Often, talking about female sexual health can feel awkward or embarrassing, even when letting your gynecologist know about symptoms or changes that concern you. 

Problems such as discomfort or a lack of lubrication during intimacy, urinary incontinence or other functional issues can be regular occurrences among women of any age, so it’s important that you understand that you are not alone. Many of these concerns arise naturally due to factors such as pregnancy, childbirth and aging, but you don’t have to accept them as a part of your life.

At Urogynecology Center NoVa, Dr. Maria Canter understands that some women are reluctant to talk about issues with intimacy or function. You might even think that they are inevitable and something you have to live with. But the truth is that vaginal health changes are common, and problems can manifest themselves through a variety of symptoms. 

As a practice dedicated to the unique needs of women, we want to ensure that you are living your best life at any age, which is why double-board certified Dr. Canter offers vaginoplasty, a surgical procedure designed to improve the intimacy and function of the vagina. Our goal is to alleviate your symptoms and restore your confidence in yourself and your sexuality.


The vagina is a muscular canal with layers of tissue that give it a soft, flexible lining. It is located in your pelvic area behind the bladder, and in most women, is about four inches long. As the thruway that connects the cervix to the outside world and enables a baby to exit the uterus, the walls of your vagina consist of strong layers of muscles and elastic fibers that allow it to stretch during sex or childbirth. The walls of your vagina also provide lubrication to reduce friction and minimize irritation or discomfort. Other vital muscles support the pelvic floor, and they all work together to allow normal, healthy functioning of the vagina and other important female structures.

While the vaginal muscles are elastic and thick, they can weaken over time, just like other muscle groups. Factors such as the natural aging process, hormonal changes and stretching or tearing that occur during childbirth can all reduce elasticity and cause the vaginal walls to loosen, making them less able to bounce back as strong as they once were. Vaginal tissues can also become thinner as estrogen levels fall, resulting in decreased moisture levels and a dry, painful or itching sensation, especially during sex. While these changes occur naturally, they cause a variety of unpleasant symptoms that can have a negative impact on your health, comfort and self-esteem.

Loose or weakened muscles in the vagina that cause laxity is a problem that plagues many women of childbearing age and beyond. Since the vaginal muscles and tissues are responsible for lubrication and feelings of “tightness,” this can lead to decreased sexual pleasure, dryness and discomfort. The muscles of the vagina are also connected to other vital organs in your pelvis, such as the uterus, bladder and rectum, so weakening vaginal walls can contribute to incontinence and other functional problems.


The vagina changes a lot throughout your lifetime, as it’s strongly influenced by hormonal factors and the aging process. The first significant milestone happens during puberty, when the vagina matures in response to rising estrogen levels — ovulation begins, healthy discharge appears and the labia become more pronounced. Other obvious changes happen during pregnancy. Increased blood flow can make the tissues swell and darken, and the pelvic floor muscles will stretch with each vaginal delivery. Vaginal skin and tissues can also tear as they expand to accommodate a baby’s head, and postpartum hormone fluctuations can result in feelings of dryness. Some of these changes are temporary, but others may be permanent and remain even after giving birth.

The vagina continues to change as we get older. The next milestone is perimenopause, the five to ten-year period before menopause begins. Although it varies, most women experience perimenopause in their 40s, during which time the body begins to produce less estrogen. As hormonal levels continue to drop and menopause sets in, the vaginal lining becomes thinner and less elastic, while vaginal and pelvic muscles weaken with age. The labia and vaginal tissues are also affected by a loss of collagen and elastin, vital proteins that are responsible for keeping your skin firm and supple. Over time, the collagen and elastin in your skin – all of it – begins to lose elasticity and sag, and the production of new collagen and elastin fibers starts to diminish. While maybe not as noticeable as changes that occur on the face or hands, this can result in visible sagging of the vaginal tissues.

Vaginal changes are completely normal and natural, but they don’t have to affect your well-being or leave you with an unsatisfying sex life. Vaginoplasty can improve the function and appearance of your vagina by rejuvenating the tissues and muscles that have been affected by factors like aging, childbirth and hormonal changes.


Vaginoplasty is a surgical procedure designed to enhance both sexual sensation and pelvic functionality by tightening and repairing the muscles of the vaginal wall. It can also improve urinary incontinence by tightening the pelvic floor muscles, which support the bladder to prevent leakage. Vaginoplasty can help address a number of the issues caused by weakening vaginal muscles and sagging tissues, including:

These and other issues often occur with aging or pregnancy, but vaginoplasty can decrease or even eliminate your symptoms altogether, restoring your vaginal health and boosting your confidence during intimacy. It can also improve the appearance of and tighten the vaginal opening, increasing sexual sensation for you and your partner. If you have other concerns that can’t be addressed with a vaginoplasty alone, this procedure can be combined with other surgeries to help you achieve your goals. Oftentimes, a perineoplasty is done at the same time as a vaginoplasty to strengthen the muscles of the perineum. Other women may combine their surgery with a labiaplasty to reduce the size or length of their vaginal lips for increased comfort and confidence in the appearance of their genitals.


