Laser Vaginal Rejuvenation
The Surgical Art of Looking Good and Feeling Better
Vaginal Relaxation - what is it?
Vaginal relaxation refers to the stretching of the pelvic floor supports (connective tissue, ligaments and muscles) that takes place as a result of time, ageing, childbirth, genetics, lifestyle etc). Pregnancy and more importantly labour and vaginal delivery are the factors most often associated with the loss of sensation and damage to the female pelvic floor. It not only results in changes in sensation during intercourse but may have an adverse impact on urinary and lower bowel function (urinary incontinence and problems with emptying the bowels).
Many women suffer from their symptoms for many years before seeking help because the symptoms are often embarrassing and because there is a lack of information and discussion about the issues in a more public forum. Often, when women find the courage to seek help from doctors (male and female) they are often met with either a lack of interest or the attitude that it is 'all part of being a woman.' Such changes to function are, in Dr Onuma's views, about as normal or acceptable as an unresolved toothache, but he continues to see a large number of women who have been put off seeking help after their first attempts have been disparaged.
Different parts of the vagina can be affected to different degrees and each individual woman will have unique functional problems as a result such as lack of sensation during sex, the feeling that there is an obstruction within the vagina, stress urinary incontinence and difficulty passing motions (faecal trapping).
Vaginal relaxation can occur in the absence of significant pelvic organ (vagina, cervix, uterus) prolapse, but often both are seen to co-exist.
(*please refer to the section on ‘Female Pelvic Organ Prolapse')
For all practical purposes, definitive treatment is surgical correction of the specific defects.
Laser Vaginal Rejuvenation is a surgical approach to improve vaginal and pelvic floor function. The concept of female pelvic floor medicine has been one that has been steadily developing and is often multidisciplinary. Depending on the pelvic floor problem, any individual patient might benefit from the imput of a gynaecological pelvic reconstrutive surgeon, a colorectal surgeon, urologist, pelvic floor physiotherapist, an expert on female hormone and psychological function. There is still much to learn about female pelvic floor function and as we do, the likelihood is that certain aspects of these individual disciplines will work more cohesively for the benefit of women.
Laser Vaginal Rejuvenation for the enhancement of sexual function is reserved specifically for those women who complain that as a result of diminished vaginal sensation (due to vaginal wall relaxation) their enjoyment of sexual intercourse has been dimiinished. It can also be of significant value in women who, as a result of vaginal wall scarring (e.g. result of tears or episiotomy during childbirth or previous vaginal surgery) suffer from pain during intercourse or an overtight vagina where intromission has become painful or impossible. LVR is unsuitable and unhelpful for women who have lost their libido (perhaps as a result of stress, depression, relationshiop dysfunction or are simply '"too tired" because they have responsibilities such as childcare). Women who have lost their libido need to seek appropriate assistance in resolving the lifestyle or medical issues that have caused their problem. Dr Onuma will not operate on women who he feels willl not benefit from surgery and this reflects the ethos of associates of the Laser Vaginal Rejuvenation Institute worldwide.
Where the cause of sexual dysfunction has a physical basis such as urinary incontinence, pelvic organ prolapse, vaginal relaxation resulting in diminished sensation, scarring of the vaginal walls from previous childbirth or surgery and labial entrapment during intercourse, surgical correction of the defect may result in significantly improved sexual function and enhancement of sexual gratification.
Laser Vaginal Rejuvenation &/or Designer Laser Vaginoplasty simultaneously combined with incontinence ± prolapse surgery will be, for many women, the key to living life and not merely existing in the belief that it is normal to suffer from diminished sensation during intercourse, incontinence or pelvic organ prolapse.
Designer Laser Vaginoplasty®
Designer Laser Vaginoplasty® (DLV®) is the functional and aesthetic surgical enhancement of the vulvar structures, labia minora, labia majora, mons pubis, perineum, introitus and hymen, (see figure). DLV® has provided creative treatment solutions for patients from 50 states withing the USA and 20 countries. This has provided associates of the Laser Vaginal Rejuvenation Institute with a vast experience and creative expertise to help women who suffer from these functional and aesthetic problems.
Dr Onuma receive's numerous requests for 'before and after photographs' of surgeries performed. Dr Onuma does not provide these as a matter of patient confidentiality. Individual patients can, on request, be provided with digital images of themselves before and after surgery.
