Frequently Asked Questions

The term Aesthetic Vaginal Surgery is also known by other names such as Vaginal Rejuvenation, Laser Vaginal Rejuvenation, Labiaplasty, Vaginoplasty, Designer Laser Vaginoplasty, Perineoplasty, and Hymenoplasty. Aesthetic Vaginal Surgery is a broad term that includes any one of these individual procedures. Since it is a rather new field dealing with the appearance and function of a woman’s private parts, the terminology has not been standardized. In simple terms, Aesthetic Vaginal Surgery and its many names deal with cosmetic surgery of the vulvar and/or vaginal region. It is cosmetic surgery for one’s “Private Parts.”

Surgery to improve the appearance and function of a woman’s vagina is important for both personal esteem and physiologic function. Childbirth is often traumatic resulting in tears that when healed are not personally satisfying. Far too often, women suffer from vaginal prolapses or “hernias”, urinary incontinence, vaginal laxity, and aesthetically unappealing labia after experiencing both complicated and uncomplicated vaginal deliveries. Many who have finished their childbearing years are now concerned about their personal appearance and are looking for ways to deal with this problem. Some feel that they have lost a great deal of sexual sensation due to “looseness” of the vagina.
Gynecologists, urogynecologists, plastic surgeons, and even some dermatologists do most of these types of surgeries. Gynecologists are trained specifically in repair of fallen bladders and rectums, fallen uteri or vaginas, and repairing tears in the vaginal region as part of their everyday work. Urogynecologists usually are highly sub-specialized and focus primarily on the worst incontinence and pelvic organ prolapses encountered. Plastic surgeons are generally trained in cosmetic surgery on men and women and very few are trained in vaginal surgery. Some plastic surgeons are highly trained in totally reconstructing new vaginas in transsexuals, transvestites, and pelvic cancer patients. However simply by their vast amount of training and experience, gynecologists and urogynecologists are best equipped to perform these specialized surgeries in my opinion.

Final cosmetic results cannot be determined unit 3 to 6 months pass. However at your 6 week postoperative appointment, the stitches are usually dissolved and restrictions are fully lifted.

I would prefer to see the patient one time prior to surgery. During this visit, everything would be completed in preparation for the day of surgery. If this is not ideal or possible, a phone consultation can be scheduled. If the patient decides to pursue having surgery, she would arrive the day before surgery and be seen in the office to take care of everything needed prior to surgery. The patient would need to stay locally for 24 hours after surgery before heading home. Postoperative visits can be in person or completed over the phone based on patient preference.

This darkened skin, attributed to hormone changes, genetics, and certain activities, can be addressed surgically or in the office with treatments along with home maintenance.

Ultimately, each patient and circumstance is unique and requires an individualized assessment and plan. However due to hormone changes during pregnancy and the traumatic nature of vaginal deliveries, you may increase the likelihood of wanting a labial revision down the road if you get pregnant after having a labiaplasty.

The laser is an important surgical tool that has many advantages. Certain lasers are very precise and are used as scalpels. Some lasers are ablative (destructive) and used more to destroy abnormal tissue or to resurface the skin. Many dermatologist and plastic surgeons use this type of laser. However, there is no magic in the use of lasers. In fact, other modalities such as radiofrequency cautery units can give more precise cuts and less tissue destruction by a factor of ten or more. Other surgeons will avoid electrical units altogether and use highly precise scissors or scalpel units. Another way to look at lasers is to realize that it is a tool in the doctor’s bag but that it is not ultimately any better than a cold knife. However, it is undeniable that using the term “laser” adds glamour and a sense of prestige to a procedure.

Almost all of the cosmetic surgeries are outpatient. Labiaplasty and vaginoplasty cases are typically finished within an hour or two. If a repair of the bladder, rectum or bowel is needed, then a 23 hour overnight stay may be warranted. If a hysterectomy is needed, then it is typical to stay one to two days. Many patients feel the pain involved is similar to the discomfort AFTER a baby has been born. They are somewhat sore but not in agony. Pain control is excellent in the large majority of cases.

The term labiaplasty is a general term referring to either a labia minoraplasty or a labia majoraplasty. Labia minoraplasty is the cosmetic reshaping of the inner folds of tissue, called the labia minora, or smaller inner lips of the vagina. Labia majoraplasty is the cosmetic reduction of the broader, outer lips of the vulva known as the labia majora. Various instruments are used such as pinpoint cautery, Yag lasers, fine scissors, or a knife. The edges are then sewn together with delicate absorbable sutures. A vaginoplasty (commonly referred to as surgical vaginal rejuvenation) is when a diamond shaped section of tissue is excised from the inside of the vagina and brought down to the outside of the vagina. Often times a small triangular area is also excised from the perineum (the area right below the vaginal opening). This is called a perineoplasty or perineorrhaphy. If needed, sutures that bundle loose muscles together are used to narrow the vaginal opening. At the very end of the procedure, a radiofrequency unit may be used to smooth out any skin irregularities and further tighten the vaginal opening. This also provides for growth of new, softer, smoother, and tighter skin just as it would when used on a face.

