Vaginal Rejuvenation

Today’s women are more self-conscious about the appearance of their genitalia than previous generations. The accepted cultural norm of shaving, waxing, and other grooming of a woman’s intimate parts has enhanced the popularity of vaginal rejuvenation at our Washington, D.C. practice. We offer surgical and non-surgical vaginal rejuvenation procedures, including labia tightening and shaping.

If you’re considering getting vaginal rejuvenation, request a consultation online to meet with Dr. Ruff, or call our office at (202) 785-4187 to speak with a staff member at West End Plastic Surgery and schedule a consultation.

Your Options

Cosmetic Gynecology, as practiced by our board certified plastic surgeons, consists of a number of procedures, which can be performed singly or in combination with other procedures, depending upon the desires and needs of each patient.

  • Labiaplasty
  • Labia Majora Reshaping
  • Labial Shaping
  • Clitoroplasty
  • Mons Pubic Reduction
  • Hymenoplasty
  • ThermiVa™


Many women have experienced lifelong embarrassment due to their labia. They may be larger than normal, creating friction while wearing certain garments, such as workout gear, swimwear, tight jeans or even shorts. These women often experience discomfort when the labial area is pushed against a chair, a bike seat or against exercise equipment. One labium may be larger than the other, creating embarrassment in intimate settings.

Removal of the extra tissue can generally be performed through a customized incision under local anesthesia or local anesthesia plus IV sedation. Dr. Ruff takes great care to eliminate the extra bulk while preserving the natural appearance of the labia postoperatively. Most of his patients drive home afterward; an additional benefit of local anesthesia is the ability to keep this a private conversation between patient and surgeon, as the use of local anesthesia does not require someone to drive you home.

Labia Majora Reshaping

With age, and often due to childbearing, the volume of a woman’s labia majora often decreases. For women who prefer a more full appearance of their labia majora, injections of Juvéderm or Sculptra can bring about a temporarily more attractive contour. For more permanent results, however, the injection of fat obtained through liposuction or VASER Liposelection offers a much more stable alternative. This procedure can be performed alone or with any other body sculpting procedure. However, fat must be obtained via liposuction so some anesthesia will be needed for that procedure. The details will be decided between you and Dr. Ruff during your consultation at his Washington, D.C. plastic surgery office.


Clitoroplasty is the removal and/or reshaping of the skin over the opening of the clitoris, called the clitoral hood. For some women, age or childbearing has caused the clitoral hood to become loose, which inhibits clitoral response during lovemaking. For other women, the clitoral hood has always been a bit too loose for maximal friction. Not to be confused with female circumcision, which is the removal of the clitoris, this procedure aims to allow proper exposure of the clitoris in order to achieve maximum stimulation. Note that for women in need of clitoroplasty due to aging, labiaplasty is also generally necessary.

Mons Pubis Reduction

Aging and weight gain can cause the mons pubis to enlarge with time. Not only is this visible through tight clothing, such as workout wear or swimwear, if the mons extends over the labia it results in poor access for intimate relations. Simple removal of the extra skin and underlying fat easily restores a more youthful and aesthetically attractive area.


Also known as revirgination, hymenoplasty is frequently performed due to cultural pressure and expectations in anticipation of marriage. This is a very private and personal matter. The procedure is usually performed under local anesthesia to allow for total privacy. During your consultation and examination Dr. Ruff will discuss with you your options and expectations.

ThermiVA: A Non-Surgical Option

This non-surgical treatment tightens lax vaginal skin using the same proven technology that’s been effective for anti-aging procedures. ThermiVa is an FDA-cleared treatment that delivers controlled thermal energy to the labia and vagina to safely tighten and rejuvenate the skin. Lax vaginal skin can cause women to be self-conscious about the appearance of their genital area and result in diminished sexual satisfaction.

Doctors have used heat to stimulate collagen growth for years as a skin-tightening procedure. ThermiVA is a temperature-controlled treatment performed in our office that requires no downtime. It’s an ideal option for women concerned about vaginal sensation but who don’t want to undergo surgical labia tightening. The complete ThermiVa procedure includes 3 treatments spaced a month apart.

Are You A Good Candidate for a Cosmetic Gynecology Procedure?

The best candidate for a cosmetic gynecology procedure is a woman with concerns about the size, shape and/or volume of her genitalia. Women of nearly every age, including teens, have found both emotional and physical satisfaction following a cosmetic gynecology procedure. If you are generally healthy and have a realistic view about the results that can be achieved, you may be a good candidate for a cosmetic gynecology procedure:

Meeting With Your Surgeon

Prior to scheduling your procedure, you will have an extensive consultation with Dr. Ruff, Dr. Ramineni, Dr. Patrick, or Dr. Hannan at their West End Plastic Surgery practice in Washington, D.C., a short drive from most areas of Maryland and Virginia. The goals of your consultation are to discuss your concerns, so that you and your surgeon can mutually agree upon which procedure(s) will create the results you desire. We will thoroughly explain each procedure along with its risks, benefits, and recovery times.

