Understanding Options for Vaginal Rejuvenation

For many women, changes in vaginal tightness due to childbirth or natural aging can impact their quality of life in a variety of ways. After a brief overview on the condition, we’ll cover the three most common procedures that promise to renew your sense of self: vaginal rejuvenation surgery (vaginoplasty), laser vaginal rejuvenation, and radiofrequency treatments. Plus, we’ll introduce you to the EmpowerRF, a device that encapsulates the pinnacle of non-surgical precision.

What Exactly is Vaginal Laxity?

Vaginal laxity, also known as vaginal looseness, is a condition characterized by the loss of tightness and tone in the vaginal walls. It is often underreported by women, with almost 80% of women not acknowledging the presence of vaginal laxity 1. The condition can have a significant impact on a woman’s sexuality and overall well-being, leading to sexual distress, sexual dysfunction, and, potentially, Stress Urinary Incontinence 2.

What Causes Vaginal Laxity?

Generally speaking, vaginal laxity can be caused by five primary factors:

  1. Childbirth: The stretching and tearing of the vaginal tissues during childbirth can lead to a loss of vaginal tone and tightness. Multiple vaginal deliveries and large babies can further contribute to this condition.
  2. Aging: As women age, the natural aging process can lead to a decrease in collagen and elastin in the vaginal tissues, resulting in reduced vaginal tone.
  3. Hormonal Changes: Fluctuations in hormone levels, particularly during menopause, can lead to changes in the vaginal tissues, contributing to vaginal laxity.
  4. Obesity: Excess weight can put pressure on the pelvic floor muscles, leading to a loss of vaginal tone.
  5. Lifestyle Factors: Certain lifestyle factors such as smoking and chronic coughing can also contribute to vaginal laxity.

How Many Women Are Affected?

The number of women suffering from vaginal laxity has ranged from 16% (in a 291 patient survey) up to 38% (in a 2,621 patient self-reported survey 3). These numbers match similar data regarding Stress Urinary Incontinence, which affects 4% to 14% of younger women and 12% to 35% of older women 4.

Treatment Methodologies

Treatments for vaginal laxity and Stress Urinary Incontinence have had a long and storied history, beginning in the 1930’s with vaginoplasties before evolving into a variety of laser and radiofrequency-based options.

Vaginal Rejuvenation Surgery: The History of Vaginoplasty

Vaginoplasty, the oldest of the treatment methods for vaginal laxity, involves surgically reducing the excess vaginal lining and tightening the surrounding soft tissues and muscles. A surgeon will remove the extra mucosa, then suture together the remaining muscle at the back of the vagina, effectively reducing its diameter. The goal is to restore the vagina’s strength and control, enhancing both physical sensation and sexual function.

The History

Historically, one of the first forms of vaginoplasty was the McIndoe procedure, developed by Sir Archibald McIndoe in the 1930s. Although McIndoe was a New Zealand-born surgeon working in England, his procedure gained recognition and was also adopted by surgeons in the United States. Initially, these surgeries were focused on reconstructive purposes, but with time, they have also been adapted for cosmetic reasons, such as tightening the vagina after childbirth or improving the aesthetic appearance.

Modern vaginoplasty uses more advanced surgical techniques and equipment, resulting in better precision and reduced recovery times. When compared to the, relatively crude, surgical techniques of the past, surgeons now have a better understanding of pelvic floor anatomy and can offer procedures that maintain or improve sensation while achieving the desired tightening effect.

What to Expect

While a vaginoplasty can be done under local anesthesia if necessary, it is generally considered a procedure that warrants general anesthesia, to ensure patient comfort. The surgery typically takes one to two hours, with patients often returning home the same day. The incisions and suturing required for a vaginoplasty usually results in up to two weeks of down time and can be accompanied by dull aches or pain for a few days after the treatment. Recovery time varies, but patients are usually advised to refrain from sexual activity and any kind of vaginal penetration (including tampons) for six to eight weeks, to allow proper healing.

As with any surgery, there are potential risks involved with vaginoplasty, including scarring, risk of infection, and possible changes in vaginal sensation. This said, the treatment has come a long way since Dr. McIndoe popularized it and most women make full recoveries with minimal risk.

Laser Vaginal Rejuvenation: The Middle Ground

Laser vaginal rejuvenation is an umbrella term for non-surgical laser-based treatments that are designed to improve vaginal tightness and elasticity by using laser energy to stimulate collagen production within the vaginal walls. Unlike vaginoplasty, laser-based treatments require no incisions or surgery, which can drastically shorten patient’s recovery time. The treatments are generally intended for women experiencing vaginal laxity – often due to childbirth, aging, or hormonal changes.

The technology behind this treatment involves the use of a specialized laser that emits controlled heat to the vaginal tissue. This heat prompts the body’s natural healing response, encouraging the production of new collagen and elastin fibers. As a result, the vaginal walls become firmer and more elastic over time.

The History

While lasers have been used in medicine since the 1960s, the use of laser technology for vaginal treatments began to gain attention in the early 2000s, as advances in laser technology made it possible to apply these treatments to delicate tissues safely. The MonaLisa Touch was was one of the first CO2 lasers to be specifically marketed for vaginal health and rejuvenation, releasing in 2014. Manufactured by DEKA, an Italian company, the MonaLisa Touch was first introduced to the market in Europe before being brought to the United States.

