Vaginoplasty & Juliet Laser

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 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 IV anesthesia 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.

Vaginoplasty Pricing

$400 consultation for initial one-hour evaluation. Surgical pricing based on evaluation of individual patient. The cost is deducted from surgery fees once a surgery is scheduled.

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

Juliet Laser

Looking for a solution to improve sensation, tightness and moisture? For those who can’t take estrogen or are looking for a more lasting rejuvenation, the Juliet Laser treatment may be the answer.

How it Works?

We are excited to offer The Juliet Laser, a breakthrough laser technology by Cutera for vaginal rejuvenation. The Juliet Laser is an excellent option for increasing vaginal moisture and sensation with orgasm, and for relieving multiple symptoms including vaginal laxity, pain with intercourse, reduced sexual sensation and urine leakage. It’s a fantastic solution for women who cannot take estrogen, including breast cancer survivors and those currently undergoing breast cancer treatment. The device utilizes an Erbium laser which delivers two passes of energy to the tissue in order to rejuvenate the entire vaginal canal. The Juliet Laser can also be used to restore the outside of the vulva area by improving dryness and giving it a more youthful appearance by increasing collagen production. This treatment is quite comfortable and does not require anesthesia or downtime, just 72 hours without intercourse. Best results are obtained with 3 treatments a month apart. Each treatment takes 10-20 minutes.

The Juliet Laser can also be used to treat skin on the face and other areas of the body to remove acne scars, discoloration, and stretch marks. The laser resurfaces skin tissue by removing dead skin and revealing renewed skin underneath through increased blood vessels and collagen, making skin appear more youthful and reducing the appearance of pores. Patients will notice some redness, peeling, and dryness within 5 to 7 days of treatment before renewed skin is revealed.

View Before & After Photos

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Juliet Laser Procedure Pricing

Non-surgical laser rejuvenation: Initial 30-minute consult for $200. May be combined with O-shot and for best results. $4500 for 3-month treatment including O-shot; $3000 without O-shot and local.

Facial Laser Rejuvenation: Initial 30-minute consult for $200. Price varies based on area treated.