Vaginal Rejuvenation
SottoPelle Testosterone Replacement Therapy

What is labiaplasty?

Labiaplasty procedures reduce and reshape the inner labia, or labia minora, via the removal of excess tissue. People also often use the terms “labia reduction surgery”, “designer vagina”, and “barbie vagina” to refer to this type of procedure. Read More on Labiaplasty.

What does labia look like before and after labiaplasty?

You can view labiaplasty before and after photos in our labiaplasty before and after gallery.

Is labiaplasty safe?

Labiaplasty is a safe procedure. There are risks, as with any procedure, but finding and using a board certified surgeon who performs multiple procedures a year will reduce the likelihood of these occurring.

What are the risks associated with labiaplasty?

Risks associated with labiaplasty are similar to risks associated with any procedure you may undergo. Bleeding, infection, swelling and pain can occur.

What symptoms cause women to choose labiaplasty?

-The size of the labia makes it uncomfortable to wear tight fitting clothing.
-The labia tissue becomes irritated during exercise.
-Sexual intercourse is painful or uncomfortable.
-Dissatisfaction with the appearance of the labia.
-Difficulty with intimacy with sexual partners related to the size or appearance of the labia.
-Asymmetry, where one side of the labia is longer than the other.

How long does the labiaplasty procedure take?

Labiaplasty procedures usually take around 2.5-3 hours. On some occasions, if the labial enlargement is extensive, it can take up to 4 hours.

What is the recovery time associated with labiaplasty?

Overall recovery time following labiaplasty is about 6 weeks. Patients usually take a few days to one week off from work after surgery, this is the amount of time pain medication is usually needed following the procedure. Vaginal rest from intercourse, while the incision site is healing, is usually 6 weeks.

What does the labiaplasty healing process look like?

How much does labiaplasty cost?

The base price for our labiaplasty is $4200 (you can view our pricing page here). Our labiaplasty procedure was developed to ensure your comfort while reducing excess cost. That’s why we perform the procedure right in our clean and accommodating offices.

Does my insurance cover labiaplasty?

Unfortunately no, as insurance companies consider labiaplasty a cosmetic procedure.

Does ALVR do financing?

Yes. Financing is available through Care Credit (

Where will the procedure take place?

Labiaplasty procedures take place in the procedure room in our office.

How many labiaplasty surgeries has Dr. Shashoua performed?

Dr. Shashoua has performed hundreds of labiaplasty procedures over the years. On average we perform 3 labiaplasties per week.

Will there be anesthesia available?

Patients are given preparation before surgery, which includes a topical numbing cream and oral sedatives. Local anesthetic is administered at the time of the procedure so the area is completely numb.

How much pain should I expect during an in-office surgery?

Prior to the labiaplasty procedure, we prescribe a few different medications to help alleviate any discomfort related to the procedure. A numbing cream is applied by the patient at home and oral pain medications are taken prior to the procedure which will help reduce the pain associated with local injection. Once the injection is completed, the patient should have no discomfort.

How much pain should I expect post-op?

Patients are provided with pain medication postoperatively which should relieve any discomfort related to the procedure. If patients have pain not controlled by medication, there is a provider that is available 24/7 to contact to ensure adequate pain relief.

When can I return to work?

If undergoing Labiaplasty, usually you are able to return to work within a week. Some patient may even be able to return sooner but we recommend taking a full week off.

Will the labiaplasty procedure improve my sex life?

Reduction of the tissue at the area of the clitoral hood will allow for easier exposure of the clitoris during intercourse which should increase sensation. Reduction of the tissue in the labial area can also reduce tugging or discomfort associated with excess tissue. Many women will also tell us they have increased sexual confidence after the procedure.

How soon can I have sex?

We advise 6 weeks of vaginal rest after the procedure. This will allow adequate time for the labia to heal and prevent any breakdown of the suture line.

Why should I choose Dr. Shashoua over other surgeons in Austin?