Vaginoplasty can benefit any woman who experiences a loose or lax sensation in their vagina. It can also be a suitable procedure for those who are bothered by discomfort, dryness, urinary incontinence and other concerns caused by weakening vaginal muscles or tissues. Vaginoplasty can restore your vaginal health and function by alleviating unpleasant symptoms caused by factors such as aging, pregnancy, genetics or childbirth, but it can also improve your confidence and enhance your sexual pleasure.

If you’re thinking about vaginoplasty, you may be a good candidate for this procedure if:

Timing can also be an important factor when considering vaginoplasty, as future pregnancies or vaginal deliveries can undo the results of your procedure. Therefore, vaginoplasty is generally recommended when you’re finished having children.


Prior to undergoing vaginoplasty, you will come in for a consultation with Dr. Canter, who will talk with you about your concerns and desired results. She will also examine you to determine what needs to be done to achieve those results and develop a treatment plan tailored to your needs. If you have additional concerns that can’t be addressed by vaginoplasty, she may recommend other vaginal rejuvenation procedures to help you reach your goals.

On the day of your surgery, you will be given general anesthesia and made comfortable. Dr. Canter begins the procedure by removing a pie-shaped section of excess mucosal skin at the back of the vagina. She then repairs the muscles found underneath the excess skin, using strong sutures to either bring separated muscles back together, or to tighten loose muscles. Your exact procedure may vary depending on the amount of correction needed, but Dr. Canter will tailor her surgical technique to your body and ensure that your vaginal muscles are tight and taut to achieve your desired results.

Once she has completed the muscle repair, she closes the mucosal skin with sutures. If you have any other concerns to address and opted to combine your procedure with a perineoplasty or labiaplasty, these will be performed at the same time as your vaginoplasty, giving you the benefit of one surgical experience and a single recovery period. If there is external skin that protrudes from your vagina, this can also be addressed, leaving you with a more aesthetically pleasing appearance. After your procedure, you’ll be brought to the recovery room to wait for the effects of anesthesia to wear off.


Vaginoplasty is done as an outpatient procedure, so you are able to return home after surgery once you’ve been cleared to do so. You may feel drowsy or disoriented due to the anesthesia, so it’s important to arrange safe transportation.

Depending on your specific surgery, it may take one to two weeks of recovery time before you feel ready to return to your everyday activities. There may be some initial pain or aching, but these are temporary and usually only last for the first couple of days. You may also find it hard to urinate immediately after surgery as a result of swelling, muscle spasms and the effects of anesthesia. To give your body enough time to heal properly, you will need to refrain from tampon use, sexual intercourse and strenuous activity for a minimum of eight weeks following your procedure. Dr. Canter will provide you with detailed aftercare instructions to ensure a smooth recovery and check on your progress during scheduled follow-up appointments.

Just like with any surgery, there is always the risk of bleeding or infection or bleeding, but if you follow Dr. Canter’s post-operative care instructions carefully, your chances of experiencing complications are low. Dr. Canter wants your vaginoplasty experience to be as comfortable as possible from start to finish, and she encourages you to contact her if you notice uncomfortable sensations or discomfort after surgery, or if you have questions or concerns. Her goal is to ensure that your surgery is safe and successful, and restores function and feeling to your vagina.


Your vaginoplasty results will become apparent in the weeks following your surgery, once most of the swelling has resolved. When you’re fully healed, you’ll be able to see and feel the improvement in your vaginal health and function. Your vagina will be tighter and any problems such as discomfort, dryness or urinary incontinence should be eliminated.

While vaginoplasty results are considered long-lasting, the natural aging process can still cause some skin laxity or weakening of the vaginal muscles, but they won’t feel as lax as they did pre-surgery. This is simply a normal part of aging and most changes are so insignificant that you won’t even notice them. You’ll be able to enjoy a tighter vagina and the resolution of other symptoms of vaginal laxity for years to come.

If you want to prolong your results, you can incorporate pelvic floor exercises or strengthening techniques in your normal routine, and further enhance your vaginal health with nonsurgical treatments such as Viveve, Emsella or the O-shot.



If the loss of function or sexual health is having an adverse effect on your quality of life, surgical vaginoplasty may be the answer you’re looking for. To learn more about vaginoplasty, contact or call Urogynecology Center NoVa today at 703-293-5239.

The information about vaginoplasty was reviewed by Dr. Maria Canter. If you have any questions, please don’t hesitate to contact us using our contact form below.

Call Urogynecology Center NoVa today to schedule a consultation.