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The female vagina is a muscular tube extending from the woman’s vulva (external genitalia) to the cervix of her uterus. The vulva itself is comprised of many anatomical features including the labia, clitoris, glands and vaginal opening.

Disease, atrophy, genetic condition, trauma or disfigurement are reasons that your vagina can become loose and slack. However, the most common reason is childbirth because the vaginal muscles are forced to stretch during delivery. The result is long term problems such as sexual dysfunction and bodily incontinence, among others. However, weakened vaginal muscles can negatively impact a woman’s self-esteem and quality of life.

Corrective gynecological treatments have been available for many years. In fact, the labiaplasty began as a procedure to treat women with impaired vaginas from birth defects to have normal menstruation, urination and sexual functions. Now, the labiaplasty is widely recognized as a form of Vaginal Rejuvenation for an improved lifestyle, as well as health concerns. In addition to labiaplasty, Dr. Silvia Rotemberg performs vaginal surgeries including G-spot Amplification, Clitorial Unhooding, and sex reassignment surgery.

Vaginal Rejuvenation

Vaginal Rejuvenation refers to a group of procedures that address vaginal relaxation due mainly to childbirth and aging.

The “down there” areas treated include:

  • Clitoral Unhooding: This procedure extracts tissue that covers the clitoris.
  • G-Spot Amplification: The highly sensitive area found in the vaginal front wall is considered to be a woman’s most erotic zone. By injecting collagen into this area, it is believed to increase your potential for arousal and orgasm.
  • Vaginal Rejuvenation may include a Labiaplasty. It is approximately a 1-2 hour surgery.

What is Labiaplasty?

Labiaplasty is a cosmetic surgery performed on women with overly large or unevenly matched inner and/or outer lips of the vagina that causes discomfort or embarrassment. The labia are reshaped and the size reduced for an aesthetic achievement by removing excess tissue from any of the four folds of the vulva. The result is natural and scars are nearly invisible. Patients have reported greater sexual satisfaction due to more confidence in their vaginal appearance.

Labiaplasty can also be the procedure of choice to treat tearing of the labia minora in an accident or during childbirth or stretching from age. Also, vaginal abnormalities and congenital defects such as the malformed uterus and fallopian tubes (Mullerian Agenesis), absent vaginal passage (Vaginal Atresia) and dual sexual characteristics (intersex conditions) can be remedied.

For male-to-female sexual transformation, labiaplasty may be included as part of the operation. During this procedure, labia minora and the clitoral hood are created.

Dr. Silvia Rotemberg will perform this one-hour procedure in the comfort and privacy of her state-of-the-art facility at hand with an anesthesiologist. Local or general anesthesia, as well as, conscious sedation can be administered for Labiaplasty.

Most people can return to work from 2-4 days following the operation. However, physical activities such as exercising and heavy lifting are restricted for two weeks. Sexual intercourse can resume after 4-6 weeks following surgery.

If you are still of childbearing age, Labiaplasty will not interfere with vaginal delivery of your baby.

Candidates for Vaginal Rejuvenation

Women in general good health looking to gain confidence and well-being in the vaginal region. It is especially recommended for women who have given vaginal birth and/or over the age of 45 years.

Sex Reassignment Surgery (male to female)

The penile and scrotal tissues are created into a vagina, clitoris and labia through the process of Vaginoplasty. This procedure is also typically accomplished in tandem with Labiaplasty to further enhance and provide a more classically feminine look and function to the labia and external vaginal regions.

Before the procedure, patients are customarily asked to take HRT (Hormone Replacement Therapy).

Alternatives to Vaginal Surgery

Are you are not a good candidate for vaginal tightening surgery or are still wondering if a procedure is right for you? Here are some less invasive options to try:

  • Kegel Exercises: A series of specific muscle exercises of the pelvic floor that can be enhanced with the use of biofeedback, weights and physical therapists trained specifically for vaginal tightening. However, you may not see much improvement if your muscles are badly damaged.
  • Laser Vaginal Rejuvenation (LVR): Lasers perform all the cutting and dissecting while sutures will tighten the pelvic muscles. Known as the “bloodless” alternative to surgery.
  • Laser Vaginal Tightening (LVT): Lasers (such as the kind used for facial skin peels) are used by inserting a special probe into your vagina. No anesthesia is required.

Please keep in mind that these minimally invasive processes will have only a temporary effect because of the loose vaginal muscles beneath the skin that will continue to undergo stretching through repeated sexual activity.

What to Expect During Consultation

Dr. Silvia Rotemberg’s first consideration is YOU and your specific needs. By using a collaborative system of “caring consultation,” she will discuss all the best options for you to reach your desired potential. As one of Miami’s top plastic surgeons, she will thoroughly examine your health before helping you make a final determination based on your goals.

Dr. Silvia Rotemberg will also make available Before and After photos to give you a better visualization of what can be accomplished. She will go over the details of your procedure(s), aftercare, and all involved costs. Of course, she will be happy to answer all your questions and want to know about any of your previous surgeries, illnesses or current medications.

Relax in the knowledge that in choosing Dr. Silvia Rotemberg for your vaginal procedure(s), you have found a surgeon with the right experience and qualifications for this complex area of your body.


Specific instructions vary as to the type of procedure(s) you opt to have performed. However, as with most surgeries, some discomfort is to be expected. Dr. Silvia Rotemberg will prescribe appropriate medication to alleviate pain and prevent infection.

In order for vaginal surgery to properly heal, it will be imperative that you abstain from sexual intercourse for about 4-6 weeks. This is because vaginal muscles can tear during sexual activity. During the recovery, you will most likely feel the most pain within the first few days or until swelling being to subside. You should notice results within 2-3 weeks of your procedure.

It is important that you receive adequate rest and avoid physical strain during recuperation so that your body can properly heal. Remember that the better your post-operative care, the more effective are your recovery and results. And, of course, keep all of your follow-up appointments to check on your progress with Dr. Silvia Rotemberg.

Risks and Side Effects

Even though Vaginal Surgery is overall safe and effective, the vagina is one of the most fragile and sensitive parts of the female anatomy. Here are potential risks and side effects to help you make the most comfortable and informed decision when considering a vaginal procedure.


Though the benefits from vaginal surgery are great and have improved the sex lives of many patients, here are the possible risks: Nerve damage, surgical wound infection, epidermoid cysts, painful coitus and scars.

Side Effects

Please contact Dr. Silvia Rotemberg if you experience the following: chest pains, shortness of breath, racing or irregular heartbeat, bleeding, infection, sudden sharp or chronic pain, a reaction to the anesthesia.


Procedures range in price from $3,000-10,000. They are generally considered elective and not covered by insurance.