This is a frequently asked and a very relevant question from women thinking about vaginal rejuvenation. I recently presented two papers at the European Society for Sexual Medicine (ESSM) Annual Congress in Prague, Czech Republic – one on vaginal rejuvenation surgery, and the other on sexual dysfunction. Sure enough, at that ESSM Congress, there was a debate session concerning whether or not laser works for vaginal rejuvenation.
I would like to share with you my thoughts regarding this very question. My credentials comprise twenty-five plus years of experience in vaginal rejuvenation surgery, cosmetic surgery, and pelvic plastic and reconstructive surgery; also as a physicist involved in the development of energy-based medical and cosmetics devices – laser, ultrasound and microwave – resulting in multiple patents.
Colpoperineoplasty (colpo – vaginal; perineo – the external area between the vaginal opening and the anus) is the proper medical term for the popular term “vaginal rejuvenation.” The surgical procedure comprises tightening the internal vaginal canal and repairing the external perineum. However, over the last few years, device companies have been using energy modalities – laser and radiofrequency (RF, a form of electric current mostly) to perform “vaginal rejuvenation.” These are not surgical in nature, but rather use energy to heat up the tissue superficially to create temporary tissue contraction.
These treatments basically are repurposing the similar technology used in facial skin rejuvenation and tightening. Similarly, the key effects would be first, temporary, and second, superficial. Obviously, such effects might be acceptable or expected for facial skin rejuvenation, but in the context of vaginal tightening, such effects would not fulfill any expectations desired by women.
Actually, the FDA gave official warnings to the device companies promoting the use of those energy devices for vaginal rejuvenation as possibly making false claims. If one looks at the history of claim approval, the very popular laser “vaginal rejuvenation” was approved by FDA to use in post-menopausal women to improve the vaginal thinning and dryness when they cannot use the conventional estrogen treatments for such problems because of contraindications, such as breast cancer.
Using the CO2 laser, such as what is used on the face, the vaginal mucosa (skin) is ablated to allow regeneration of new mucosa to help with the dryness and thinning. The key effect is only “skin deep.” It is technically impossible to tighten the much deeper muscular and supporting fascial tissue to restore the vaginal tightness that only surgery can achieve. The same reasoning applies to the RF devices. The heat energy effect only penetrates to a few millimeter deep, not anywhere close to the structural tissue supports that need tightening.
I hope this explanation makes sense to women looking to tighten their vaginal looseness and the gaping vaginal opening. Those energy devices claiming vaginal rejuvenation will not achieve their expectations, even after several expensive treatment sessions. Unfortunately, I have seen too many of these disappointed women from all over the world coming to me to have the proper vaginal rejuvenation surgery after spending much money for those ineffective energy treatments.
I certainly understand the reluctance of many in having invasive surgery done under general anesthesia with the associated post-operative pain and disability. However, I have developed a vaginal rejuvenation surgery, leveraging my years of experience in pelvic plastic and reconstructive surgery and also cosmetic surgery, using minimally invasive techniques and only local anesthetics (numbing medicine). This procedure not only tightens the internal vaginal canal and the gaping vaginal opening back to the pre-babies state, the use of only local anesthetics (numbing medicine) enables faster recovery and less post-operative pain and disabilities. My presentation on this minimally invasive vaginal rejuvenation surgery under local anesthetics at the 2020 ESSM congress was well received. This is an option that one who has concerns over vaginal looseness might want to consider, even if it is a surgery. On the other hand, one should be hesitant and study and think over carefully before considering the energy device treatments for “vaginal rejuvenation.”
Michael Lau, MD