Surgery can trim either excessively large labia minora or those that are asymmetric. It can also reduce enlarged, bulging, or sagging labia majora. The excess bulge of skin in the vagina can be trimmed, and the vaginal entrance may be tightened to one’s satisfaction. The entire vagina can be made tighter by excising loose vaginal skin. Surgery alone will not improve the tone of your vaginal muscles. You need pelvic floor exercising similar to Kegel’s exercises. Surgery can also add support to your fallen bladder, rectum, bowel, or vagina. In some cases, radiofrequency devices are used to smooth out wrinkled vaginal skin. This is performed in order to make it look new and young again. Many women tell us that they once again are happy to be able to wear jeans, bathing suits, and form-fitting outfits simply because the rubbing and irritation have disappeared.

A vaginoplasty is usually done in a surgery center under general anesthesia. All other cosmetic vaginal surgery is typically  performed in the office under oral, topical, and local anesthesia. We tailor the surgery to the patient’s projected pain tolerance, anxiety level, and health status.

General anesthesia, IV anesthesia (“twilight”), and local anesthesia are all used depending on where the surgery is performed, the individual’s anxiety level, and the complexity of surgery.

A patient interested in aesthetic vaginal surgery usually calls to set up an initial appointment for evaluation. If at the time of evaluation the patient and physician agree that surgery is the correct choice, then a surgical date is finalized. The patient may also be asked to get surgical clearance prior to surgery. The patient is then seen one week before surgery to go over all the details of surgery and obtain informed consent. Laboratory work may also be needed in certain situations. The majority of the time a simple blood count is all that is needed.

Dr. Thomas has many years of experience and has undergone special training in aesthetic vaginal surgery. In fact, Dr. Thomas is one of the only surgeons in Texas who has been trained by Dr. Red Alinsod and is a fellow of the Alinsod Institute of Aesthetic Vaginal Surgery (FAIAVS). He has concentrated his skills in the art of aesthetically pleasing vulvovaginal cosmetic surgery. Furthermore, Dr. Thomas is always in the forefront of his field and travels regularly to meet, discuss, and train with other prominent physicians in order to better serve his patients. Dr. Thomas truly cares for his patients, and it is this commitment to service that drives his entire team.

Fortunately, serious risks of aesthetic vulvovaginal surgery are quite rare and seen in less than 1% of cases. Anesthesia is a risk factor because of the very rare possibility of a reaction to either the injected medication or inhaled agents. You can also aspirate food or fluid that can obstruct your breathing tube or even cause a pneumonia. There is risk of infection at the surgical site. There is also a possibility of bleeding or hemorrhage and a need to have a transfusion. With transfusions, there is risk of HIV, Hepatitis, and perhaps other unknown viruses. There is even the risk of death. A risk you should also consider is one similar to “buyer’s remorse” when one is not fully happy with the result of surgery. The risk of having the surgery redone or amended is present but fortunately is very rare. We will fully review the risks of surgery before the case is even scheduled and give you every opportunity to have your questions answered.

We advise “Pelvic Rest” for six to eight weeks. This means nothing goes inside the vagina, such as tampons or vibrators, and no sexual intercourse for that length of time. The only thing allowed in the vagina is the applicator full of estrogen cream we give you to aid in the healing process. We also recommend loose clothing and no tight underwear, thongs, or jeans that may cause rubbing and discomfort. We advise against lifting objects heavier than a six-pack of Cokes or a gallon of milk. We also advise against participating in activities that can cause you to strain or bear down. We do not want tension on our suture line nor do we want to stretch tissues we have just tightened. Basically, treat yourself like a princess during this healing phase.

If you had a labiaplasty or vaginoplasty, you can return to light duty at work or reduced activity within 3-5 days. If you had both a labiaplasty and vaginoplasty, then it may take you a whole week before you feel comfortable to go back to work. Much depends on the type of work you do. For example, a woman who has a desk job will return to work sooner than one who has to walk or run and carry objects from place to place. We will need to individualize your return to work date. In any event, you are usually healed by six to eight weeks although complete healing takes up to three months.

