What A Cosmetic Gynecologist Wants You To Know About Your Vag After Childbirth

It’s no secret that pregnancy causes changes to the body (and if it is a secret, glad you’re here, and get ready for some eye-opening truths). Many moms worry about whether or not their figure will #snapback to their pre-baby shape. Typically, OB-GYNs advise new moms to wait six weeks before any moderate exercise. But, what about the vagina? After that six-week-wait, will it, too, snap back to pre-baby vigor and beauty after giving birth?

Golden Girl Betty White once joked: “If you want to be real tough, you should grow a vagina. Those things can take a pounding.” That’s particularly true of the V during a vaginal delivery, during which it accordions to give way to a bowling ball bouncing baby.

But even the tough-as-nails vagina has its breaking point. For instance, the 3- to 4-inch long organ can, on the outside, suffer vaginal tears during labor. And, unbeknownst to new moms, problems can arise weeks after delivery day. 

“It’s not even about the tear ,” says Dr. Amir Marashi, an OB-GYN, cosmetic gynecologist, and author of A Woman’s Right to Pleasure. “A lot of people get scared like, ‘Oh my god! I got, like, a first-degree tear.'”

“Of course, it’s worse when you get a third or fourth-degree tear,” but muscles that comprise the pelvic floor, he says, are an even bigger concern. Before specializing in cosmetic gynecology, Marashi says he delivered lots of babies and often saw how unkind childbirth could be on the vagina. Because of that, he would take extra time and care to stitch women up post-delivery. His colleagues dubbed him “Vagilangelo,” and “The Vagina Whisperer.” 

“The muscle around the vagina, the most important part, is sitting between the vagina and rectum, and another part is sitting between the vagina and bladder,” says Marashi. “So, in a normal vagina, before having kids, these muscles separate the rectum from the vagina and separate the bladder from the vagina. Now, imagine you’re in labor for two to three hours. At the end of the labor, your baby’s head is literally sitting inside the vagina, stretching all these muscles.”

Will It Snap Back?

“What happens when you stretch a rubber band and let go? It goes back to normal. But imagine for five hours, you’re holding this rubber band, stretched. When you let go, it never goes back to the normal shape,” says Marashi. “Now, as your rubber band gets older, you’ll see little cracks on it, too. The same thing happens to us and the vagina.” Actually, it’s kind of like Mick Jagger’s face. The moves are still there—just with a little extra skin flapping in the wind.

“As you get older, you lose collagen and the muscle that stretched and the microtears—even if you don’t get the tear—there are microtears inside this muscle.” The loss of tone and strength can be moderate and subtle for some women, says Marashi. In others, having one or multiple children can have a life-altering ripple effect.

How Will It Look?

Pre-baby, your lady parts may look like a cute little smooch. But afterwards, you might be looking more like an influencer who’s gone without their lip injections for too long. That’s normal, so don’t freak out. The exterior vagina can take on a different size and shape postpartum, too. “Patients tell me that the outside looks not as pleasing as it was before because it’s stretched out.” The vaginal opening can be wider, and the labia minora (or the tinier lips) can be elongated, while the labia majora, the fattier outer lips, can wrinkle. Marashi and other cosmetic OB-GYNs specialize in doing a face-lift of sorts down there, but more on that later. But in extreme cases, women can be diagnosed with cystocele, or the bladder’s prolapse into the vaginal canal, or rectocele, the bulging of the rectum into the vagina. Either prolapse can be so severe that the resulting bulge can hang outside of the vaginal opening. In that case, Marashi says he will perform a pelvic floor reconstruction to put the goods back in place.

How Could Your Sex Life Be Impacted?

Many of Marashi’s patients are mamas who complain their lady parts are looser postpartum, and that sex with their partners doesn’t bring them to orgasm. (While there can be many causes for lack of sex drive, if you’d rather do a crossword puzzle, or it’s been a while since you’ve done the deed with your partner, you might want to get that checked out.)

As the pelvic wall thins, the perineum—or the area between the vaginal opening and the anus—becomes shorter. The vagina, which naturally slopes downward, now flattens and becomes like throwing a hotdog down a hallway tunnel-like. “Now, the entrance of the vagina is lower,” says Marashi. In vagninal sex, an erect penis rubs against the nerve-ending rich top wall, home of the elusive G-spot.

