This Is Everything You Need to Know (But Are Shy to Ask) About Vaginal Rejuvenation

You've got questions that you're too embarrassed to ask — and we totally get it. After all, "how exactly does vaginal rejuvenation work, like, really?" is not a question to broach with coworkers at the holiday mixer. So, we did the dirty work for you.

The Lookbook asked three top doctors to give us the real scoop on the procedure that some of our favorite Housewives — including The Real Housewives of New York City's  Sonja Morgan, The Real Housewives of Orange County's  Kelly Dodd, and The Real Housewives of Atlanta's Cynthia Bailey — have all tried. (Clearly, this is a coast-to-coast phenomenon!) Find answers to all your Big (V) questions, below. 

So, what exactly does vaginal rejuvenation do? 

Here's how Dr. Norman Rowe, a board-certified surgeon in New York City, would describe the procedure to the layman: "vaginal rejuvenation helps to tighten the inside and outside of the vagina," he says. Rowe adds that the procedure can assist with bummer situations such as stress incontinence, which can happen after child birth. It also has benefits after menopause: "Post menopausal women seek this procedure to reduce dryness and pain during intercourse," Rowe explains. And, there can be cosmetic advantages as well.

Dr. Robert Moore, an Atlanta-based urogynecologist and RealSelf contributor, says: "The muscle at the opening of the vagina is also repaired [during the treatment], which results in an improved cosmetic appearance of the opening of the vagina, as well as a tighter vaginal opening. Ultimately, the repair returns to vagina to its pre-childbirth state."  

How does it work?

Vicki Gunvalson accompanied Kelly to her V-treatment, but not everyone gets to see what goes on behind closed doors.

For the rest of us, here's the breakdown from Dr. John Miklos, an expert in cosmetic vaginal surgery and another RealSelf  contributor: "Vaginal rejuvenation surgery is accomplished by performing surgery through the opening of the vagina and primarily addressing the floor or posterior vaginal wall. The operation is focused on pulling the lateral walls, or the levator ani muscles of the vagina, towards the midline or center of the floor of the vagina. By pulling the lateral wall together, this narrows the internal aspect of the vagina. The second step of the surgery requires tightening the vaginal opening." 

That doesn't go down without some radio frequency. "During the procedure, a small probe is inserted into the vaginal canal," says Dr. Rowe. "Radio frequency is used to heat the tissue, which results in tightening of the tissue, as well as creation of new collagen and elastin." 

But does it really work? 

So, now we have some of idea of how the procedure works. But, um, does it work? "In experienced hands, this surgery is approximately 85 to 90 percent successful as defined by the patient, [meaning] she is satisfied with the enhancement of friction during the act of intercourse 12 months after surgery," Miklos explains. 

Does it hurt? 

Answers differ here, so this one likely comes down to the patient. Dr. Rowe says the patient should feel no pain, just warmth, during the treatment. He also says that there's no pain after the procedure and no downtime.

Dr. Miklos, however, says that "almost every patient has some pain after vaginal rejuvenation." He adds that those who experience the most pain post-procedure are the patients who require the most amount of sutures to tighten the vagina. 

How much does it cost?

The cost for the procedure varies depending on how much surgery is needed, Dr. Miklos says. But, he estimates that fees can range from $5,000 to $10,000 for patients who just need tightening. That's not always the case, though.

"More than 50 percent of patients require vaginal reconstruction at the same time of vaginal rejuvenation because their uterus, bladder or intestines are falling into the vagina," Miklos says. "This condition need to be corrected before the vaginal rejuvenation, and then the price range can range from $7,000 to $20,000." 

Can anyone have the procedure done?

Vaginal rejuvenation is not for everyone — and that's not just those who can't afford to part with thousands of dollars. Dr. Rowe cautions that "any woman with a grade two or higher bladder prolapse should not have the procedure."

Dr. Miklos would add these precautions to the list: "Patients who should not undergo vaginal rejuvenation surgery include those patients who have or had female genital cancer, radiation therapy to the vagina or vulva, pelvic floor pain, levator myalgia, vaginal or uterine infection, and possibly fibromyalgia," he says. 

Still in? Here's what to do next!

Before the procedure, you'll need to have a consultation with your doctor. Then, there's a small amount of prep work. According to Dr. Rowe, anyone with a history of genital herpes will have to take an antiviral medication for three days. Dr. Miklos adds that post-menopausal patients who have not had estrogen therapy would benefit from using transvaginal estrogen replacement for six weeks before having the procedure.