The most common DLV procedures are as follows:
Laser Reduction Labioplasty can sculpture the elongated or unequal labial minora (small inner lips) according to ones specification. Most women tell us that they do not want the small inner lips to project beyond the large outer lips. The most common reason for this is functional; infolding of the labia during intercourse causing discomfort, thickening and/or stretching of the labia as a result of chronic irritation from physical interaction with clothes or indeed the opposite labia, labial discomfort when wearing underwear such as a G-string and also discomfort when wearing tight trousers or simply sitting down. Some women are unsettled by the length of their labia, an aesthetic issue for which laser reduction labioplasty is also effective. With laser reduction labioplasty, we can often accomplish the desires of the woman. Our labioplasty techniques can also reconstruct conditions that are due to the aging process, childbirth trauma, or injury.
Laser Perineoplasty can rejuvenate the relaxed or aging perineum. It can also enhance the sagging labia majora (large outer lips) and labia minora. Overall, the procedure can provide a youthful and aesthetically appealing vulva.
Hymenoplasty (reconstruction of the hymen) can repair the hymen as if nothing ever occurred. The Laser Vaginal Rejuvenation Institute is sensitive to the needs of women from all cultures that embrace these particular issues because of cultural, social, or religious reasons.
Combination of DLV with LVR. LVR and DLV can be performed in combination. They can also be performed with most cosmetic surgical procedures; the most popular of these are breast implants, breast reduction, tummy tuck, nose surgery, and eyelid surgery. (*these additional procedures would be carried out by an independent plastic surgeon who you would be expected to consult with before arrangements are made to carry out the required surgery under one anaesthetic).
Laser Vaginal Rejuvenation® for the Enhancement of Sexual Gratification
Laser Vaginal Rejuvenation® (LVR®) is a surgical procedure designed to enhance sexual gratification.
According to Master and Johnson, sexual gratification is directly related to the amount of frictional forces generated. We can accomplish this with LVR.
LVR is the modification of gynaecological surgical procedures used for the treatment of female pelvic organ prolapse. Our laser techniques result in gentle precision procedures with controlled accuracy. Our pioneered techniques result in rapid healing and resumption of daily activities in a short period of time.
Laser Vaginal Rejuvenation® (LVR®) will effectively enhance vaginal muscle tone, strength, and control. It will also effectively decrease the internal and external vaginal diameters as well as build up and strengthen the perineal body (see figure below).
In vaginal relaxation, the muscles are relaxed and have poor tone, strength, and control. The internal and external diameters increase. The muscles of the perineum are weak and poorly supported. Under these circumstances, the vagina is no longer at its optimum physiological state. As a result, the sensual side of sexual gratification is diminished. LVR was designed to enhance sexual gratification for women, who for whatever reason lack an overall optimum architectural integrity of the vagina.
Our mission is to empower women with knowledge, choice, and alternatives
We encourage patients to participate in their healthcare and surgical options.
Pelvic floor surgeons with an interest in female sexual function have learned a tremendous amount from listening to women. Members of the Laser Vaginal Rejuvenation Institute have treated women from all over the world.
Many women who have sought Dr Onuma's help with problems related to urinary incontinence, pelvic organ prolapse and reduced sensation or pain during intercourse have often been seeking help for 10 -15 years beforehand and report that they have often been ignored or told that their concerns are misplaced because they are simply consequences of being female! Few people find it easy to talk to strangers (doctors) or friends about leakage during exercise, the bulge that they have noticed protruding from their vagina or their labial discomfort or lack of vaginal sensation. These issues, however, need to be raised and explored in order to provide options for improving quality of life. Patients are becoming more informed and aware that there are solutions and doctors and other healthcare professionals are becoming better listeners and improving the range of options available.
In the same way that female urinary incontinence and faecal incontinence have been taboo subjects until the last few years, female sexual dysfunction (physical, hormomal, psychological) remains essentially an area where many health care professionals remain uneducated. Fortunately the Laser Vaginal Rejuvenation Institute has members who have a focused interest in the physical sexual function aspect of female pelvic floor medicine.
