Hymenoplasty Surgery: Meaning, Side Effects, Recovery, Results

Hymenoplasty Surgery refers to the reconstruction of a broken hymen. It is usually done by joining the two free ends of the broken hymen and stitching them together with the help of dissolvable stitches. It can also be done by excising a thin layer of tissue from the wall of the vagina and placing it over the torn hymen.

A gynaecologist usually performs a hymenoplasty. The goal of doing this surgery is to ensure that the woman bleeds when she has sexual intercourse after hymen repair surgery.

Anatomy and Physiology of the Hymen

1. The hymen is a layer of pink soft tissue at the vaginal opening. It is a part of the vulva. The hymen partially covers the vaginal opening so that the menstrual blood and other secretions pass easily.
2. The exact function of the hymen is unknown. However, in young girls, it is believed that the hymen's function is to protect the vaginal opening from the entry of various harmful microorganisms until puberty.
3. When a girl reaches puberty and gets her first period, the hymen develops a small opening (more like a rupture) through which the blood passes from the vagina to the outside. However, this is not an ideal scenario. 
4. One may get their periods and still have an intact hymen without any perforations. Similarly, the hymen usually ruptures during sexual intercourse due to penetration. But, in some women, the hymen may remain intact. 

Hymenoplasty is commonly performed due to some religious, cultural or psychological beliefs. However, this procedure also helps treat the following condition.

1. Torn/broken hymen
2. Hymen with a complicated structure
3. Muscle tightening

Hymenoplasty is generally performed for cosmetic purposes. However, hymenoplasty is preferred due to certain religious customs and beliefs. The eligible candidate for hymenoplasty needs to be:

1. A patient who is over the consensual age
2. A patient who is a non-smoker
3. A patient who is healthy and not suffering from any serious illness or conditions like cancer or sexually transmitted diseases.

Hymenoplasty takes about 15-30 minutes and is usually performed under local or general anaesthesia. 

Three main procedures are performed to restore the broken hymen. These are:

1. Hymen stitching
2. Hymen Reconstruction
3. Alloplant technique

Basic steps to perform Hymenoplasty:

1. The patient is made to lie in the lithotomy position.
2. The heart rate, pulse, blood pressure, and oxygen saturation are monitored throughout the procedure.
3. The doctor administers local or general anaesthesia before the operation.

Further steps depending upon the procedure:

In Hymen stitching:

1. The torn hymen tissues are approximated and joined together with the help of self-dissolvable hymenoplasty stitches.
2. If the hymenoplasty surgery is successful, the doctor shall discharge the patient within a few hours after the procedure.
3. The patient does not need to return to the doctor's clinic to get the sutures removed.

In Hymen reconstruction:

1. Here, the hymen does not have enough tissue to be stitched together. 
2. Therefore the doctor takes a graft from elsewhere in the body and stitches it with the remnants of the broken hymen.

In Alloplant technique:

1. This procedure is done if the above two methods fail.
2. Alloplant refers to biochemically synthesised grafts that can be used to do hymenoplasty.
3. The doctor will choose the correct method depending on the condition of the patient's hymen.

Irrespective of the method chosen, the basic steps for the procedure remain essentially the same. The doctor shall prepare the patient before and on the day of the hymenoplasty. Here's how:

Before Hymenoplasty 

1. The patient is properly evaluated and chosen by the doctor to undergo the hymen repair surgery. 
2. There's usually a gap of around two weeks between consultations in which the doctor will thoroughly assess the patient's condition and plan for the surgery. This period is also known as the reflection period.
3. The doctor will advise the patient to stop working two to three days before the date of surgery. 
4. The doctor will ask the patient about any medications she is currently taking. Medications that promote bleeding will be restricted by the doctor till the surgery is done to avoid any risk of bleeding during the procedure.
5. The patient should be a non-smoker and should stop smoking well in advance before the procedure.
6. The doctor will ensure that the patient is not suffering from sexually transmitted diseases or vaginal cancer by taking a thorough history and examination.
7. The patient will be made to sign an informed consent and other formalities before the procedure.