Your surgeon and the team at West End Plastic Surgery will:

  • Review the various options with you
  • Clearly discuss the potential risks of each procedure
  • Outline in detail how the procedure is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost and payment information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medication you currently take, including over the counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How Cosmetic Gynecology Procedures Are Performed

Your procedure will be performed in the accredited, state-of-the-art surgical suite located in Dr. Ruff’s Washington, D.C. plastic surgery office. With extremely rare exceptions, most cosmetic gynecological procedures are outpatient in nature and are performed under local anesthesia. If you’re a bit squeamish about these things, we are happy to provide sedation along with local anesthesia, though sedation requires that a friend or family member drive you home. Most procedures of this nature take approximately 1-2 hours to perform. For procedures involving fat transfer, about 2-3 hours will be required, as it is a two-step procedure: first, liposuction is performed then the fat is processed and inserted into the areas desired. The type of anesthesia used and whether or not a hospital stay is required will be discussed with you at your initial consultation with Dr. Ruff at his Washington, D.C. plastic surgery office.

Once your procedure is complete, your surgeon will place tiny sutures, most of which will be absorbable, and a dressing.

What To Expect After Your Cosmetic Gynecology Procedure

Activity When
Bandages Removed One to Five Days After Surgery
Shower One to Two Days After Surgery
Stitches Removed (assuming some are not absorbable) Five to Seven Days After Surgery
Back to Work Two to Three Days After Surgery
Driving Same day to Three Days after Surgery
Sexual Activity Four to Six Weeks After Surgery
Fading of Scars Several Months to One Year

Immediately After Your Cosmetic Gynecology Procedure

In most cases, cosmetic gynecology surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy if you have had sedation or general anesthesia and the surgical area will be sore, so you will need to have someone drive you home. If your procedure was performed under local anesthesia, you can drive yourself home afterwards. There will be some bruising, swelling and numbness. Most patients do not require prescription pain medication but if you find that you need something, just call the office and we will make sure that you are comfortable.

The First 24 to 48 Hours After Your Cosmetic Gynecology Procedure

You may experience some numbness and temporary discomfort around the incisions. Any pain or discomfort you experience can be controlled with Tylenol or prescription medication. You will also experience swelling and some bruising. Your comfort level will improve rapidly after the first two days.

Dr. Ruff will see you within 2-3 days at your first post-operative visit. There may be a small amount of bleeding around your incisions. This is normal and can usually be controlled by applying light pressure to the area. If the bleeding does not respond to light pressure or concerns you, please call West End Plastic Surgery for further instructions.

The First Two Weeks After Your Cosmetic Gynecology Procedure

Although you will be up and around immediately, and might have driven home, you’ll find that, in the first few days after your procedure, you’ll have some soreness, bruising and swelling.

You will become more comfortable during the first few days after your procedure. You may also notice:

  • Mild to moderate swelling, tenderness, and bruising in the area of the incisions. This will gradually disappear within the first week after surgery, with most of the swelling and bruising disappearing within one to two weeks.
  • Numbness in the area of your incisions; this is normal and may take several weeks to disappear completely.
  • Itching as a result of the healing of the nerves near your incisions.

Resuming Your Normal Routine

Everyone heals at different rates and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work within a day or two of your surgery.
  • You can resume driving as soon as you feel comfortable doing so.
  • You can most likely return to your physical exercise program within two to four weeks of your procedure. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • You may resume intimate activity within six to eight weeks of your procedure.
  • Most of the visible signs of your surgery should fade within about three weeks.

What Are Possible Side Effects or Risks of Cosmetic Gynecology Procedures?

All surgical procedures have some degree of risk, however, major complications from cosmetic gynecology procedures are unusual. During your initial consultation with Dr. Ruff and the staff of West End Plastic Surgery, your individual risks will be assessed and discussed. As with any surgery, you can help reduce the risks by closely following the pre- and post-surgery instructions provided to you. Rest assured, your surgeon will be with you every step of the way to ensure a safe and pleasing outcome.

Most likely risks include the following:

  • Infection
  • Asymmetry
  • Blood or fluid collect
  • Skin sloughing, delayed healing at the incisions points
  • Wide or thickened scars

How Long Will the Results of Your Cosmetic Gynecology Procedure Last?

The results from cosmetic gynecology procedures generally last between five to ten years, longer in some cases. It is important to keep in mind that the effects of aging, gravity, and future childbearing may affect your results over time.

Questions You May Have

Will my insurance coverage pay for my Cosmetic Gynecology Procedure?

Depending upon the causes of your concerns, one or more of your procedures might be covered by insurance, though unless you have problems with function of your genitalia, in general, surgeries performed for “appearance” reasons are not covered by health insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation.

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