In the hands of an experienced surgeon, the risks of cosmetic vaginal surgery are very small. As with any surgery, bleeding and infection can occur. However, major blood supply to this area is generally avoided so the possibility of hemorrhage and blood transfusion is negligible. That is why these procedures lend themselves to an outpatient surgery center for healthy patients. Infection is surprisingly rare and minimized with the use of postoperative prophylactic antibiotics.
To determine the risks associated with cosmetic vaginal surgery in your particular case, it is crucial that you consult with an experienced surgeon as soon as possible. A knowledgeable doctor will be able to help you understand the process associated with your surgical situation.
The anesthesia used for such procedures is likewise extremely safe. Twilight anesthesia, the lightest level of anesthesia, similar to that used for colonoscopy, allows the patient to breathe on their own, awake one to two minutes after the surgery is over, and leave the surgery center within an hour.
Anesthesia complications are extraordinarily rare in well-regulated surgery centers using highly qualified personnel. As part of the decision to have these procedures, it is very important to examine the certifications of both the surgery center and the anesthesia provided at them. Depending on an individual’s body, they will need to understand the particular risks associated with their CVS procedure.
The surgical risks for external cosmetic procedures differs from vaginoplasty. Too much tissue can be removed, which may be hard to correct. Although a surgeon attempts to get the best results the first time, it is always better to err on the side of leaving tissue behind that can be revised at a later date. Too much removal of the clitoral hood exposes the clitoris to constant irritation. If the overlying skin and adjacent prepuce are too tight, it can interfere with engorgement during sexual arousal. Rarely can there be damage to the blood supply and nerves to the clitoral area.
Vaginoplasty can have its own set of potential risk, albeit very low. Fortunately, the vaginal canal cannot be overtightened. If the canal is too narrow, post operatively a short course of mechanical vaginal dilation solves the problem. On occasion, during perineal healing, there is contracture at the base of the vaginal opening which causes pain upon penetration.
This is easily remedied by releasing a small band of tissue in the office with local anesthesia. The three main risks to this surgery are hematoma formation, or a blood clot at the site of surgery, opening of the perineal skin, and entry into the rectum. The hematoma issue is limited by the use of specific clot-preventing agents at the time of surgery. Perineal skin separation is avoided by meticulous hygiene and prevention of hard bowel movements and straining. Inadvertent entry into the rectum is exceedingly rare. Once detected the key is to make a meticulous repair. It will not add any additional time to the recovery.
It would be extraordinarily unusual for a patient to experience a decrease in sensation as a potential risk of cosmetic vaginal surgery. After the healing process is over, there is no residual pain or hypersensitivity. On the contrary, sexual responsiveness is increased. There is greater clitoral stimulation with hood reduction. The previously enlarged labia will no longer interfere with sex; by rebuilding the perineum the penis is pushed along the clitoris. Decreasing the internal vaginal diameter increases friction and sensation.
Ongoing pain is an extremely uncommon risk of cosmetic vaginal surgery and may be due to nerve entrapment. The remedy is usually a local injection of a steroid or excision of the area.
Scarring, when the surgery is properly done, is also a rare event. The surgical technique, suture selection and post-operative use of estrogen and collagen, all contribute to scar prevention.