Gynaecology

Perineum and Pelvic Floor Repair

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Award Winning Specialist Clinic

We've won 12 top industry awards since 2010 and regularly feature in the national and international press.

Industry Leading Consultants

We've invited only the very best consultants in the country to practice with us.

Care Quality Commission

Our Leadership has been rated Outstanding by the independent regulator of health and social care in England

GMC Registered Surgeons

All of our surgeons are registered with the General Medical Council.

Medically Reviewed October 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is Perineum and Pelvic Floor Repair?

When a bad tear occurs during birth or there has been poor stitching, the area between the vagina and the rectum can look disfigured when healed. This can affect confidence and cause discomfort during intercourse.

In some cases, it can lead to weakness in the pelvic floor and lax muscles, presenting problems in urinary function and, in worst cases, can even cause incontinence.

The good news is that surgery can make a massive difference to the way you look and feel, restoring both the cosmetic appearance of the perineum as well as the muscle tone deep in the pelvic floor and vaginal muscles.

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Words from our clients:


Why do people have this treatment?

Pregnancy and childbirth, particularly a vaginal delivery, can have a huge impact on a woman’s body. Sometimes giving birth can lead to tearing of the perineum, which requires stitches to fix. If these stitches are not done well, or the area has healed poorly, the perineum may look or feel disfigured and you may experience pain or discomfort during sex. This can have a negative impact on your self-esteem and body confidence and may also have an adverse impact on your romantic and sexual relationships. Perineum repair will be required.

Another common problem following pregnancy and childbirth is pelvic organ prolapse, caused by weakened muscles and ligaments in the vagina. In pelvic organ prolapse, one or more of the organs situated in the pelvis, including the bowel, uterus or bladder, slip out of their normal position and bulge into the vagina. Although this is not life-threatening, pelvic organ prolapse can cause discomfort or you may notice a heavy or ‘dragging’ feeling around the genitals. Pelvic organ prolapse can cause discomfort or numbness during sex and problems with urination, such as stress incontinence, an increased urgency when you go to the toilet or problems emptying your bladder. Depending on the severity of the prolapse, you may see a bulge or lump coming out of your vagina, or there may be no visual evidence of the prolapse. Pelvic organ prolapse is also a side effect of the ageing process.

The effects of a pelvic prolapse can impact on your sexual and romantic relationships, your social life, self-confidence, self-esteem and overall mental wellbeing.

If you are experiencing any of these symptoms and they are impacting on your quality of life, then you should consider perineum and pelvic floor repair.

Who is suitable?

Cadogan Clinic considers individuals fit for perineum and pelvic floor repair if all of the following are true of them:

  • Physically and psychologically fit and healthy
  • Bothered by the appearance and/or function of their perineum and pelvic floor area
  • Have realistic expectations of what can be achieved by surgery

You may also be experiencing one or more of the following:

  • Pelvic organ prolapse (bladder, bowel, uterus, top of the vagina)
  • A loss of sexual function or sensation
  • Urinary incontinence
  • Pain during sex
  • Injury or trauma caused by childbirth

If you are planning another pregnancy, particularly with a vaginal birth, you may wish to consider waiting until you have completed your family. Perineum and pelvic floor repair will not make your body immune from the changes brought about by pregnancy and childbirth. If you go on to have another pregnancy after your surgery, this may affect the result and you may need to repeat the surgery at a later date.


Perineum and Pelvic Floor Repair
Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.


What to expect

Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.

Your journey with the Cadogan Clinic will start with up to two consultations with one of our leading specialist plastic surgeons at our award-winning premises in Chelsea. These consultations will take between 30 and 60 minutes.

During your consultation, your surgeon will ask about your expectations for your perineum and pelvic floor repair and talk about what will happen during the procedure. They will also explain how the procedure will affect you and the recovery period.

It is important that you are open and honest about what you hope to achieve through surgery to help ensure the best possible result. Your surgeon will be happy to answer any questions you may have at this point. It may be a good idea to write your questions down before attending the consultation. Having established what you want from the surgery, and what is possible given your anatomy, several key measurements will be made and standard clinical photography will be taken. Your medical history will be discussed and a physical examination will be carried out.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed with your perineum and pelvic floor repair or not following a two week 'cooling off' period.

If you decide to go ahead with surgery, the next time you will return to the clinic is on the day of your perineum and pelvic floor repair. It is important that you prepare by taking the following measures ahead of surgery.

  • Stop smoking. Smoking can slow the healing process. If you smoke, your doctor will recommend that you stop smoking six weeks before surgery and during the recovery period. You should avoid smoking for at least 48 hours before your surgery.
  • Avoid taking certain medications. You should avoid taking aspirin, anti-inflammatory drugs and herbal supplements in the week ahead of your surgery. Taking these can increase bleeding.
  • Avoid alcohol. You should not drink any alcohol for 48 hours ahead of your surgery. This is because alcohol can hamper the healing process.
  • Arrange for help during recovery. Make plans for a friend or family member to drive you home after you leave the hospital and stay with you for at least the first night of your recovery at home.

In the six hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid which will be allowed up to two hours before you are admitted to the clinic. Clear fluids include still water, black coffee and black tea.