But in a vagina that has lost its tone, getting it on can be a bore, no matter what type of sex you’re having. When that happens, “you don’t feel sex and internal orgasms as much as you used to feel it,” says Marashi. “ still tell me that the clitoris gets stimulated, but sometimes, after two or three kids, that they don’t feel anything. There’s not as much friction.”

To Fix?…

Marashi says he has three popular procedures mamas can choose from to get their mojo back and look like a blossoming Georgia O’Keeffe painting. His most popular request, he says, is a vaginoplasty, a veritable face-lift for the lady garden. The hourlong surgery, which carries a $7,000 price tag, is the most invasive of the three and involves deep muscular cutting and stitching. Patients can’t have sex for six weeks afterward while the surgery site heals. There’s also a $3,500 outpatient procedure he calls the Vagilangelo, which involves a few sutures and the injection of platelet-rich plasma, or PRP, directly into the vaginal tissue. There is also less invasive and nonsurgical laser resurfacing ($1,000 per session). For moms who lost volume in their labia majora, Marashi says he can inject a patient’s own fat—often while joining fellow plastic surgeons on a mommy makeover procedure—into the area to plump it back up. 

…Or Not To Fix

If a woman’s postpartum vagina looks and feels different, it doesn’t necessarily warrant a trip to an OB-GYN—unless, of course, the changes interfere with her quality of life. “Your vagina will look different, anatomically, no question about it, but it’s not wrong for the vagina to be looser,” says Marashi. A woman’s sex partner should also be supportive of the change, but if that comes with difficulty, there’s sex therapy, trying different positions, and sex toys to bring back the spice. And for those moms who want things tighter but don’t want to go under the knife, Marashi has a simple prescription: Kegels, and lots of them. “I actually want to start while pregnant and continue. I tell them 20 times, three to four sets. If you can hold a kegel for seven to 10 seconds, that’s really good,” says Marashi. “But I don’t really care how long they can hold it. With time, it’s going to get better.”

Images: Ava SolUnsplash

What Is Labiaplasty, And Why Are Women Getting It?

I’ve got a fine relationship with my vagina. To be honest, before this article I had not given it much thought. It’s there, it does what it needs to do, and I carry on with my life. But for some women, how their vulva looks and feels causes them major stress. That’s where labiaplasty comes in. For some people, when they hear about a labiaplasty, they think (logically) “okay, yeah, plastic surgery for your labia.” For others, when they hear it, their first reaction is “WTF.” But whether you’ve heard about a labiaplasty before or not, I’m sure you have some questions and probably some misconceptions that I plan to debunk. But let’s get one thing straight: labiaplasty is NOT a millennial-geared surgery to promote altering your body for purely aesthetic reasons to look like a Victoria’s Secret Model or porn star. It can be done for aesthetic purposes, but there are also legit medical reasons for this.

I Spoke To An Expert

For this taboo and rarely-spoken-about topic, I called in the big guns, Dr. Lara Devgan. She is ranked as the #1 female cosmetic surgeon in New York on Rate MDs, and tbh, that’s good enough for me. But, according to her website, she is also a “board-certified, Yale-educated, Johns Hopkins Medical School-instructed, and Columbia/ New York Presbyterian Hospital-trained plastic & reconstructive surgeon.” Dr. Devgan is everything my Jewish parents wished I’d grown up to be, but here I am, writing about vaginas on the internet. Sorry, mom and dad. Did I mention she’s Kim K’s plastic surgeon?

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#tbt to glowy skin with queen Kim ???— 2 days after medical-grade microneedling and the entire @devganscientificbeauty line: Platinum Hyaluronic Serum, Platinum Glow Serum, Platinum Vitamin C+, Platinum Recovery Cream, Platinum SPF 45 Daily Tinted BB Cream, Platinum Revitalizing Cleanser, and Platinum Microdermabrasion Scrub. Add sequins to taste! ✨✨✨??? #drdevgan #scientificbeauty #kimkardashian #skincaregoals . . To see me as a patient in my New York City private practice, please contact my office. . ☎️ 212-452-2400 ? [email protected] ? www.LaraDevganMD.com ? Skincare shop (worldwide shipping): www.LaraDevganMD.com/shop ? New York City, New York, USA . ? Snapchat: nyplasticsurg ? Twitter: LaraDevganMD ? Facebook: LaraDevganMD . This is my actual patient. Individual results may vary. Images © Lara Devgan, MD, MPH, FACS. Please do not use or distribute images herein without written permission. #plasticsurgery #plasticsurgeon #beforeandafter #nyc #cosmeticsurgery #beauty #transformation

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WTF Is Labiaplasty?