Dr. Shashoua is board certified in Female Pelvic Medicine and Reconstruction. He has been performing these procedures successfully for many years. Dr. Shashoua and his two nurse practitioners provide patients with 24/7 compassionate care.

Do you perform labiaplasty revisions?

Yes, however every patient will have different needs for their labiaplasty revision so we recommend scheduling a free consultation if you are interested in learning more.

How long will the labiaplasty results last?

The results of labiaplasty should be lifelong. Some swelling may occur with pregnancy following labiaplasty, but this should not require another procedure.

I’m not from, nor do I live, in Austin. How long before I can travel back home after the surgery?

We see many patients from all over Texas as well as other states. Patients usually stay in town the night before surgery and for 1-2 nights following surgery. After labiaplasty, patients are managed remotely by phone calls and securely uploaded photos.

Can the labiaplasty surgery be combined with other cosmetic surgical procedures?

Yes. Vaginal rejuvenation and labia majora reduction can be combined with labiaplasty.

If I had a labiaplasty and I’m not happy with the results what can I do?

At Austin Labiaplasty and Vaginal Rejuvenation, we specialize in labiaplasty procedures, whether it’s the first time you’re having one or if you’ve had one before and the results weren’t what you expected. Often we see patients that presents with excess tissue still present and in some cases where too much tissue was removed or scar tissue has occurred. By scheduling a consultation, we can review your options and formulate a plan to get the results you desire. Most procedures can be done in the office under local anesthetic however, in some instances if reconstruction is needed, an outpatient procedure may be needed.

What if I had surgery at ALVR and I’m not happy with the result?

We always want our patients to have a positive result and to be happy with their outcomes. If you have had a labiaplasty procedure and are unhappy with the outcome, revisions are covered under your initial labiaplasty procedure cost for the first year. We assess our patients frequently within the postoperative period and are very receptive to any concerns you may have and will treat any issues that may arise in a timely manner. Revisions are done in a similar manner as the original labiaplasty procedure with oral and local anesthetic. The recovery time and discomfort after revisions is typically much less and patients are back to normal activity a little sooner. Full recovery it still 6 weeks.

Will surgery be painful?

We provide adequate numbing medication at the time of your procedure as well as have you bring in oral pain medication. Aside from the initial injection, you will be comfortable during the procedure and will have post-operative pain coverage once the procedure is completed.

Can I pee after the procedure?

Of course, you can! Using the restroom after surgery is no different than before, however, you may have a little burning as the urine touches the skin. Not to worry! We provide a water bottle for easy rinsing after you go, to help provide relief.

Can I wear a tampon?

After having a Labiaplasty procedure, tampons are actually preferred for menses. This just helps to keep the area clean. If you don’t use tampons, that’s ok too, pads are a good alternative but should be changed regularly to keep the area clean. If you’re having a vaginal rejuvenation procedure, you will need to avoid tampons for 6 weeks.

When can I start back at the gym?

We typically tell patients for the first few weeks it may be uncomfortable to be really active. Walking on a treadmill and upper body activities are usually tolerated well. For aggressive activity such a cross fit, biking, horseback riding, etc., we usually recommend waiting until 6 weeks.

How long will it take?

Labiaplasty procedures usually take around 2.5-3 hours. On some occasions, if the labial enlargement is extensive, it can take up to 4 hours.

When will I be able to have intercourse?

For healing and comfort purposes, you will need to wait 6 weeks to become sexually active again.

When can I go back to work?

If undergoing Labiaplasty, usually you are able to return to work within a week. Some patient may even be able to return sooner but we recommend taking a full week off. If having a vaginal rejuvenation procedure, you will need to take 2 weeks off work.

What is vaginal rejuvenation?

