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Vaginal Rejuvenation: Dr. Litrel’s Top 10 Questions Answered

Dr. Litrel RealSelf.com photo

Vaginal rejuvenation questions are answered by Dr. Michael Litrel of Cherokee Women’s Health. Dr. Litrel believes the best patients are well-informed so here are 10 recent questions he answered on RealSelf.com about vaginal health.


If you’re considering vaginoplasty, labiaplasty, or other pelvic surgeries, you want a board-certified surgeon with the experience and expertise to provide you with the results you desire.

Dr. Michael Litrel is a board-certified OB/GYN, and he also has a board certification in Female Pelvic Medicine and Reproductive Surgery (FPMRS), which means he understands the toll childbirth and aging can take a woman’s body — and how to best restore vaginal health.

1. I am very insecure about my vagina and the color of it. Is it normal? I’m afraid to have sex.

Your appearance is perfectly normal and does not have any issues that require intervention from a cosmetic surgeon. Your insecurity is normal as well to some degree.  Everyone has some fear about social rejection, the feeling that others will not like or love us. This is really a spiritual issue, learning to love ourselves and love others, growing daily in our abilities in this arena. This is what makes life meaningful and fulfills our purpose in life: love.

When it comes to sexuality — the sharing of our bodies with another in a pleasurable and intimate manner — the insecurity that one can feel can prevent us from extending ourselves in this way. This is painful because sex, intimacy, and pleasure are so important to enjoy life.

But as a doctor who specializes solely in the care of woman, the common problem that women experience is not that they can’t find sexual partners, but rather that they choose the wrong sexual partner. Or, too many. For men, in many and most cases, sex is the end. Sex and orgasm itself is the goal.

Women like sex and orgasm, too. But for women, sex is really the beginning — the beginning of a powerful and important relationship — and the beginning of New Life (pregnancy). This is why so often women are broken hearted by the way they are treated by men. Men get sex, and eventually leave for someone else.

Thus, it’s important for women to choose a partner who is committed to not just his own orgasm and his own pleasure, but one who is committed to you and the future of the relationship that, God willing, may some day include children.

Bottom line is this: If insecurity about the appearance of your genitals is holding you back from sex — when you find the partner who is not just attractive physically but spiritually as well — one who will be committed to you and the future, that person will love you so you will not be so afraid.

So, it’s okay to wait to have sex and indeed it’s usually better. It builds a better long term relationship. When a woman waits to have sex, not only does the guy think she’s special, he also thinks he’s special. And thus, the relationship becomes special.

2. Is there any way to make my vagina look new again?

Women sacrifice a lot. Pregnancy and delivery is difficult enough, as is raising children. But the changes to a woman’s body are just another painful thing women must confront. There are office procedures and surgeries that can help you with both sexual function and the appearance of your genitalia. As far as specifics are concerned, that is something that is tailored to the desire and anatomy of each patient.

Learn more! Download our FREE Vaginal Rejuvenation eBook.

3. I’m suffering from some mild incontinence and loss of muscle tone in my vagina. Does the Apex M pelvic floor exerciser work?

There are three good things about the apex devices:

  1. They can help improve the muscle tone on your pelvic floor and can help with incontinence. 
  2. They are done in the privacy of your own home.
  3. They are safe and won’t hurt you. It’s reasonable to try this before surgery. It’s reasonable to use this afterwards as well.

4. Can any board-certified surgeon do perform labiaplasty?

I would strongly advise you to wait until you find a specialist surgeon who focuses on labiaplasty. This can be a cosmetic gynecologist or a plastic surgeon. But don’t see someone who does not do a lot of these surgeries. Board-certification is about education and passing examinations. But the key is experience and skill rather than diplomas on the walls and initials after your name.

5. Vaginoplasty: Can vaginoplasty be personalized based on the size of my husband? Do all “holes” end up the same after vaginoplasty regardless of requests?

Your surgery should be tailored to the size of your husband. Sexual issues are usually top-of-mind for women considering vaginoplasty. Thus, your experience with your sexual partner is an essential part of the interview, the examination, and the performance of the surgery.

6. I recently had vaginal tightening surgery. Is it normal to have a lot of pain afterward?

Everyone responds to the pain of surgery in a different way. Our bodies are different. It’s important to get an examination by your surgeon to make sure that there are not issues. But assuming a normal exam, be assured that everyone will have a different response. Typically, by seven to fourteen days patients feel alright. If the pain continues, pelvic floor physical therapy can help. Muscle relaxers can also help if the examination demonstrates tenderness on your pelvic muscles.

7. Would a perineoplasty help with some feelings during sex?

The quick answer is that it will help — some. Your question shows a sophisticated knowledge of your body and the problems you are having. Pelvic reconstruction is likely required, along with vaginoplasty, to give you the tightness you desire and to correct the anatomic deformities and changes you eloquently describe. There are non-surgical modalities such as ThermiVa that can help. But that may be a waste. It will depend upon your anatomy and the findings on your physical examination. Good luck!


8. Can I enjoy sex after my clitoris is removed?

This should not be done for any reason other than the rare presence of cancer. In some parts of the world there is “female circumcision”, where young girls suffer genital mutilation. This is cultural and often the clitoris is not injured in the process. If you are considering a procedure, make sure you understand what is being done and why.

9. Is a partial labiaplasty possible?

This is a good question. The truth is that every labiaplasty has to be tailored to a patient’s anatomy and also her desire. So really, you should just receive what it is that you desire rather than a “one-size-fits-all.” Likely, you have excess skin adjacent to your clitoral hood or the hood itself is more pronounced than you desire. This is a common problem that can be handled during an office procedure.

10. What are the adverse effects from an overly aggressive labiaplasty?

The labia minora come in all sizes and shapes. Our bodies differ. Consider how noses and ears are different sizes and shapes. The main thing that troubles patients with a “botched labiaplasty” is emotionally upset with appearance. This can cause issues with sex because if we are not comfortable with how we look, then it is more difficult to be intimate with another. There are less common instances when an over-aggressive labiaplasty can cause pain with sex but I would not worry about this. The most important things for sexuality to go well is to be in a loving relationship. This is a loving relationship with another — and also with yourself.

Were your questions among the ones Dr. Litrel answered here? If not, let us know! Request an appointment online or call us at 770.721.6060.

And, you can always check Dr. Litrel’s RealSelf profile where he answers questions about several types of vaginal reconstructive surgery and female pelvic health.