Dr. Devgan explains labiaplasty as “cosmetic rejuvenation of the female genitalia.” Put simply (thanks Google), a labiaplasty is “plastic surgery performed to alter the appearance of the labia, typically the labia minora, or to construct labia.” So at this point in your life, if you don’t know the difference between your labia minora and labia majora, we’ve got an issue. Go back to health class, then come back to this article. Just kidding! I’ll tell you. The labia minora are the inner lips, and the majora are the outer lips.

Why Would Someone Do This?

Dr. Devgan explains that this surgery is performed for functional and/or cosmetic reasons. Many women who opt for this surgery are either unhappy and self-conscious about how their genitals look or they experience friction or discomfort from exercise, clothing, or sex. Furthermore, the excess tissue that may hang below the rest of the vulva can mess with the vagina’s normal flora and cause frequent yeast infections. Dr. Devgan says that this is one of the fastest growing plastic surgery procedures in the US and one of the more common surgeries she performs.

How Does The Surgery Work?

Because every woman is different, it really depends on the individual needs of the patient. Dr. Devgan explains that “the exact maneuvers we do in surgery depends on a woman and her unique anatomic characteristics and concerns.” However, most surgery is performed under local anesthetic (you are awake and your vajayjay is just numbed) and takes about 30 to 45 minutes. For some in-depth diagrams to explain the surgery, check out Dr. Devgan’s website.

The Recovery Time

Labiaplasty tends to be minimally painful—think less than painful than watching Colton confess his love for Cassie and her leave. But don’t worry, the doc still gives her patients pain meds just in case. Dr. Devgan says that most of her patients take 4 to 7 days off work, although she has had women go back to work the next day. She recommends taking the first 3 days to ice the area with pelvic elevation. Dr. Devgan recommends no sex, tampons, or strenuous activities for at least 6 weeks. The scars are v minimal and usually disappear to be almost invisible, to the point where your gyno or SO won’t notice them.

How Will It Impact Your Life

For women who have lived their lives feeling self-conscious of how they look, it can be a life-changing surgery. Dr. Devgan says, “patient satisfaction for this procedure is extremely high.” For Dr. Devgan, it is “one of the most gratifying procedures” and she commonly hears, “wow, I should have done this sooner” from her patients. Patients can wear jeans and won’t be uncomfortable or feel that they constantly need to re-adjust themselves. They can wear bathing suits without feeling embarrassed that someone can see their labia. Dr. Devgan explains that it will not interfere with giving birth vaginally in the future, with orgasms, arousal, or using the restroom. But it can make sex more comfortable and enjoyable.

The Bottom Line

As Dr. Devgan said, a labiaplasty is not a “sexy surgery” nor is it a “porn surgery.” In fact, a small study published in 2016 found that women who had undergone labiaplasty were just as likely to have done so for improved appearance and sexual performance as they were for “practical” reasons, like physical discomfort. (But honestly, who’s to say that wanting to feel more secure about your appearance isn’t practical?) This surgery might seem weird to talk about, but it shouldn’t be. Let’s be real, if men had a similar issue, it would not be such a taboo topic. Dr. Devgan says, “if some meaningful percentage of the male population had an issue where skin on their testicles was impeding on their abilities to conduct their normal lives, it would be a front and center topic that was totally acceptable and totally covered.” The bottom line is, if you’re considering getting labiaplasty, you shouldn’t be ashamed to talk about it with a trusted surgeon. And if you’re perfectly happy with your lady parts and don’t want to change it, that’s great too.

For any further questions, Dr. Devgan’s website provides a ton of information and before and after pictures (which are honestly so impressive). And you can follow her on Instagram at @laradevganmd.

Images: Andre Maliik / Unsplash; laradevganmd / Instagram; Giphy (2)