Perineal lift – what to expect from the treatment?

Vaginal delivery, depending on its course, the baby’s birth weight, or its position, can have a varying impact on the anatomical and functional changes in the vaginal area.

During pregnancy, the female reproductive organs respond to hormonal changes, which soften the tissues and affect the tension of the perineal muscles. During childbirth, the ligaments stretch, and the muscles in the vaginal vestibule relax. The delivery process may also require a controlled episiotomy to prevent spontaneous tearing of the tissues in these areas.

All these factors contribute to the fact that the vagina, which is stretched during childbirth, usually does not return to its pre-delivery state. This, in turn, can lead to a number of functional disorders within a woman’s reproductive organs.

Among the postpartum defects in the perineal area, the most common are the weakening and stretching of the muscles surrounding the vaginal vestibule. This is often reported by patients as the sensation of a loose vaginal entrance, decreased satisfaction with sexual life, recurring infections, and inflammation caused by excessive discharge from the genital tract.

Furthermore, excessive muscle relaxation in the vaginal vestibule area may lead to difficulties in conceiving again. Additionally, patients complain about discomfort during physical activities, aesthetic concerns, and lack of satisfaction with their sexual life (a loose vaginal entrance negatively impacts any sensations). A method that effectively addresses these issues is perineal lifting using PDO threads.

The perineal lift procedure is preceded by a medical qualification based on the results of the conducted tests. Based on these results, the aesthetic medicine doctor diagnoses the degree of the issue and selects the appropriate technique for the procedure. The most common indications for performing a perineal lift include:

• Decreased satisfaction with sexual life for both partners

• The subjective feeling of muscle relaxation in the vaginal vestibule area and the associated discomfort in various aspects of life

• Recurring intimate infections

• Discomfort related to the appearance of external genitalia after childbirth (perception of the change as a cosmetic defect)

• Fertility problems (after excluding other potential causes)

• Dysfunctional vaginal issues

• A loosened vaginal entrance as a result of menopause, decreased collagen levels in the tissues, and their sagging

It’s important to note that the issue of an enlarged vaginal entrance is often associated with vaginal laxity syndrome, which, if left untreated, will worsen. In extreme cases, it can lead to uterine prolapse (descent of the pelvic organs). This condition is a consequence of insufficient support due to lack of tissue tension and relaxed muscles in the vagina, pelvic floor, and rectum. For more information on vaginal revitalization, which can also be performed at our clinic, please refer to the separate article.

Gynecologists are increasingly recommending that patients dealing with the relaxation of the vaginal vestibule muscles consult about potential treatments offered by aesthetic gynecology.

In certain cases, the only effective therapy may be surgical perineoplasty, which aims to restore the anatomical state from before childbirth by surgically lifting the connective tissue and muscles. In such cases, we are not only talking about a procedure that tightens the vaginal entrance, but rather a perineal reconstruction designed for women who do not plan to become pregnant again but wish to restore the aesthetics and functionality of their intimate areas.

A much less invasive alternative to surgical perineoplasty is vaginal lifting – vaginal tightening using threads, with various types of threads available to best suit the patient’s needs.

These threads have a revitalizing effect on the tissue, stimulating the production of collagen and elastin, which in turn helps stabilize the structures of the external genital organs. The threads are fully dissolvable and biocompatible. Made of polydioxanone (PDO), they are completely absorbable by the patient’s body. An additional component of the threads is the combination of polylactic acid and polycaprolactone, which moisturize and revitalize the tissues. They are safe and can be successfully used for vaginal vestibule reconstruction.

The vaginal tightening procedure using PDO threads is preceded by a gynecological examination and the submission of a cytology test result, which must have been performed no earlier than six months before the scheduled procedure date. Qualification for the procedure at the Anti-Aging INVICTA Clinic is included in the total cost of the treatment.

The procedure using PDO threads is performed under local anesthesia. The threads are applied submucosally and subcutaneously through 4 to 6 shallow micro-incisions in the subcutaneous tissue. The threads are anchored with hooks oriented in two directions. The procedure is completed by tying the threads.

The perineal lift procedure using PDO threads typically lasts between 45 minutes and one hour. Recovery time after the procedure is usually 2 to 3 weeks, during which small wounds heal, and any swelling reduces. The undeniable advantages of the vaginal tightening procedure using threads include its minimally invasive nature (compared to, for example, perineoplasty), faster healing, and shorter recovery time.

Among the few contraindications for performing the perineal lift with PDO threads are factors such as: cancer, acute inflammatory conditions of the vagina and vulva, allergies to anesthetic drugs, existing blood clotting disorders, pregnancy, early postpartum period, menstruation, or any undiagnosed vaginal bleeding.

As mentioned, vaginal lifting is not painful because it is performed under local anesthesia. Immediately after the procedure, the patient can go home. So, when will the results be visible? The effects of the perineal lift with threads can be seen after just one treatment. The vaginal vestibule area is revitalized, the vaginal entrance is visibly tightened, and there is an overall improvement in aesthetics. Over time, the threads dissolve, but the final tissue lifting remains even after they are absorbed, as they initiated a fibrosis reaction.

After the recovery period, patients notice an increase in sexual satisfaction, and unusual tension in the perineal muscles and the associated discomfort are reduced. Recurring infections lose their source, and the patient can enjoy a higher quality of life free from these troublesome conditions. The results of the procedure last for several years.