Vaginal rejuvenation, or vaginoplasty, is a surgical procedure done to reduce the size of the vaginal opening, remove excess or loose vaginal tissue, and to repair surrounding supportive tissues in the vagina. This procedure is often called “Feminine Rejuvenation” or “Vaginal Tightening.” The purpose of the surgery is to tighten the vagina and to improve pleasure during sexual intercourse. It’s worth noting that while vaginoplasty is surgical, there are non-surgical forms of vaginal rejuvenation, such as ThermiVa. Read more about vaginoplasty.

Is the vaginal rejuvenation procedure safe?

Vaginal rejuvenation is safe when performed by a board-certified surgeon who specializes in these procedures. There are risks associated with this procedure and anesthesia as with any procedure you may have.

What are the risks associated with vaginal rejuvenation?

Risks associated with vaginal rejuvenation, as with any surgery, include injury, infection or bleeding. Additionally, there is risk of pain with intercourse following any vaginal surgery.

What symptoms cause women to choose vaginal rejuvenation?

-A sense of vaginal looseness.
-Decreased sensation with intercourse due to looseness.
-A gaping appearance to the opening of the vagina.
-Rectocele or prolapse after vaginal delivery.

How long does the vaginal rejuvenation procedure take?

Vaginal rejuvenation procedures take around 2 hours and are typically done under anesthesia at a surgical center.

What is the recovery time associated with vaginal rejuvenation?

Patients usually take 1-2 weeks off from work after surgery. The main restriction following vaginoplasty is no sex for 6 weeks to allow the area to fully heal.

How much does vaginal rejuvenation cost?

Vaginal rejuvenation costs can vary depending on the degree of relaxation that is present. We offer a free consultation, at which time a full exam would be performed to determine the best treatment plan for your desired outcomes.

Does my insurance cover vaginal rejuvenation?

Vaginal rejuvenation may be covered by insurance if upon exam you also have prolapse or pelvic floor issues present. At your consult, we would perform a thorough exam to evaluate your anatomy to determine medical need for repair.

Does ALVR do financing?

Yes. Financing is available through Care Credit (

Where will the procedure take place?

Vaginal rejuvenation procedures are performed at a hospital or surgery center.

How many vaginal rejuvenation surgeries does Dr. Shashoua perform?

Around 5 a week. Vaginal rejuvenation is a part of most prolapse surgeries performed by Dr. Shashoua.

Why should I choose Dr. Shashoua over other surgeons in Austin?

Dr. Shashoua is board certified in Female Pelvic Medicine and Reconstruction. He has been performing these procedures successfully for many years. Dr. Shashoua and his two nurse practitioners provide patients with 24/7 compassionate care.

When can I return to work?

If having a vaginal rejuvenation procedure, you will need to take 2 weeks off from work.

How much pain should I expect post-op?

Depending on the extent of the rejuvenation, you will likely be on pain medication for 2-3 weeks postoperatively. Pain medication is provided to patients during the postoperative period and should relieve discomfort allowing the patient to return to their day to day activities. There is a provider available 24/7 if the pain has not improved on the pain management plan we have prescribed for the patient.

How soon can I have sex?

Vaginal rest is advised for 6 weeks after surgery. This allows time for the vaginal tissue to heal.

Will the vaginal rejuvenation procedure improve my sex life?

After vaginoplasty, the caliber of the vagina is decreased or narrowed, resulting in increased sensation for both the patient and her partner.

How long will the vaginal rejuvenation results last?

Vaginal rejuvenation should provide lasting, long-term results.

Is vaginal rejuvenation a vagina tightening surgery?

Yes, vaginal rejuvenation surgery involves reducing the size of the vaginal opening and removing loose tissue, which has the effect of tightening the vagina. If you believe you are in need of a vaginal tightening procedure, look no further.

Can vaginal rejuvenation be combined with other cosmetic surgical procedures?

Yes, vaginal rejuvenation can be combined with labiaplasty and labia majora reductions.

I’m not from, nor do I live, in Austin. How long before I can travel back home after the surgery?