On the day of Hymenoplasty 

1. The patient must report for the procedure at a scheduled time on the day of the hymen repair surgery. 
2. The patient will be taken to the treatment room, where the procedure will be performed.
3. The patient shall be asked to change into a gown to prepare for the procedure. 
4. An IV line will be established to ensure the infusion of saline and anaesthetic medications.
5. Antibiotics will be administered to prevent infection.

The Recovery Process in Hospital

1. The doctor moves the patient to the recovery room to keep her under observation, where the vitals and effects of anaesthesia will be monitored.
2. The patient is usually discharged on the same day if there are no hymenoplasty side effects or complications.
3. The patient is prescribed painkillers and antibiotics and discharged home with instructions for care after the hymenoplasty.

Recovery process/expectation after hospital discharge 

1. The patient may resume work 3-4 days after the procedure or as directed by the doctor.
2. Take adequate rest to ensure fast healing and recovery.
3. There's no need to visit the doctor to remove the hymenoplasty stitches since they dissolve within one to two months.

Care after Hymenoplasty

1. Avoid taking showers for 2-3 days after the procedure or as directed by the gynaecologist. Follow the doctor's recommendations and guidelines while taking a shower after a hymenoplasty.
2. Take medications as prescribed by the gynaecologist to minimise hymenoplasty side effects and ensure a speedy recovery.
3. Switch to using pads instead of tampons when on periods.
4. Refrain from sexual activities till six to eight weeks after hymenoplasty.
5. Maintain proper hygiene of the vaginal area. Wash it with mild soap and water to avoid the risk of infections. Keep it clean always by wiping it gently with a clean piece of cloth once or twice a day. Don't clean the inside of the vagina until the hymenoplasty stitches are dissolved and healed.
6. Avoid doing heavy exercises or lifting weights for up to 2-3 weeks or as long as the doctor suggests.
7. Follow a healthy diet that is rich in fruits and vegetables. Avoid oily and spicy foods.
8. Avoid smoking or drinking till the hymen is completely healed, as it may interfere with the healing process.
9. Use heat packs or ice compression to relieve pain or swelling after the procedure.

The First Follow-up Appointment

1. The patient is expected to come for a follow-up as and when the doctor suggests, usually after a month or two.
2. During the follow-up visit, the doctor checks if the wound has healed.
3. The doctor may also ask about any discomfort experienced during the first sexual intercourse after the hymen repair surgery.
4. If the patient gets an infection during recovery, the doctor will prescribe certain antibiotics and painkillers to treat them.

These are the benefits of hymen repair surgery:

1. Hymenoplasty is safe as it has minimal side effects.
2. It may indicate virginity as it causes bleeding after hymenoplasty. 
3. It is effective.
4. It is cost-effective. 
5. Recovery is excellent and quick.
6. The patient is discharged the same day and may return to work the next day.
7. Low risk of postoperative complications.

Hymenoplasty is a safe procedure, and its side effects carry minimal risk and are pretty rare. 

Hymenoplasty side effects are as follows:

1. Pain
2. Swelling
3. Bruises or scarring 
4. Skin discolouration (very rare) 

It may also cause certain complications, which is, again, very rare considering the safety and efficacy of the procedure. Complications of hymenoplasty include:

1. Haemorrhage (bleeding from ruptured blood vessels)
2. Haematoma (accumulation of blood between tissues)
3. Pain during sexual intercourse, also known as dyspareunia
4. Infections of the genital tract

One should consult a doctor when experiencing pain, bleeding or itching in the genital region after one to two months of hymenoplasty surgery. 

The cost of Hymenoplasty in India depends upon various factors such as the hospital charges, the doctor's fees based on the experience, anaesthesia (local or general), etc. It ranges anywhere between ₹17,000 to ₹40,000.

Hymenoplasty is a safe procedure that, when performed by well-trained and experienced doctors, involves little to no risks and side effects. Our team of experts at Hexahealth can help you get a successful hymenoplasty surgery at the correct cost. Contact us right now to avail a free consultation call!