We recommend that you wait six to eight weeks before resuming sexual intercourse. However, intercourse is not recommended until cleared by the surgeon.  If you had a vaginoplasty, it is also recommended that some stretching exercises of the surgical site start at six weeks to soften any scarring that may occur and to make the sexual experience more comfortable after surgery. This stretching exercise is not needed if you had a labiaplasty alone.

Undergoing either a labia minoraplasty or a labia majoraplasty takes approximately 1 to 1.5 hours. However, combination procedures do add time to the case.

Most of these surgeries can be performed in the privacy of my office. A combination of oral, topical, and local anesthetics are utilized along with Pro-Nox analgesia. Most patients prefer the office setting for surgery compared to a surgical center due to the following reasons….privacy, efficiency, discretion, cost savings, and rapid recovery from anesthesia.  Vaginoplasties are performed in an outpatient surgery center under general anesthesia.

The simple answer is neither one! Plastic surgeons typically focus the majority of their practice and time on common procedures like breast augmentations, face lifts, liposuction, and abdominoplasties. Ob/Gyns, although much better trained and possess a vast experience with female genitalia, have minimal if any specialized training in the art of aesthetic (cosmetic) vulvovaginal surgery. Aesthetic (cosmetic) gynecologic surgery is ideally performed by a board certified gynecologist with extensive specialized training in aesthetic vulvovaginal surgery.

First and foremost, you should verify credentials. Make sure the surgeon is board certified in his/her respective specialty. Next, confirm specialty training in aesthetic vulvovaginal surgery. Review before and after photos. Consider the amount of experience amassed.

Common complaints include the following….labial discomfort/pain when wearing certain clothing or working out; interference with activities such as intercourse, inserting a tampon, urinating, cycling, and horseback riding; or simply the dislike of a bulge (camel toe) seen when wearing tight clothes. For some women, elongated, hyper-pigmented, or asymmetric labia cause embarrassment and may even interfere with intimate relationships. Many patients simply do not like the appearance of their labia and request a subtle sculpting.

Yes. A scar is formed with any invasive (an incision is made) surgery. Most scars associated with labiaplasty tend to be small and heal quite well. Most often they are not even noticeable if the patient complies with postoperative instructions and allows the surgical site time to fully heal.

There are many sites on the Internet that address the topic of sexual gratification and surgeries that may enhance this experience. In summary, there is an opinion that aging and the trauma of childbirth results in looseness of vaginal tissue, weakening of vaginal muscles, and resultant decrease in friction, hence, decreased sexual gratification for both men and women. Unfortunately, this topic is much more complex than simply tightening a vagina to increase frictional forces for both sexes. Surgery can indeed result in tightening of the vagina, but there is no guarantee that your sex life will be better or that your orgasms will be more pronounced. You must weigh carefully the claims of an improved sexual experience. Sexual response is multifactorial and it is often the case that a person’s personal relationship with his or her partner is the primary determining factor in the happiness of an intimate relationship. Surgery is no panacea but it certainly can improve appearances and increase friction involved. A positive body image is priceless. One more thing, surgery does not affect a woman’s ability to become aroused or her ability to become moist prior to having intercourse.

If you had a labiaplasty, there will probably be a dramatic decrease in the interference of tissue that will be felt by both you and your partner. If you had a vaginoplasty or vaginal rejuvenation, there will be increased frictional forces that both partners will feel. You may need to perform some stretching exercises of your vagina after surgery to allow comfortable intercourse. This is even more important if your partner is large in size.

Yes. I work with highly respected Aesthetic Plastic Surgeons who are able to perform anything from liposuction, tummy tucks, to breast implants or facial reconstruction. Those names can be provided upon request. Your whole “mommy makeover” can be achieved at one time!

Aesthetic Vaginal Surgery is not covered by health plans since it is cosmetic in nature.

There is a $200 fee for the initial consultation charged at the time of booking. During this initial consultation, we will discuss the risks/benefits/options of surgery, do an examination, discuss costs, and give you every chance to ask questions that are vital to you.

Each procedure varies in cost depending on the length of surgery and difficulty involved. If having a vaginoplasty, a perineoplasty is included. Any subsequent procedures are discounted 50%. The listed price is ALL-INCLUSIVE of the facility fee, the surgeon fee, the anesthesia fee, photo documentation, preoperative visits, and postoperative visits if performed in the office. If you request or need to have the procedure performed in a surgery center, then an estimate will be provided at the time of consultation.


YES we do. We have financing programs available, and the application process is quite easy. In fact, you can apply right on our website and get an answer within minutes!