Hymenoplasty

A hymenoplasty is a procedure to repair a torn hymen. The cost of the procedure depends on different factors and the average cost is about Rs 25000

Hymenoplasty has become very popular in recent years, especially in cultures in which virginity is highly valued. In some societies, an intact hymen is seen as a symbol of purity.

What is hymenoplasty?

Hymenoplasty is a procedure in which a torn or broken hymen is restored through surgery. It is also known as Revirgination (making a woman a virgin again), or hymenorrhaphy or hymen reconstruction surgery. It restores the hymen to its pre-sexual intercourse state.

What is the Hymen?

The hymen is a thin, fine membrane which covers the vaginal opening. It is usually partial, with a small opening to allow the menstrual blood to flow out. It gets torn at the time of the first sexual intercourse.

Can the hymen get torn even without sexual intercourse?

Yes, the hymen can sometimes get torn with activities like bicycling, horse riding, swimming, gymnastics or even due to injury after a fall.

Why is a Hymenoplasty done?

A Hymenoplasty is done to repair the hymen and restore the hymen to its earlier state before sexual intercourse. It is a cosmetic repair. It may be needed due to :

Cultural or religious reason: Some cultures or religions place a lot of emphasis on female virginity and it may be necessary for a women to undergo hymenoplasty or revirgination procedure before marriage.
Accidental rupture of Hymen: In cultures in which an intact hymen is valued, an accidental rupture of the hymen may be considered a serious condition. The hymen can get torn while swimming, bicycle riding, horse riding, inserting tampons etc. The hymen will then need to be repaired by a hymenoplasty.
After rape or sexual assault: A woman may feel the need for hymenoplasty after a rape or sexual assault as a means of recovery from the trauma and to reclaim control over her body and her sexuality
Tightening of vaginal opening; Some women may have a loose and sagging vaginal opening after childbirth. These women may need a hymenoplasty together with tightening of the vagina (Vaginoplasty).
Psychological Satisfaction: Some women prefer to go in for a hymenoplasty before marriage to feel like a virgin at the time of her marriage.

Can all women get Hymenoplasty?

No, Hymenoplasty cannot be done if:

You are on your menstrual periods
If there is an active vaginal infection like a yeast or Bacterial Vaginosis infection. The infection will need to be cured before the surgery.
If your have delayed periods . A pregnancy will need to be definitely ruled out.
Any infection or inflammation in the groin.
In girls younger than 18 years and unaccompanied by her parents.

How is a hymenoplasty done? What is the procedure?

There are different procedures for doing a hymenoplasty:

Hymen Stitching: When the hymen is torn, small tags of tissue can be present along the edge of the vaginal opening. These tags can be cut open and stitched to create the hymen.
Hymen Reconstruction: Sometimes there may not be adequate hymen tissue present to create the hymen. In this case, tissue flaps from the surrounding area can be taken to reconstruct the hymen.
Alloplant: Artificial tissue can be used to make the hymen. Alloplants are biomaterials that are chemically processed and are often used for transplantation.

What can I expect before the procedure?

There will be at least 2 consultations before the procedure. At the first consultation, you will be evaluated for your physical health, medical history, and reasons for seeking the surgery.

The preoperative and postoperative directions will be explained to you.

The vulva and the hymen will be examined to plan for surgery. You will be given directions for blood tests and other tests necessary for the surgery.

On the second visit, the reports will be checked to see if you are fit for surgery. And a date for surgery will be discussed and fixed. You must not take aspirin or any other blood-thinning medication for at least a week before the surgery.

What can I expect during the procedure?

Hymenoplasty can be done under local or general anaesthesia, depending on the patient’s preference and the surgeon’s recommendation. Local anesthesia numbs the area, making it painless during the surgery but you will be awake and aware of the surgery. General anesthesia will cause you to be asleep during the whole procedure.

You will be asked to come to the hospital on the day of the surgery on empty stomach – that means that you cannot eat or drink anything for 6 hours before the time of surgery. This is to ensure that you do not vomit when under anesthesia.
On the OT table, you will be placed in the lithotomy position. This means that you will lie on your back and the legs will be secured in position and kept apart for a clear view of the vulval area.

The vulva will be thoroughly cleaned with antiseptic solution and the legs and other abdomen covered with sterile drapes , leaving only the vulva exposed.
The hymen tags will be identified.
Incisions will be made along the edge of the hymen tag to open them up into two layers.
Bleeding points, if any, will be cauterized
The hymen will now be stitched in layers. The stitches are made along the hymen tags to create a seamless closure. The torn edges of the hymen are reconstructed using sutures which dissolve by themselves in 15-20 days. A small opening will be left for the menstrual blood to flow during the periods. The aim is to recreate a natural-looking hymen without any visible scars.
The operation is completed in about 20-30 minutes.
Sterile dressing will be placed on the vulva.
You will be taken to the Recovery Room and rest for 3-4 hours.
You can go home after 4 hours.

What can I expect after the procedure?

Once the surgery is over, you will have to remain under observation in the hospital for at least 4 hours . Depending on your recovery, you may be allowed to have tea and biscuits after 2 hours. At your discharge, you will be given thorough directions for the post –operative care.

What postoperative care should I take after a Hymenoplasty?

Postoperative care is crucial for a successful recovery. There will be mild bleeding for 1-2 days. The tissues may be slightly swollen and there may be pain when you sit or walk. These will decrease in 2-3 days.

