Vaginal Rejuvenation: Vaginoplasty & ThermiVa

Dr. Susan Hardwick-Smith is Texas’s resident expert in vaginal rejuvenation procedures, and at the Complete Midlife Wellness Center in Houston, she consults and offers both surgical and non-surgical procedures for women who are hoping to remedy the natural effects of childbirth and aging that may result in vaginal relaxation and decreased sexual satisfaction.

Dr. Susan offers both surgical vaginal tightening known as vaginoplasty, as well as in-office ThermiVa treatment, offering mild vaginal tightening, as well as other benefits including increased sensation, moisture and improvement in urinary leakage.


Interested in Vaginoplasty?

Have you felt that having children or getting older have left your vagina feeling naturally relaxed, and wanting to restore and rejuvenate your natural tightness? Having a vaginoplasty is the perfect way to regain tightness in your vagina to improve friction for increased sexual satisfaction.

Dr. Susan, named one of Houston’s Top Three Gynecologists of 2016-2020, recently launched the Complete Midlife Wellness Center, specializing in surgeries and procedures that help women who are past their years of having children, and wanting to focus on feeling better and healthier as they age. Vaginoplasty, by itself or paired with labiaplasty, is a great way to surgically repair some of the effects of motherhood and time, and return your vagina to a healthier condition for improved sexual satisfaction and personal confidence.

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Why Dr. Susan?

  • Consistently voted one of Houston and Texas’ Top Gynecologists, Dr. Susan specializes in cosmetic gynecologic surgeries, as well as other health services for women approaching and at their midlife. This means she’s available to consult, to guide, to perform the surgery, and to follow up without you having to set foot in a standard OB/GYN office with long wait times, short visits and potential judgement. Your first visit is usually an hour, and may be done remotely if you live outside of Houston or the USA. This is not something that should be rushed, and requires not only experience, but a kind, empathetic ear.
  • Dr. Susan has been a pioneer in this field for 15 years regarding both labiaplasty and vaginoplasty, so whether you’re just doing a vaginoplasty or wondering if you should consider both procedures, Dr. Susan has the litany of knowledge to help you through your decision and serve as a consultant and guide throughout your journey.
  • Required Pre-Operation and Post-Operation appointments help you have the proper support as needed for each step of your procedure, and to ensure that you are recovering properly following your surgery.

Vaginoplasty Questions


Surgery is performed at Museum District Ambulatory Surgery Center, adjacent to our office at 1200 Binz Street in Houston. This is a top of the line cosmetic surgery center with highly trained Physician anesthesiologists (not anesthesia nurses) and a seasoned cosmetic surgery support team.

Patients receive intravenous propofol so you are safely asleep and feel no pain. Most patients do not need to be intubated. Prior to waking up, I administer a long acting local anesthetic that will keep you pain free for 8-12 hours.

Most patients can go home or to their hotel about 2 hours after the surgery, after urinating and having something to eat and drink. For the first 3 days, it is important to use ice off and on and rest as much as possible to avoid excess swelling from being upright. Immediately after surgery you can shower (no baths for 2 weeks), eat, and then rest. The local anesthetic wears off after about 8-12 hours and narcotic pain medicine may be needed for 2-3 days. Many patients just take Advil or something similar. After 3 days, you are able to drive short distances, fly or walk short distances, but should avoid any strenuous activity for 2 weeks. After our 2 weeks postop visit, most patients can return to normal activities with the exception of intercourse and heavy lighting that strains the muscles. You can resume those activities at the 4-6 week mark depending on your personal healing. If possible, I recommend taking a week off work, unless you have a totally sedentary job.

Most patients take pain medicine for 7-10 days, then complain more of itching and irritation from the stitches rather than pain. Topical lidocaine gel is really helpful for this.

Like all surgery, we will go over a detailed consent form at your pre-op visit and I will outline all possible risks, although they are extremely rare.

When done correctly, by a surgeon who is very experienced, the goal is that with a tighter vagina you will experience more friction which will improve sexual sensation inside the vagina. If you are one of many women who only experience clitoral (external) orgasms, even before you had children, then vaginal tightening may not have the desired effect. These are important questions that we go over at your initial consultation.

I have been focusing on cosmetic gynecology since 2008, currently 12 years, and have done over 200 vaginoplasty cases

There are 3 elements to the cost. One is from my office, one is from the anesthesiologist, and one is from the surgery center. Our cost is $6000 for a posterior vaginoplasty (most) and $7000 for an anterior and posterior vaginoplasty (about 1/3), which includes all pre-op and postoperative care until 3 months after surgery, as well as the surgery itself. Anesthesia and surgery center costs are based on time so can vary based on the complexity of the case, but generally are between $2000-$2500.

Generally not, because this surgery is not usually done to treat a medical condition, and this is not a medically necessary procedure but rather personal choice. Similar to changing the size of your nose or breasts, it is an optional procedure that is not covered by insurance. If you have a significant cystocele (fallen bladder) or rectocele (protruding rectum) insurance may cover the procedure and surgery center/anesthesia costs. My office is not in network with insurance, but in those cases you may submit the bill to your insurance for reimbursement.

If you have other questions, please schedule a consultation at !


Interested in learning about how to tighten your vagina without having to go through an invasive surgical procedure? Dr. Susan also offers ThermiVa vaginal rejuvenation to patients who are looking for a non-invasive, in-office procedure that helps you manage mild vaginal relaxation, vaginal dryness, decreased clitoral sensitivity and some types of urinary leakage.

How it Works?

ThermiVa is a quick, non-invasive, non-ablative treatment delivering physician controlled radiofrequency energy using a thoughtfully designed handpiece to gently heat tissue. By using radiofrequency energy, the tissue is heated to stimulate and re-build your body’s own collagen, naturally. Collagen is a protein that makes your skin firm and elastic.  The natural aging process can diminish collagen.  When the skin has less collagen, it can lose its youthful appearance and elasticity. Treatments using radiofrequency technology are widely used in dermatology and aesthetic medicine. 

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We invite you to schedule a consultation with Dr. Susan to learn if ThermiVa is the right solution for you, or for any questions you have about procedures such as labiaplasty or vaginoplasty.

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“I had the vaginal tightening done as well as labiaplasty which I have to say completely changed my sex life for the better! Thanks Dr. Susan!”

“After having 3 babies, I told Dr. Susan that my husband was on the smaller side, and she ‘custom made’ my vagina a little higher than usual as a result. She really listened to my specific case. My husband and I could not be happier.”

“I found myself back in the dating world at age 45, and after having 2 kids I was concerned about vaginal relaxation. After the procedure, I feel confident and youthful. I am not worried about that first sexual encounter, whenever it may be. I feel that I can be fully available and be myself without that fear. That’s priceless.”