Following the success of the MonaLisa Touch, FemiLift and diVa Laser Vaginal Therapy hit the US market (in 2015 and 2016, respectively), signaling the entry of Israeli and US manufacturers into the laser vaginal rejuvenation “arms race.”

What to Expect

Regardless of the device used, laser rejuvenation treatments typically range between 10 to 30 minutes per session and are performed on an outpatient basis. No incisions are required, and because of this, there is little to no downtime associated with the treatment. Patients can usually return to their normal activities shortly after each session, although they may be advised to abstain from sexual intercourse or vaginal penetration for a short period following the treatment.

During treatment, some patients may feel a warm sensation, but discomfort is generally minimal. Local anesthesia or numbing cream may be used to enhance comfort during the procedure. The total number of sessions required varies depending on individual needs but typically ranges from one to three. Like any medical procedure, laser vaginal rejuvenation carries potential risks, such as temporary discomfort, redness, swelling, and in rare cases, burns or scarring – however, these side effects are much less severe than those posed by traditional surgery.

Vaginal Radiofrequency Treatments: The Latest Development

Vaginal radiofrequency treatments offer a non-invasive approach to addressing vaginal laxity by utilizing radiofrequency energy to heat the vaginal tissues, promoting collagen production and subsequent tissue firming. Like their laser-based kin, radiofrequency treatments require no incisions, surgery, or downtime and are generally the most mild option for those who may be sensitive to the high thermal temperatures of lasers.

The appeal of radiofrequency treatments lies in their simplicity and efficiency. Treatment sessions are typically brief, involve minimal downtime, and are generally well-tolerated by patients. Similar to laser rejuvenation, a series of treatments is usually recommended to achieve optimal results, with the benefits accruing over time.

The History

The use of radiofrequency energy in aesthetic procedures began to gain prominence in the early 2000s, with the development of devices designed to deliver controlled radiofrequency energy for skin tightening, wrinkle reduction, and body contouring.

ThermiGen, with their ThermiVa system, was the first company to produce a radiofrequency device dedicated to vaginal treatments in the U.S. market, with ThermiVa gaining visibility and FDA clearance around 2015. As a pioneer in the field, ThermiVa played a significant role in introducing radiofrequency technology for non-invasive vaginal rejuvenation to the public at large.

What to Expect

During a vaginal radiofrequency session, a specially designed handpiece is inserted into the vagina, emitting controlled radiofrequency waves that penetrate the layers of the vaginal tissue. The sensation is generally described as a warm, comfortable heat, with the entire procedure lasting approximately 30 minutes. As collagen production increases over time, patients may notice enhanced tightness and elasticity, reduced dryness, and an overall improvement in sexual function and urinary control.

EmpowerRF: The Cutting Edge

EmpowerRF by InMode is a notable advancement in vaginal radiofrequency treatments, integrating multiple modalities – including radiofrequency, micro-needling, and electromagnetic muscle stimulation – to revitalize and strengthen the vaginal area. This holistic approach addresses not only vaginal tightness but also the overall health and function of the vaginal tissue, offering a comprehensive solution for intimate wellness. Each of the three modalities plays a key role in the final result:

  • Radiofrequency Energy: This is the core of the EmpowerRF experience, where gentle heat is emitted to tighten the vaginal walls. The energy stimulates collagen and elastin production, hallmarks of skin vitality, promoting a natural tightening effect.
  • Electrical Muscle Stimulation (EMS): With precision and care, EMS targets the pelvic floor muscles. These muscles are the foundation of vaginal integrity, and EMS serves to fortify and restore their strength, enhancing both structural support and functional control.
  • Sub-Dermal Fractional Microneedling: This innovative technique ventures deeper into the tissue. Tiny needles create micro-injuries that trigger the body’s natural healing response. This response rejuvenates the vaginal area from within, fostering new collagen growth and improving the skin’s texture and elasticity.

The EmpowerRF Experience: What to Expect

When you start the EmpowerRF process at RestoreMe, it begins with an in-depth consultation. Our experts design a treatment plan tailored to your specific needs and goals. During the treatment, you’ll have a comfortable visit, with our team focused on providing excellent care.

EmpowerRF treatments don’t involve any recovery time, unlike surgical alternatives. You’re able to get back to your regular schedule right after your appointment. Most patients feel only a mild warmth and little discomfort during the treatment. For the best outcomes, similar to other non-invasive procedures, you should have multiple sessions over a period of time.

Why Choose Us?

At RestoreMe, our devotion to your wellness journey is unwavering. With over a decade of experience serving the Northern Colorado community, we believe in empowering all our patients with choices that resonate with their body and life story. If you or your loved one is suffering from vaginal laxity, or any of the vaginal side effects of aging or childbirth, please consider reaching out to our experienced team – we would love to work with you to restore your confidence and sexual health.


  1. Current Perspectives in Vaginal Laxity Measurement: A Scoping Review (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556325/) ↩︎
  2. Vaginal Laxity, Sexual Distress, and Sexual Dysfunction: A Cross-Sectional Study in a Plastic Surgery Practice (https://academic.oup.com/asj/article/38/8/873/4822795) ↩︎
  3. Self-Reported Vaginal Laxity-Prevalence, Impact, and Associated Symptoms in Women Attending a Urogynecology Clinic (https://pubmed.ncbi.nlm.nih.gov/30327263/) ↩︎
  4. The Definition, Prevalence, and Risk Factors for Stress Urinary Incontinence (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472862/) ↩︎

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