You will be advised to:

Avoid sexual intercourse for 4-6 weeks, to allow the hymen to heal.
Do not bath for 2- 3 days.
Active sports or exercises should be started only after 4 weeks.
Take pain relievers and antibiotics, as directed.
Clean the vulva very gently with warm water and the antiseptic solution provided each time you pass stool or urine.
In case of any pain or swelling, use a warm compress for relief.
Avoid smoking or drinking alcohol for 3 to 4 weeks after your hymenoplasty surgery.
Do not use vaginal tampons or douches for 2 months.
Avoid going to any public pool or saunas for at least 4-6 weeks after the surgery
Wear loose-fitting clothes and avoid wearing tight underwear after surgery to prevent irritation in the operated area.
Attend follow-up appointments to monitor the healing process and address any concerns or complications that may arise.

How soon can I walk after surgery?

You will be able to walk within 4-5 hours and be able to go home. But you will be advised to lie down and stay at rest for at least 2 days.

Are there any risks or complications with Hymenoplasty?

Complications are very minimal and very uncommon. But as with any surgical procedure, there may be some potential complications:

Infection: Although rare, there is a risk of infection at the surgical site. This can be avoided by proper sterilization techniques during the surgery and by taking appropriate antibiotics in the post-operative period.
Pain and Discomfort: Some women may experience some pain and discomfort following the surgery. But this generally goes away after about 2-3 days of surgery. It can be managed with pain medicines.
Itching: Itching can occur over the stitches when healing occurs. This is normal and will clear up with ointments.
Bleeding: Some mild bleeding may occur after the surgery for the first 2-3 days.
Swelling: Swelling may be present for 4-5 days after surgery but generally, clears up in about 1 week.
Numbness: A slight numbness may occur around the area but will soon resolve.

Does hymenoplasty really work?

Yes, hymenoplasty is a very effective surgery to reconstruct the hymen.

What diet should I follow after a hymenoplasty?

There are no specific diet rule to follow. But it is better to avoid eating any spicy food or unhealthy food to avoid getting diarrhea. Diarrhea can cause infection of the surgical area.

When can I have sexual intercourse after a hymenoplasty?

It is best to avoid sexual intercourse for at least 4 weeks to allow the hymen to heal completely.

Will I bleed when I have sexual intercourse again after a hymenopasty?

Yes you will bleed again, similar to anyone having sex for the first time. The reconstructed hymen is the same as the natural hymen and you will have normal bleeding.

When can I go back to work?

You will need to be at rest for at least 2 days after the surgery and will be able to do minor day to day work for another 2 days. You can join your job again after 4 days.

Is Hymenoplasty legal in India?

Yes, Hymenoplasty or hymen repair surgery is legal in India. It is performed across India in several gynecology clinics and is considered a legal surgical procedure.

Does Hymenoplasty make you tighter?

Hymenoplasty makes the vaginal opening tighter and smaller. If vaginoplasty is not done together with hymenoplasty, the vagina is not tightened.

Will my partner know if I have a hymenoplasty?

No, your partner would not know whether you have had a hymenoplasty or not. The sutures used are very fine and dissolve in 2- 3 weeks without leaving any scars. The 1-2 fine scars that remain will fade and will be hidden in the folds of the hymen. There would be no visible difference between a natural and a surgically reconstructed hymen.

How long before my marriage should I schedule a hymenoplasty?

Since it takes about 4-6 weeks for complete healing of the hymen, it is best to schedule your surgery about 4 weeks before your marriage.

Will a hymenoplasty affect my fertility?

No, it will not. The uterus, the Fallopian tubes and ovaries are not touched during the procedure and fertility is not affected in any way.

Will I be able to pass urine without any problem?

Yes you will be able to pass urine normally. The urethral opening (through which urine comes out) is not touched.

Can I have the surgery when I am on my periods?

No, hymenoplasty is not done when you are on your menstrual periods to avoid risks of infection.

What will be the cost of Hymenoplasty?

The cost will vary from women to women depending on the complexity of the surgery. In Guwahati, India, it usually costs around Rs 25000 to Rs. 35 000.

Will a family member be informed about the procedure if they ask about it?

No. The procedure will be absolutely private and confidential. No one except you will be able to access your medical file. We do not give any information concerning the procedure to a third party, irrespective of the relationship.

What are the benefits of Hymenoplasty?

The benefits of hymenoplasty can vary depending on individual circumstances. Some potential benefits include:

Restores the integrity of the Hymen: The hymen becomes intact again.
Restores Cultural Expectations of Virginity: For individuals who come from cultures where virginity is highly valued, hymenoplasty can help meet expectations and maintain the appearance of an intact hymen.
Psychological Well-being: Hymenoplasty can provide psychological relief to the pain and trauma suffered by victims of rape and sexual assault.
Sense of Youth: Restores a sense of youth in older women who undergo this procedure.

How long does the effect of Hymenoplasty last?

The results of the hymenoplasty remain as long as you do not have sexual intercourse. After sex, the hymen breaks again like a normal hymen.

What are the alternatives to hymenoplasty?

There are two alternatives to hymenoplasty. These procedures are done when hymenoplasty is done together with tightening of the vagina. These include laser vaginal rejuvenation (a noninvasive procedure in which a laser beam fixes the torn hymen) and vaginoplasty (tightening of vaginal tissue that recreates hymen).