As more women turn to vaginoplasty, surgery to reconstruct or tighten the vagina, doctors are growing uneasy about how quickly demand is rising and how loosely the procedures are being offered.
What was once a specialised medical intervention is now being marketed to younger women, often with little oversight, raising fresh concerns about safety and standards of care.
Dr Francis Were, an obstetrician and gynaecologist who has also specialised in cosmetic gynaecology, is worried about the increasing number of spas offering these services outside of formal medical regulation.
Spas are ideally regulated to offer skin and beauty care, such as massages and not vaginal tightening procedures.
“There is a demand for vaginal tightening, but unfortunately, most women are seeking these procedures in spas, partly because some of them offer very cheap services.”
Vaginoplasty was once a specialised medical intervention, but is now being marketed to younger women with little oversight.
“Those offering these procedures in spas are beauticians who may know how to operate machines, but they have not studied the anatomy of the female genital area.”
By contrast, becoming a cosmetic gynaecologist involves years of medical training: first as a doctor, then as a gynaecologist, and finally specialising further in cosmetic gynaecology, which covers the entire female genital area and addresses both functional and aesthetic concerns.
“Yet many women, often unknowingly, seek these services in places that are neither medically equipped nor regulated,” he says.
For those considering such procedures, Dr Were emphasises the importance of seeking care from registered cosmetic gynaecologists in accredited facilities under the Kenya Medical Practitioners and Dentists Council .
The reasons why women seek vaginal tightening vary depending on the symptom they are experiencing. “Some are born with what they describe as a ‘loose’ vagina, while for others, the change may follow childbirth,” he says and points to the kinds of cases that warrant vaginoplasty.
“Some women report difficulty retaining tampons due to a lack of grip, while others complain that they have not attained maximum pleasure during intimacy. Others complain that they have not attained maximum pleasure during intimacy. Some just wish to make their vagina more appealing. In such cases, tightening procedures are seen as a way to address the issue, particularly when non-surgical options, such as physiotherapy exercises, have not worked.”
Douching and other forms of vaginal cleansing can have serious malodorous consequences that erode intimacy.
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He adds that, for sexual purposes, the ideal width of the vagina is about four centimetres when examined using two fingers. However, not all cases are purely physical. Dr Were points out that some women may have body dysmorphic disorder (BDD), a mental health condition in which a person perceives flaws in their body that may not be noticeable to others. “For some, the feeling starts in their teenage years. They grow up believing that there is something wrong with them, and that perception continues into adulthood.”
In such situations, the decision to undergo a procedure may be influenced as much by perception as by physical need.
There are also risks associated with non-medical approaches to vaginal tightening, particularly with products that promise quick results. Some can lead to vaginal fibrosis, which is the hardening of the vaginal wall. While this may initially create a sensation of tightness, it reduces the tissue’s ability to stretch.
“There may be pleasure at first, but later there can be tearing because the vaginal wall cannot stretch.”
This can have long-term implications, particularly during childbirth, when a stiff birth canal can make vaginal delivery difficult and necessitate a caesarean section. Such procedures are not without risks, even when performed in medical settings. These include infection, wounds reopening, and excessive bleeding after the first 24 hours. In some cases, blood clots may form under the vaginal tissue. While these are manageable, they require proper medical check-ups.
More women are turning to vaginoplasty, surgery to reconstruct or tighten the vagina.
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Pre-existing conditions such as diabetes can affect wound healing and slow the recovery process. Women with blood disorders such as haemophilia should also avoid such surgical procedures. This highlights the importance of assessing whether a patient is fit to undergo surgery. For some women, surgery may not be the first step. If the pelvic floor muscles are not severely affected, physiotherapy — particularly Kegel exercises — may be recommended as an initial approach.
Dr Were cautions that women who intend to have children or add more should first decide on their desired family size. “It is meant to be a one-off procedure. Once the vagina has been repaired, if you want to give birth naturally, a caesarean section may be necessary.”
Does vaginal tightening disrupt the menstrual cycle? “No, periods will come normally because the hormones are not affected.”