Vaginal rejuvenation procedures typically require an overnight stay in the hospital. You can travel back home a few days after surgery.

How many vaginal rejuvenation surgeries does Dr. Shashoua perform?

Around 5 a week. Vaginal rejuvenation is a part of most prolapse surgeries performed by Dr. Shashoua.

Do I have to have stitches removed?

The answer is no! All the sutures that we place are dissolvable so there’s no need to remove anything. It usually takes around 5-6 weeks for them to fully go away.

Will I lose sensation with intercourse?

Many women worry that after operating on the labia that they will lose clitoral sensation. When we operate in the area of the clitoris we are very careful to avoid operating on the erectile tissue of the clitoris itself. If anything, after we reduce some of the tissue covering the clitoris, the sensation is improved.

How much will be removed during the procedure?

We discuss your desired outcomes preoperatively to determine exactly how much to remove. Some women want most of the labia removed and some women want a little left. Each person is unique and we tailor each procedure accordingly.

What is ThermiVa

ThermiVa is a non-surgical and non-invasive therapy that aids in restoring and reviving vaginal tissue. This cutting edge technology utilizes the power of radiofrequency to produce powerful results, with minimal downtime.

Why choose the ThermiVa?

Many factors influence the function and appearance of the vulvovaginal tissue. Childbirth, aging, menopause or surgical-related hormone changes, weakened pelvic floor, and various medical conditions can have a negative impact on vaginal moisture, laxity, and sensation. This can result in painful sexual intercourse, irritation of the vaginal tissues, vaginal dryness, a less youthful appearance, and decreased sexual sensations. In addition, some women may experience mild incontinence related to weakened pelvic floor muscles and vaginal atrophy. The ThermiVa is a non-invasive therapy that aims to help reverse the aforementioned issues to renew sexual vibrancy, restore labia and vaginal tightness, and treat some vulvovaginal medical issues. In addition, the ThermiVa may be able to help women with mild incontinence by helping strengthen the vaginal tissue.

How does ThermiVa work?

ThermiVa is a temperature controlled radiofrequency technology that creates thermal energy to increase blood flow and activate your body’s own healing mechanisms, thus encouraging increased collagen production, elasticity, and angiogenesis (new blood vessel production). As a result, this promotes increased sensation, moisture, tightening and plumping of the vulvovaginal tissue.
We treat the targeted tissue directly with small wand that delivers the energy and produces a warming sensation at the area being treated.

Who could benefit from the ThermiVa?

√ Women with orgasmic dysfunction
√ Women desiring increased vaginal sensation
√ Women who suffer from vaginal dryness and atrophy
√ Women who suffer from vestibulitis
√ Women who suffer from painful intercourse
√ Women who are seeking conservative management for mild stress incontinence and/or overactive bladder.
√ Women who suffer from Lichen Sclerosis

What are potential benefits of ThermiVa:

√ Improve sexual function by restoring the vaginal canal for improved sexual sensation, promoting intense and more frequent orgasms.
√ Improved sexual function by stimulating blood flow and improving nerve sensitivity at the clitoral area.
√ Increase nerve sensitivity for greater sensation and control.
√ Improve vaginal moisture inside and outside the vagina, contributing to increased softness and thickness of the vaginal and/or vulvar tissue.
√ Potential improvement of mild incontinence or hyperactive bladder.
√ Restore and revive the vagina after childbirth. The ThermiVa technology helps to reverse the age associated changes to the vagina.

How many treatments are required with the ThermiVa?

Each person is unique, thus the recommendations for the duration of treatment will be tailored to meet your specific needs. Typically, patients are advised to undergo a minimum of 3 treatments, every 3 to 6 weeks. This is not an implant or permanent device, therefore the aging process continues to occur after your treatments. To help ensure the longevity of your ThermiVa therapies, maintenance sessions may be recommended after desired results are achieved.