Women come to us because they want knowledge, choice, and alternatives. Women want their gyanecologist to listen to them and provide viable solutions. Women throughout Australia have told Dr Onuma that whilst Kegels (pelvic floor exercises) provide some assistance, often they do not provide a definitive solution -but no one is listening. Women who have had children want a solution to rejuvenate the vagina and achieve the best sexual experience possible.
No one wants to age or lose optimal function anywhere, and this includes the vaginal and vulvar structures: LVR has the solution. We have found that the vaginal and vulvar issues women are self-conscious about can be solved with LVR.
Patients with involuntary loss of urine with coughing, sneezing, laughing, exercising, or sex can have their stress urinary incontinence corrected along with enhancement of sexual gratification.
 "Perineum") figure 1 |
Click to enlarge |
The Laser Vaginal Rejuvenation Institute has been featured in numerous national and international media.
U.S. and International Print U.S. and Foreign Television
| Cosmopolitan | NBC - Ch. 4 Extra |
| Harpers Bazaar | NBC - Texas |
| Mademoiselle | CBS - Ch. 2 Special Assignment |
| Marie Claire | FOX - Miami - Florida |
| USA Today | FOX - Colorado |
| The Los Angeles Times | FOX - New York |
| Details Magazine | HBO - Documentary |
| The Boston Globe | UPN - Ch. 13 News |
| Los Angeles Magazine | KMEX - Ch. 34 "Ocurrio Asi" |
| Women's More Magazine | Telemundo - Ch. 52 |
| For Him Magazine | WSVN - Ch. 7 Florida |
| Fairfield County Weekly | RTL 1 - Nat'l German TV |
| Self Magazine | RTL 2 - Nat'l German TV |
| Nerve Magazine | PEEP - Nat'l German TV |
| Vogue (German) | Nat'l Australian TV - Ch. 9 |
| Elle (France) | Telemundo - International TV |
| Svenska Dagbladet (Sweden) "Doctors" | Nat’l Italian TV |
| NYT Henk.Koht (Finland) | U.S. Radio |
| Taet Pa (Denmark) | 97.1 Talk Radio |
| Canadian Post | KFI News Radio |
| Marie Claire (UK) | Dr. Kurionsky, NY |
| Maclear's Magazine | (Canada) Internet |
| WebMD | |
| EYADA.com | |
| Shenetworks.com | |
| Brainpop.com | |
| Salon.com | |
| Endemol (UK) | |
| E! Entertainment - Dr. 90210 |
As a sexual biological organism, women are superior to men.
Women are multiorgasmic. The female sexual response cycle is unimpeded by a required refractory period that prevents successive orgasms in the male.
Principal understanding of the physiology of the human sexual response emanates from observational research studies by William H. Masters, M.D. and Virginia E. Johnson. The researchers tested 382 women and 312 men in more than 10,000 episodes of sexual activity. They also studied more than 7,500 cycles (one cycle is an individual episode of sexual activity) of female sexual response during intercourse, masturbation or oral sex. They were the first researchers to put forth a four stage model that described and explained these natural physiologic changes. The four stages are excitation, plateau, orgasm, and resolution.
We developed the LVR program by listening and caring about the needs of women in this area of sexual gratification. We also integrated the historical research of Masters and Johnson into the ultimate individual design of each of the laser surgical procedures. Women of the world inspired all of the surgical designs. For this, we as well as present and future patients thank the “true pioneers” and inspirational forces that made Laser Vaginal Rejuvenation a reality…WOMEN.
 "Orgasm")
Variations in the Female Sexual Response Cycle
Laser vaginal rejuvenation is an inpatient surgical procedure. The procedure is designed to enhance the feelings of sexual gratification. This is accomplished through a reconstruction process of vital areas of vaginal relaxation that are essential to sexual gratification, namely the outer third of the vagina, the orgasmic platform, internal and external vaginal diameter, introitus, and perineal body. (See figure 1)
Laser vaginal rejuvenation for the enhancement of sexual gratification is the modification of a standard existing gynaecological vaginal surgery used throughout the world for the treatment of vaginal relaxation and its associated symptoms, primarily that of stress urinary incontinence (involuntary loss of urine with stress such as exercise, etc.)
Vaginal relaxation is the loss of the optimum structural architect of the vagina. In the vaginal relaxation process, the vaginal muscles become relaxed with poor tone, strength, control and support. The internal and external vaginal diameters can greatly increase. The muscles of the perineum (the group of supporting muscles right outside the vaginal opening at the bottom) thin and separate in the midline producing a weakened, poorly supportive, thinned out perennial body.