Your perineum and pelvic floor repair will take place at our award-winning clinic in Chelsea.

You will be given a general anaesthetic to put you to sleep for the operation. In some cases the surgeon may use a local anaesthetic and sedation if appropriate.

Once the anaesthetic has taken effect, the surgeon will go through the vagina and use stitches to reconstruct the perineum while tightening the surrounding muscles and tissues to lift and support the pelvic organs. The surgeon may also make repairs to the front and rear walls of your vagina. Cuts in the vaginal wall are closed with dissolvable stitches. This means you will not have to return to the clinic to have any sutures removed.

The length of the procedure depends on the extent of your prolapse. Perineum and pelvic floor repair is performed as a day case.

Following your perineum and pelvic floor repair, you will recover in our ambulatory recovery rooms. You may feel a little drowsy but this often wears off within a few hours.  Once you are able to eat and drink, and our specialist nursing team are happy that your initial recovery is complete, you will be allowed to leave the clinic with a friend or family member.

As this surgery involves a very delicate area of the body, you will likely experience some mild pain or discomfort in the aftermath of your surgery. It is common to experience lower back pain, discomfort when sitting down and to experience a feeling of fullness in your bowel. You may experience some vaginal bleeding or discharge in the days following your perineum and pelvic floor repair. This may last for up to two weeks.

You should avoid heavy lifting, such as shopping and young children, for two to four weeks following your perineum and pelvic floor repair. You should avoid sports for four weeks.

If your work is physically strenuous and involves a lot of heavy lifting, we recommend being signed off for four weeks. If your job involves light duties then you may feel ready to return within a week or two.

You should avoid driving for six weeks as performing an emergency stop may cause pain to the treatment area.

Our on-call nursing service is open 24/7 during your recovery period to help with any questions or queries that you may have.

It is important that you follow all the aftercare instructions issued by your doctor. Failure to do so may impact on your recovery and the final result.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

Following your surgery you may experience some mild discomfort and swelling but this will usually disappear completely one or two weeks. Many of our patients go back to work after one week but your surgeon will advise you to refrain from exercise, driving and sexual intercourse until full healing has taken place.

Most of our patients opt to undergo this procedure under general anaesthetic so you will feel no pain. After your surgery, any pain or discomfort you may experience will be controlled with medication provided by your doctor and this will usually subside within a few days.

Prices begin at £6000 depending on your initial consultation with your expert cosmetic gynaecological surgeon.

It generally takes around four to six weeks to fully recover from perineum and pelvic floor repair.

You should aim to go on short walks after your surgery, gradually increasing the distance each day. Exercise, such as swimming and gentle cycling, can be resumed four weeks after surgery.

You will need to do special pelvic floor exercises at home to help you heal from your perineum and pelvic floor repair.

You can return to work within four weeks or sooner, depending on the type of work you do. You can start driving again six weeks after surgery. Sexual activity can be resumed within four to six weeks after surgery. If you are experiencing vaginal dryness, then vaginal lubricant may help.

It is important that you rest and allow yourself time to recover. You must follow all the after care instructions issued by your surgeon in order to achieve the best result and ensure a swift recovery.

Perineum and pelvic floor repair is a straightforward operation and many women go on to make a good recovery. However, there are some risks that you should be aware of. Complications of perineum and pelvic floor repair surgery include: injury to the uterus or bowel, perforation of the bladder or rectum or a recurrence of symptoms, which may require further treatment. All of these complications are rare.

Rarely, over tightening of the perineum may cause the entrance to the vagina to become tight, which may require you to use lubrication or vaginal dilators. Sometimes corrective surgery may be needed, but this is very rare.

Any type of operation also carries a risk of excessive bleeding, developing a blood clot in a vein, 

infection or an allergic reaction to the anaesthetic. However the risk of any of these happening during your vaginoplasty is small.

Our expert surgeon will discuss all the risks with you and will be happy to answer any questions that you may have before you undergo your vaginal tightening surgery.

Perineum and Pelvic Floor Repair is a cosmetic surgery treatment to restore both the cosmetic appearance of the perineum as well as the muscle tone deep in the pelvic floor and vaginal muscles which may have been damaged during childbirths.

The perineal body is a fibromuscular mass located at the centre of the perineum. This structure contains smooth muscle, skeletal muscle, and collagenous and elastic fibres.

The perineal body sits beneath the skin and muscle fibres from the perineum and pelvic floor are anchored to this body. Women and men both have a perineal body.

In women, the perineal body sits between the vagina and anus. Part of the function of the perineal body is to support the posterior part of the vaginal wall against prolapse. Therefore if the perineal body is torn, damaged or weak, this puts the woman at a higher risk of developing pelvic organ prolapse.


What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.




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2023

Aesthetic Awards

Highly Commended Best Clinic in London

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2021

Aesthetics Awards

Highly Commended

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2021

My Face My Body

Best Clinic Winner

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2020

My Face My Body

Best Clinic Winner

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2019

My Face My Body

Winner

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2018

My Face My Body

Highly Commended

Laurel Wreath for Awards
Laurel Wreath for Awards

2018

Aesthetics Awards

Highly Commended

Laurel Wreath for Awards
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2017

Aesthetics Awards

Winner

Laurel Wreath for Awards

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