," he says, "and it's very easy to reduce it down to, say,
'rejuvenate your vagina and you'll rejuvenate your sex life.' But
that's too simplistic.
"Before even considering an invasive procedure like vaginal
tightening surgery, it's absolutely critical for a woman to consult
with a sexual health professional to make sure that the cause of
the sexual dissatisfaction is thoroughly assessed and diagnosed.
Noninvasive treatment procedures should first be employed. Only if
all of those steps are taken and fail to bring about satisfaction
should surgery even be considered."
Of course, not all genital surgeries are performed to improve
sexual function.
Procedures designed to enhance the aesthetic appearance of the
external female genitalia are also gaining in popularity.
Karen, a 25-year-old from San Diego, first noticed her labia minora
were too large when she was a little girl.
"I was into athletics, and when we were changing, I could tell what
was normal and what was not," she explains. "I just knew that
something wasn't right." She says she wasn't unhappy with her body.
"It was more of a sense of embarrassment and being shy," she says.
"I wished that I was different."
Years passed before she found a doctor who had a track record doing
surgeries to reduce labia size (called reduction labioplasties).
For a long time, she didn't even know the option was available to
her. As it turned out, the reduction was a simple procedure, and
she's very pleased with the results.
"I saw eight women last year for this," says Dr. Christine M.
Rodgers, a plastic surgeon in Denver. "Some of these ladies have
very long labia, which make them feel that they look too old, and
they want to look young."
"With the advent of explicit magazines, videos, and apparel, female
genitalia are much more on display," notes Dr. William H. Canada, a
Las Vegas plastic surgeon. "Women may become self-conscious of
their external genitalia's appearance on the beach as well as in
the bedroom."
Doctors are now offering a range of surgeries, including unhooding
of the clitoris, elevation of the pubis, and more. Patient demand
seems be driving these procedures.
"Genital surgery for cosmetic purposes is increasing," says Dr.
Gary J. Alter, assistant clinical professor of plastic surgery at
the University of California at Los Angeles. "And it's not going to
go away."
(WHO'S NEXT TO BE UPTIGHT?! 
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