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Prof. asoc. Dr. Stefan Gress

Vaginal Tightening

Professor Gress is one of the
top specialists internationally


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Whats next?

How is the procedure performed?

The days after surgery

Risks and complications

According to Master and Johnson , the degree of sexual stimulation is
directly proportional to the friction forces during sexual intercourse.
It goes without saying that a small penis in a large vagina creates little pleasure.

This is a phenomenon that affects women immediately after pregnancies ending in vaginal deliveries. Perhaps it was not really that intense before, but now it is even less so: vaginal stimulation during sexual intercourse!

Sexual stimulation is heavily dependent on the intensity of mechanical friction along with a whole host of other factors. If the friction is not strong enough, the stimulation is too weak, especially in order to reach climax. If it is too strong, it can cause pain. It goes without saying that a small penis inside a large vagina is not very pleasurable.

Many couples suffer as a result of this fact. It is not uncommon for couples to split up because a significant component of the life they share together as husband and wife has dwindled.

A harmonious partnership cannot, of course, be reduced to sexual satisfaction and pleasure alone. Nevertheless, the desire for sexual fulfillment is one of the greatest and most basic human needs. A harmonious and thus sensual partnership requires the ability to both enjoy pleasure as well as give it.

As women age, anatomical changes can be considerable, especially after childbirth. Filling out a very stretched vagina,hen, is a difficult feat for a man with an average-sized penis.

Adapting a penis to these changes through surgical means is not possible. Although it can be lengthened to some extent, it is not possible to effectively increase its girth.

However, narrowing the vagina and resetting it along with all the structures that have been stretched and lost their tension over time is certainly a possibility. The end result aims to replicate the anatomy of a youthful woman who has not yet had a vaginal delivery, creating the conditions for optimal sexual stimulation.

The aim is to increase frictional pressure during sexual intercourse as much as possible.
It is merely an anatomical change that returns your body to the condition it was in before giving birth – or even better. However, if you are no longer sexually attracted to your partner, there is not a great deal we can do!

After a physical examination and some questions regarding your medical history, which focuses primarily on your gynecological situation (especially the number and type of births), we will suggest and discuss with you the therapy that we feel would be most promising for you.

A large number of organs are located in the pelvis, which is shaped like a ring: the rectum, the bladder, the vagina, the ovaries, etc.
In order to stop these organs from slipping down, a kind of hammock is stretched out within the pelvis: the pelvic floor. It essentially comprises muscles (Levator ani muscle) and fascia (connective tissue plates, similar to the structure and density of a muscle tendon).
At its core, there are openings for the passage of the intestines, the vagina, and the urinary tract.

Pelvic floor:

Red section: Levator ani muscle with passage of the intestines (anus)
Blue section: Fascial plate (urogenital diaphragm) with passage of the vagina and urethra

Principle of the procedure (vaginal surgery)
Anatomically speaking, the vagina is like a tube and is the counterpart to the penis. If the vaginal tract is too wide, it is surgically possible to narrow it. However, narrowing the vagina by removing skin alone would not be sufficient as vaginal skin is very elastic – how it is designed to be for childbirth. As the skin is stretched again, e.g. during sexual intercourse, the result would therefore not be a permanent solution (that is why lasers that purport to tighten the vaginal skin do not really work!).

It is important that the muscles surrounding the vagina (pelvic floor muscles) are also tightened so that external pressure can be applied to the vagina, thus preventing the vaginal skin from stretching excessively again. Additional padding and thickening of the vaginal wall using autologous fatty tissue intensifies this effect.

The procedure involving these three steps provides the optimal anatomical basis for ideal sexual stimulation. It goes as far as is medically possible and is extremely successful and effective. We are proud to be able to say that, up to this point, every patient has been highly satisfied with the results of this operation.

1. Narrowing the vaginal canal Vaginal skin is removed from the posterior wall of the vagina. Tissue can also be taken from the anterior wall if the vagina is very wide and the patient is experiencing urinary incontinence. Tightening the anterior wall of the vagina simultaneously lifts the base of the bladder, treating incontinence problems.

2. Tightening the pelvic floor muscles and fascia This provides the vagina with external pressure, support, and firmness. It is straightened up again, just like in your younger years. This is the vital step that ensures the long-term success of the treatment and counteracts renewed overstretching of the vaginal skin.