Under these circumstances the vagina is no longer at its physiologically optimum sexual functioning state. In short, the sensual side of female sexual gratification is diminished. Thus, vaginal relaxation has a detrimental effect on sexual gratification because of the reduction of sexual feelings or pleasure.
How a woman feels about her sexuality is greatly influenced by her perception of her own wellbeing. Women who suffer from urinary incontinence or prolapse of the uterus &/or vaginal walls report high levels of sexual dysfunction. Embarrassment resulting from incontinence occurring during sexual intercourse or experiencing a sensation of a lump in the vagina can be distressing to the extent that it leads to avoidance of intimate contact with one’s partner.
Loss of libido that results from psychological or psychiatric dysfunction, chronic illness, debility or overt tiredness are generally best managed by treatment of the specific underlying cause.
Where the cause of sexual dysfunction has a physical basis such as urinary incontinence, pelvic organ prolapse, vaginal relaxation resulting in diminished sensation, scarring of the vaginal walls from previous childbirth or surgery and labial entrapment during intercourse, surgical correction of the defect may result in significantly improved sexual function and enhancement of sexual gratification.
Laser Vaginal Rejuvenation &/or Designer Laser Vaginoplasty simultaneously combined with incontinence ± prolapse surgery will be, for many women, the key to living life and not merely existing in the belief that it is normal to suffer from diminished sensation during intercourse, incontinence or pelvic organ prolapse.
Brief Overview
Laser Vaginal Rejuvenation® for the Enhancement of Sexual Gratification
Laser Vaginal Rejuvenation® (LVR®) will effectively enhance vaginal muscle tone, strength, and control. It will also effectively decrease the internal and external vaginal diameters as well as build up and strengthen the perineal body (they are immediately outside the vagina and above the anus). Sexual gratification for the female according to Masters and Johnson is directly related to the amount of frictional forces generated. We can accomplish this with LVR.
Our mission is to empower women with knowledge, choice, and alternatives. We encourage patients to participate in their healthcare and surgical design. In one of our patient surveys, women were asked; do women want to be loose or relaxed or do women want to be tight? Women answered 100% -women want to be tight. LVR can accomplish an individual degree of vaginal tone.
We have learned a tremendous amount from listening to women we have treated worldwide. Women come to us because they want knowledge, choice, and alternatives. Women want their gynaecologist to listen to them and provide viable solutions. Women throughout Australia have told Dr Onuma that Kegels do not work - but no one is listening. Women who have had children want a solution to rejuvenate the vagina and achieve the best sexual experience possible. For women with no children, solutions are available through design modification to accomplish their desires.
No one wants to age or lose optimal function anywhere, and this includes the vaginal and vulvar structures: LVR has the solution. We have found that the vaginal and vulvar issues women are self-conscious about can be solved with LVR.
Patients with involuntary loss of urine with coughing, sneezing, laughing, exercising, or sex can have their stress urinary incontinence corrected along with enhancement of sexual gratification. (*see the section on female urinary dysfunction).
Vaginal Relaxation is the Loss of the Optimum Structural Architecture of the Vagina
In vaginal relaxation, the muscles are relaxed and have poor tone, strength, and control. The internal and external diameters increase. The muscles of the perineum are weak and poorly supported. Under these circumstances, the vagina is no longer at its optimum physiological state. As a result, the sensual side of sexual gratification is diminished. LVR was designed to enhance sexual gratification for women who for whatever reason lack an overall optimum architectural integrity of the vagina.
Designer Laser Vaginoplasty®:
Includes the following;
Designer Laser Vaginoplasty® (DLV®) is the aesthetic surgical enhancement of the vulvar structures (labia minora, labia majora, mons pubis, perineum, introitus, hymen). Although our experience and techniques provide us the ability to design most anything that one can desire, our most common DLV procedures are as follows:
Laser Reduction Labioplasty can sculpture the elongated or unequal labial minora (small inner lips) according to ones specification. Most women tell us that they do not want the small inner lips to project beyond the large outer lips. With laser reduction labioplasty, we can often accomplish the desires of the woman. Our labioplasty techniques can also reconstruct conditions that are due to the aging process, childbirth trauma, or injury.
