Awake body surgery
Awake Perineoplasty in Ottawa
Perineoplasty reshapes and strengthens the tissue between the vaginal opening and anus, often after childbirth. For selected patients, it can be done awake with local anesthesia and sedation.
Perineoplasty at a glance
| Typical operating time | About 1 to 2 hours |
|---|---|
| Awake suitability | Selected patients |
| Typical return to desk work | Desk work often within 1 to 2 weeks |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is perineoplasty?
Scar or lax tissue is repaired and the perineal body rebuilt, often together with vaginoplasty. The plan depends on your anatomy and symptoms.
Who may be a good candidate
- People with perineal scarring, laxity or discomfort after childbirth
- Those with a functional or cosmetic concern
Why awake perineoplasty may work
The perineum is a small, accessible area that can be numbed well. Outpatient female genital cosmetic surgery is increasingly described, though procedure-specific published evidence for awake perineoplasty is limited. We describe it as an option for selected patients.
When awake may not be the right choice
Combined or deeper repairs may be better with regional or general anesthesia, and we will recommend the safest option.
Your awake perineoplasty journey
1. Before surgery (pre-op)
A private, chaperoned examination and discussion of goals and risks.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
Your dignity and privacy are protected. The area is numbed and sedation is added if needed.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Soreness and swelling. Rest, cold packs and stool softeners. |
| Week 1 to 2 | Light activity. Avoid straining and sitting for long periods. |
| Weeks 3 to 6 | Gradual return. Stitches dissolve. |
| Months 2 to 3 | Healing continues. Intimacy after clearance. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Pelvic floor physiotherapy, scar treatments, or no treatment.
Risks
Bleeding, infection, wound separation, scarring, pain with intimacy, altered sensation, unsatisfactory results, and anesthesia-related risks.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake perineoplasty
Can perineoplasty be done awake?
In selected patients with a limited plan.
Is it painful afterward?
Soreness is expected and managed with medication and cold packs.
Is it done with vaginoplasty?
Often yes.
Is my privacy protected?
Yes.
Related procedures
Pricing for this procedure is quoted at your consultation. See pricing and financing.
Explore your options at a consultation
References
- Padovesi Mota IL, et al. Outpatient female genital cosmetic surgery: a systematic review and meta-analysis. Aesthet Surg J. 2026. PMID 42615976
Starting from $5,000 for Perineoplasty (CAD, before 13% HST). Your personalized written quote follows consultation. See pricing and financing.