How much does ThermiVa cost?

ThermiVa costs $900 per treatment. If you are interested in learning more you can visit the treatment page for ThermiVa as well as our pricing page.

What are the risks associated with ThermiVa?

ThermiVa is a safe therapy. With this said, any procedure has associated risks. These can be discussed in detail during your consultation with one of your providers.

How can I prepare for my ThermiVa treatment?

You will want to shave the area being treated the night before or morning of your ThermiVa therapy. Come to your appointment adequately hydrated and having recently eaten. Wear comfortable clothing. Please inform our office if you have any of the following: menses, urinary tract infection symptoms, bacterial or viral infection, are pregnant, or open wounds.

What can I expect on the day of the treatment?

1. ThermiVa is performed in the comfort of our office. No anesthesia or medications are required.
2. The length of therapy varies from patient to patient. Typically, each treatment lasts about 30 minutes.
3. The vaginal canal and external vaginal tissues are directly treated with a small device by one of our expert providers. The wand used to treat the area will produce a warming sensation of your tissue. This is not a painful procedure, therefore numbing of the area is not required.

What can I expect after my treatment?

1. There is no downtime and no activity restrictions following the therapy.
2. You may have sexual intercourse the day of treatment.
3. The increased blood flow to your tissues produced during the treatment may result in a warm and full sensation of the vagina, with an increased pink tone to your skin. This is completely normal and an indicator of a successful treatment.
4. Often times, women will have immediate results of vaginal tightening and plumping after a single treatment. The longevity of these results is achieved after the recommended number of treatments are completed.

What is SottoPelle testosterone replacement therapy?

SottoPelle is a form of bioidentical hormone replacement therapy (BHRT). SottoPelle comes in pellet form and both estrogen and testosterone pellets can be inserted depending on the patient’s hormone levels.

How do I know if I have low testosterone?

Many people who are looking into pellets may have symptoms of decreased energy, decreased libido, mood swings and vaginal dryness. The first place to start is getting some labs. We will check your hormone levels and based on that, will recommend specific hormone dosing.

Why are pellets better than other forms of hormone replacement therapy (HRT)?

SottoPelle hormone replacement pellets are bioidentical and most similar to the natural hormones you produce. Pellets also allow for a more consistent release of hormones rather than highs and lows that you can get when taking oral or topical hormone therapy.

How are pellets placed?

At the time of your visit, you will be ask to expose your buttocks/hip area. The area is prepped for the procedure and a small amount of local anesthetic is injected at the site. Once the area is numbed a small incision is made and the rice sized pellet is placed within the fatty tissue. A waterproof dressing will be placed over the incision and compression applied for a few minutes. You will be sent home with an ice pack and will leave the dressing on for three days.

How do you decide dosing?

At your initial visit we will order a panel of lab work that will give us an idea of your baseline hormone levels. Based on your symptoms and your labs, we calculate a dose of either testosterone, estrogen or both. In some instances you may need to take oral supplements to optimize your pellet dosing.

How often do I have to get treatment?

Every patient is different, but typically pellet dosing is every 3-6 months. Most patients can tell when their pellet dosing is starting to decrease based on symptoms.

Can I decide to stop them?

If you find that pellet therapy isn’t something you want to continue, you can stop them. They are fully absorbable so once your pellets are dissolved they are out of your system.

What are some side effects from pellet therapy?

Side effects will depend on the type and dose of hormone that you receive. Testosterone side effects can include enlargement of clitoral tissue, worsening acne, hair growth, increased cholesterol and thicker blood. Estrogen side effects can include breast tenderness, and as with any estrogen supplement there is a risk of cancer. Your doctor will discuss your risk factors and adjust dosing if indicated.

How much do testosterone pellets cost?

SottoPelle is $425 per insertion for women, and $875 per insertion for men. For more information, visit our pricing page.

Give us a call to learn more.
(512) 973-8276

Before & After

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