Mummy makeover – surgical and non-surgical methods to restore the quality of your sex life to its pre-childbirth state.
Contrary to many opinions that women encounter in Poland and around the world, they should not be treated as “baby-making machines.” A modern and conscious woman is not afraid to demand sexual fulfillment, which undoubtedly includes feeling her partner properly during intercourse and having an orgasm. Unfortunately, these feelings usually worsen after vaginal delivery. However, this doesn’t mean that it can’t be remedied..
For over a decade, a gynecological subspecialty called “aesthetic gynecology” or “cosmetogynecology” has been developing worldwide, including in Poland. Specialists in this field travel around the world, publishing scientific papers, and raising women’s awareness of the quality of their sexual lives both before and after childbirth. The most frequently reported problems after vaginal delivery include stress urinary incontinence, reduced or complete lack of sensation during intercourse, and decreased orgasms..
For the former, minimally invasive procedures such as laser therapy, radiofrequency (RF), or HIFU are the primary options. Of course, surgical procedures using foreign materials, such as suburethral slings, should not be forgotten, but these procedures should be reserved only for patients with severe urinary incontinence. For the largest group of women, which includes patients with mild to moderate urinary incontinence, non-surgical procedures should be the first-line treatment. Surgical treatment should be a last resort. Unfortunately, for women after multiple vaginal deliveries who sometimes experience spontaneous urine leakage even with minimal exertion, such as getting up from a chair, surgery is the only solution. In this article, however, I do not intend to focus on the ultimate solution to urinary incontinence, such as surgery, but solely on minimally invasive methods. These therapies also address another problem faced by women after vaginal births – wide vagina syndrome, which includes vaginal dilation and lowering of the perineum, resulting in the so-called “gaping vulva” symptom. Figuratively speaking, looking from the outside, the inside of the vagina can be seen without the use of a speculum. This condition is often very embarrassing for a woman who is, in a sense, “condemned” to this condition due to vaginal delivery. Minimally invasive procedures address this need. These procedures can be performed using a laser, a radiofrequency (RF) emitter, or high-intensity focused ultrasound (HIFU). All of these methods lead to a single goal – stimulating the body to regenerate by producing new collagen, elastin fibers, and blood vessels.
Technically, the laser effect is achieved by creating micro-damage in the skin or mucosa and generating a thermal effect. However, the laser beam’s penetration depth is very superficial, which also has the advantage of reducing the risk of deep damage. RF works through temperature. Heated tissue to 42-47 degrees Celsius triggers the described regenerative processes. It’s important to note that the treated tissue is not damaged in any way. The primary advantage of this method is the greater penetration depth of radio waves compared to lasers, meaning not only the vaginal mucosa but also the underlying muscle bundles are contracted. Due to the temperature range (max. 47 degrees Celsius), no protein denaturation occurs, meaning no structures are permanently damaged. In HIFU, focused ultrasound heats and, as it were, “cooks” the tissues deeper beneath the skin or mucosa. The depth of penetration is the greatest, but it is impossible to accurately assess (especially in the case of the folded surface of the vaginal mucosa) and may vary in different parts of the body undergoing treatment, which is a disadvantage of this method. Its undoubted advantage, however, is its high effectiveness and relatively long-lasting effect, as the tissue at the point of sound wave focus is permanently damaged.
Hyaluronic acid and platelet-rich plasma have different effects. These therapies have been crucial for improving the quality of life and sexual satisfaction of women for several years, especially those who have had a vaginal delivery..
The mechanism of action of hyaluronic acid involves binding water to the surface of its molecules. This reaction results in improved volume, i.e., the volume of the tissue injected with the acid. An additional effect achieved through this treatment is improved hydration due to the accumulation of water at the site of application. In corrective procedures involving the vaginal vestibule and labia majora, as well as scars in this area (e.g., after a perinatal episiotomy), the volumetric effect is primarily utilized. Injecting the acid under the vaginal mucosa, both effects are achieved: improved volume (vaginal narrowing, G-spot augmentation) and increased hydration. In the case of hydration, the density of the acid is less important, but when the main element of the treatment is restoring the firmness of the labia majora or enhancing the G-spot, it is the density of the acid that determines the final effect. The higher the density of the preparation, the more water molecules it can bind, and the more pronounced the increase in volume will be. The duration of the final results will also be longer (up to 1-1.5 years) depending on factors such as frequency of intercourse, cycling, or horseback riding. The greater the pressure on the treated area, the faster the degradation of the administered acid.
Autologous fat grafting is primarily aimed at improving volume. However, thanks to the presence of stem cells in the fat, it can also serve a regenerative function. Therefore, it is sometimes used to improve the volume of sunken (especially painful) scars following perinatal episiotomy. In this latter case, the application of highly fragmented adipose tissue, known as nanofat, is particularly beneficial.
Platelet-rich plasma (PRP) is a specially prepared whole blood product devoid of red blood cells. It contains numerous growth factors, which contribute to its regenerative properties. It is widely used not only in aesthetic medicine but also in dentistry, the treatment of musculoskeletal disorders, and difficult-to-heal wounds. It also has a wide range of applications in gynecology. Besides its purely aesthetic applications, such as increasing the firmness and nourishment of the vulvar skin, it plays a leading role in improving the sensation of sexual stimulation. O-shot (injection of the corpora cavernosa of the clitoris), P-shot (injection of the corpora cavernosa of the penis), and G-shot (injection of the anterior vaginal wall around the G-spot) are becoming increasingly popular worldwide. An additional positive effect observed by patients is improved vaginal lubrication. Thanks to its regenerative properties, PRP is also administered to patients after surgical procedures to improve wound healing, such as after perinatal episiotomy. Injecting the skin of the vulva, for example, the labia majora, can improve skin firmness. A vampire lift (of the vulva or vagina) can also be performed, which involves exposing the area to a laser beam and then “smearing” it with PRP. The skin/mucosa damaged by the laser “sucks in” the smeared plasma. These treatments result in tighter, more youthful-looking vulvar skin..
Surgical procedures designed to restore the vagina and perineum to their pre-partum state are a completely different matter. These procedures involve deeper tissue damage and, therefore, higher perioperative risks. However, such procedures are necessary for women whose postpartum changes are so severe that minimally invasive therapy will not provide any improvement, and only through physical restoration of the pre-partum vaginal dimensions can a woman achieve sexual satisfaction. Vaginoplasty and perineoplasty are such procedures.
In short, the procedure involves narrowing the vagina, “closing” its entrance, and “lifting” the perineum. The goal is to improve sensation during sexual intercourse, but not only that. After childbirth, often after several births, the vagina and the muscles surrounding it (the muscles of the rectovaginal fascia) relax and widen. Women complain of a feeling of looseness and a lack of sensation in their partner during intercourse. Furthermore, distressing symptoms of postpartum vaginal and perineal damage include frequent vaginal infections associated with the so-called “gaping vulva” (the vaginal entrance is open and the interior is visible), frequent abrasions, and discomfort in everyday life. However, the main problem is the sexual aspects, which significantly impair quality of life. Thanks to this procedure, a woman has the opportunity to regain lost sensations and enjoy satisfying intimate experiences..
Generally speaking, the procedures that fall under the term “Mummy makeover”, i.e. restoring the condition of intimate body parts changed after childbirth to their pre-childbirth state, constitute a certain process and are quite complex..
Thanks to aesthetic gynecology, pregnancy and vaginal delivery don’t have to be a limitation for women. Currently available treatment methods are very effective and allow women who choose vaginal delivery to make informed decisions..