3. Padding and thickening the vaginal wall with autologous fatty tissue Fatty tissue is a wonderful filler that can be used to create volume. Injecting the body’s own fatty tissue into the vaginal wall thickens and pads it out without the need for additional incisions and scars.
The fatty tissue is removed from the (outer) thighs or the inside of the knees, specially prepared, and injected circularly into the middle section of the vagina (the most sensitive part of the vagina) through thin cannulas under the vaginal skin.

The duration of the procedure is around two-and-a-half hours and is performed on an inpatient basis at the clinic. The inpatient stay is two nights.

Cross-section of the vagina with surrounding pelvic floor muscles (red) and the connective tissue layer (white) below the vagina.
Removal of a segment at the posterior and anterior vaginal wall along the entire length of the vagina (marked in orange).
Narrowing of the vaginal canal, tightening of the connective tissue layer (fascia), tightening of pelvic floor muscles, lining the vaginal wall with fatty tissue (yellow)

This is a very elegant method of vaginal tightening that requires no incisions and leaves no scars. However, the extent to which the vagina can be narrowed is limited. A narrowing of around 20% can be achieved by injecting autologous fat.
This is the method of choice for women who have not yet given birth and want improved vaginal stimulation!
However, after a vaginal delivery, this therapy is not very effective as the overstretching of the tissue caused by childbirth is not corrected to a satisfactory level and a vaginal narrowing of around 20% does not usually go far enough to achieve a noticeable change.This procedure can be performed under local anesthesia on an outpatient basis. Major aftercare is not necessary. Sexual intercourse is permitted again after two weeks.

Cross section through the vagina…

Vaginal narrowing including the tightening of the pelvic floor muscles is performed under general anesthesia as part of a two-day inpatient stay. Narrowing is performed under local anesthesia on an outpatient basis by means of autologous fat injection alone.

In any case, you should not take any blood-thinning medications (e.g. aspirin, etc.) 14 days prior to the procedure.

An extensive preliminary examination is necessary in all cases. You will receive all the important information on how to prepare for each procedure.

Vaginal narrowing including tightening of the pelvic floor muscles

  • Protection of the pelvic muscles for six weeks (no
  • heavy lifting, no straining on the toilet, etc.)
  • Removal of the tamponade and bladder catheter the day after the procedure at the clinic
  • Discharge from the clinic on the second postoperative day
  • No sexual intercourse for six weeks
  • Drink plenty of fluids to ensure soft bowel movements
  • Check-up after six weeks

Vaginal narrowing using autologous fat injections alone

–             Check-up and dressing change the day after the procedure at the practice with removal of the vaginal tamponade

–             No sexual intercourse for two weeks

Prof. Gress has published most of his medical publications with Springer Verlag.

His textbook on correcting the outer female genital region entitled „Aesthetic and Functional Labiaplasty“ was published in 2018.

This book describes his techniques for reducing the labia minora, primarily the “composite reduction labiaplasty”, and techniques for correcting the labia majora and the mons pubis. This textbook is now the standard for colleagues in this field throughout the world.

Publications by Prof. Gress:

(click for further information)

alle wichtigen Fragen


 Costs and operating time

 Sutures, stitches


 Is vaginal laser treatment an option?

 Vaginal narrowing through lasering the vaginal skin alone?

 Laser or scalpel?





 Showering, water, soap

 Sexual intercourse


 How many appointments do I need?

 Success of treatment

 The right treatment





 Individual information

Best Results

by specially developed, internationally leading surgical technique “Composite Reduction Labiaplasty”

Greatest Experience

With the most operations in
the female genital
area worldwide

Media Partner

First point of contact for international media for all questions relating to intimate surgery

Experience makes the difference

  • More than 6700 procedures in the female genital area
  • Over 20 years of experience
  • Inventor and developer of the “Composite Reduction Labiaplasty”
  • Internationally recognized top specialist
  • Author of the international textbook “Aesthetic and Functional Labiaplasty” (Springer Publishers)
  • Professor and Lecturer in Plastic Surgery

„Pioneer of female genital surgery“

„The Vagina Picasso“

„The labia pope of Germany“

In the most important national and international specialist societies

American Society of Plastic Surgeons

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen

International Confederation for Plastic, Reconstructive and Aesthetic Surgery

International Society of Aesthetic Plastic Surgery

The Aston Baker
Cutting Edge
Aesthetic Surgery

2018, New York

Faculty Member
The greatest honor for
a Plastic Surgeon

The internatioanl Textbook
written by Prof. Gress

Published in January 2018 by Springer Verlag, it has developed into an international bestseller and standard work in plastic surgery