Laser Perineoplasty can rejuvenate the relaxed or aging perineum. It can also enhance the sagging labia majora (large outer lips) and labia minora. Overall, the procedure can provide a youthful and aesthetically appealing vulva.
Hymenoplasty (reconstruction of the hymen) can repair the hymen as if nothing ever occurred. The Laser Vaginal Rejuvenation Institute is sensitive to the needs of women from all cultures that embrace these particular issues because of cultural, social, or religious reasons.
Combination of DLV with LVR. LVR and DLV can be performed in combination. They can also be performed with most cosmetic surgical procedures; the most popular of these are breast implants, breast reduction, tummy tuck, nose surgery, and eyelid surgery.
What can you do?
Courage! See your local doctor and engage them in a frank discussion about your perceptions about what your problems are. It is important to be frank and direct because not all doctors will know to discuss all the issues which are important to you. They will probably ask you about issues related to libido and try to exclude the presence of other causes of decreased sensation during intercourse. They may consider that referral to a counsellor may be appropriate.
If you feel that your problems have a physical basis such as lack of sensation or pain during intercourse, then you can ask for a referral to a specialist with an interest in the physical basis of female sexual dysfunction. Of course your local doctor is entitled not to make such a referral, however, you are entitled to consult another doctor in order to obtain the referral that you require.
Trust yourself and persist. It is NOT in your mind! Someone WILL listen to you and place you on the path to a better quality of life.
Frequently Asked Questions
E-mail or patient/doctor telephone conversations. We also offer and encourage you to have a complimentary telephone conversation with our gynaecologic surgeon, Dr Onuma, to address your issues and discuss our procedures. You can arrange a telephone conversation by scheduling one with our receptionist by calling +618 8363 4066 or you can make a request via E-mail. Simply provide your telephone number and the best time to contact you. Our policy is to return your call or E-mail the day it is received. We are continuously updating our web site in order to provide you with a comprehensive and user friendly site that educates, describes, and explains our patient services. Our goal is to provide women with knowledge, choice, and alternatives.
Q: I am interested in having the procedure, can you explain more about it.
A: Because we offer numerous services it is hard to respond to a general question such as this. We have made every attempt to have a comprehensive, descriptive site with visual aids to assist you in identifying and determining your concerns and interest.
Q: I have had a child or a number of children and since, things just aren't the same vaginally. My vagina isn't like it was before I had children. Sex just isn't as gratifying as before. For me, having children resulted in vaginal enlargement, with loose, weak, vaginal muscles. My vaginal muscle tone is poor and the support outside the vagina at the bottom is poor also. I performed Kegals until I was blue in the face and they didn't help me at all. I didn't know about this procedure. But I am happy to know that something can be done. Please explain to me how Laser Vaginal Rejuvenation can correct my problems and enhance sexual gratification.
A: Many women have your exact same problem, share your self conscious concerns, and desire to enhance sexual gratification. Women are very concerned about their sexual health, sexual gratification, and procedures to enhance sexual gratification.
Laser vaginal rejuvenation for the enhancement of sexual gratification is a modification of a standard gynaecologic surgical procedure. The laser is used to perform, precise, aesthetic surgical incisions. The techniques that we have developed result in a relatively bloodless procedure performed on an outpatient basis. In brief we will tighten the vaginal muscles and support tissues, as well as reduce redundant vaginal mucosa (relaxed vaginal lining). The procedure will enhance vaginal muscle, tone, strength, and control. It will effectively decrease the internal and outer (introitus) vaginal diameters, as well as build up the perineal body (the area immediately outside the vaginal and above the anus). According to Masters and Johnson, sexual gratification for the female is directly related to the amount of frictional forces generated. We can accomplish this. The procedure can also provide an aesthetic enhancement of the external vaginal structures, resulting in a more youthful look. As with all of our surgical procedures you are an integral part of the team and we listen to you and abide by your wishes. In this procedure the woman determines how tight she wants to be. In our survey: Guess what 100% of the women said!
Q: I have had several children. I have vaginal relaxation and I also lose urine when I laugh, cough, sneeze, or exercise. This problem has really impacted on my life, it is socially embarrassing and hygienically unacceptable. Can I correct my urinary problem and enhance sexual gratification all at once?
A: Your urinary problem is called stress urinary incontinence. It is caused by the vaginal relaxation of the top part of the vaginal wall. Laser vaginal rejuvenation can be combined with minimal access incontinence surgery such as the TVT procedure (Johnson & Johnson TVT and TVT O and American Medical Systems Monarch TVT procedure) or laparoscopic Burch colposuspension.
Q: How long does laser vaginal rejuvenation take?
A: The surgical time depends on the extent of the procedure. In general the procedure takes about one hour. Where there is significant vaginal wall or uterine prolapse correction of these will be undertaken at the same time and would increase the duration of surgery.
Q: Where is the procedure performed?
A: In a fully accredited hospital.
Q: I have vaginal relaxation of the bottom floor of the vaginal and the perineal body. Can I have laser vaginal rejuvenation?
A: In this case we only need to repair the lower floor of the vagina and the perineal body (area immediately outside of the vagina). Usually in this case vaginal relaxation is less extensive. Laser vaginal rejuvenation will also enhance sexual gratification.
Q: I haven't had any children but I have some vaginal relaxation and I would like to enhance vaginal muscle tone and strength as well as decrease the vaginal diameter. Can I have the procedure?
A: Depending on your circumstances you can be a candidate for the laser vaginal rejuvenation. Such procedures primarily involve the bottom part of the vagina and the perineal body. It is important to note that a future pregnancy can alter the shape and sensation of the vagina.
Q: What types of anesthesia are available?
A: You can be provided with your choice of anaesthesia by our board certified anaesthetist. [local, nerve block, epidural, spinal, IV sedation, general]. Some types of anaesthesia are procedure dependent.
Q: When can I resume sex after laser vaginal rejuvenation?
A: We ask that you abstain from sexual intercourse for 6 weeks. Oral sex may be resumed much earlier.
Q: When can I return to work after laser vaginal rejuvenation?
A: In general returning to work is dependent on the type of work you do. Most patients can return within 5 to 7 days. If LVR is combined with incontinence or pelvic organ prolapse surgery then this will increase to between 2-6 weeks.
Q: I am from out of town. How long do I have to remain in Adelaide after laser vaginal rejuvenation?
A: You can return home in 4-5 days.
Q: How much discomfort will I have after laser vaginal rejuvenation?
A: With our technique of submucosal tumescence, pudendal block with long acting local anesthetic, most patients report mild to moderate discomfort which can be controlled by analgesics and cold packs to the area.
Q: How much does laser vaginal rejuvenation cost?
A: The fees depend on the type of the procedure and the extent. A fee range can be provided once we know your particular needs. Quoted fees will provide a guide as to the fees raised by the surgeon, anaethetist and hospital/surgery centre.
Q: What are the surgical risks for laser vaginal rejuvenation?
A: Laser vaginal rejuvenation is a safe procedure with low risk. To put the risk in perspective, pregnancy is associated with far more risk than any of these procedures. Like any surgery the risks are haemorrhage and infection. These are less than 1%. If one requires work on both the upper and lower vagina then there is risk of injury to the bladder and the rectum. This is exceptionally rare and in many years of our surgical experience we have not encountered any of these complications. With any surgery one can encounter scarring. Over correction can potentially result in painful sex. Although rare there are anaesthetic risks also depending on the type of anaesthesia. Prior to any surgery a thorough discussion will take place not only about the operation technique and likely outcomes but also the specific risks associated with your particular plan of management.
Q: Can laser vaginal rejuvenation be combined with designer laser vaginoplasty?
A: Laser vaginal rejuvenation can be combined with designer laser vaginoplasty such as laser reduction labioplasty.
Q: Can laser vaginal rejuvenation or designer laser vaginoplasty be combined with cosmetic surgical procedures?
A: Yes, Dr Onuma works in association with plastic and reconstructive surgeons so as to be able to combine laser vaginal rejuvenation or designer laser vaginoplasty with most cosmetic surgical procedures such as breast, nose, eye, or tummy tuck surgery.
Q: My inner vaginal lips (labia minora) are too long. Can I have them reduced?
A: The labia minora can be aesthetically sculptured to your specifications with laser reduction labioplasty. The principle revolves around function - making the labia less uncomfortable but the end result also encompasses the desire of many women to have smaller, neater labia.