Vaginal & Vulval Reconstruction / Vaginoplasty

Dr. Wai-Yee Li performs two kinds of vaginal surgery at LA Breast & Body: reconstruction that rebuilds and restores the vagina and vulva after surgery or radiation for gynecologic conditions, and cosmetic vaginal tightening, known as vaginoplasty. These two paths serve very different patients, and this page is written for both. One thing is worth stating at the outset: the practice offers reconstructive and cosmetic vaginal surgery only, and does not perform gender-affirming procedures.

Dr. Li spent years specializing in vaginal and vulval reconstruction — the surgeon gynecologic-oncology teams asked for by name when a patient needed rebuilding after cancer treatment. That reconstructive foundation is what she brings to every conversation here, whether the reason a woman comes in is medical or cosmetic.

Vaginal reconstruction after cancer or radiation

Vaginal and vulval reconstruction rebuilds tissue that surgery, radiation, or disease has scarred, narrowed, or removed. The goal is to restore the vaginal canal and the vulva so that the anatomy functions and looks as natural as each woman's starting point allows.

Treatment for gynecologic conditions, both benign and malignant, can change this anatomy. Surgery to remove a tumor may take vulvar or vaginal tissue with it. Radiation to the pelvis can, over time, leave the vaginal canal narrowed and less elastic — a change surgeons call 'vaginal stenosis' (narrowing). Scarring from a benign condition or from an earlier operation can have the same effect. Reconstruction addresses these problems directly: releasing scarred or contracted tissue, restoring the vaginal canal, and rebuilding vulvar structures, individualized to what a woman has lost and what she needs.

Reconstruction here is about more than appearance. Narrowing and scarring after treatment can make everyday comfort, follow-up pelvic examinations, and intimacy difficult, and restoring the canal and the surrounding tissue is aimed at those practical concerns as much as at how the area looks. What is realistic depends on how much tissue was affected and on how the area has healed, particularly after radiation, and Dr. Li is straightforward about that from the first visit.

This is where Dr. Li's background matters most. She specialized for years in exactly this anatomy, working alongside gynecologic-oncology teams whose patients needed rebuilding after cancer treatment. Reconstruction after cancer or radiation is planned in coordination with your oncology team, at the pace your treatment allows. The timing varies — some reconstruction is carried out as part of the cancer operation, and some is planned as a later, separate stage once treatment is complete — and that decision is made together with the doctors managing your care.

The same reconstructive discipline behind her breast reconstruction work, restoring form after cancer, informs how she approaches reconstruction here: the technique is chosen for the individual patient rather than fitted to a single formula, and the plan is built around what will genuinely help. Women who come to Dr. Li for reconstruction have usually been through a great deal already — surgery, radiation, or both for a gynecologic cancer, or scarring and narrowing from benign disease or a previous operation. The consultation is unhurried and matter-of-fact, and nothing about your history is treated as unusual.

Vaginal tightening (vaginoplasty)

Vaginoplasty is cosmetic surgery that tightens the vaginal canal and rebuilds its muscular support. It is most often considered after childbirth or the passage of time has stretched the canal and the pelvic floor in ways that exercise alone may not fully correct.

Vaginal childbirth stretches both the vaginal canal and the muscles that support it. For some women that looseness — 'vaginal laxity' — never quite returns to how it felt before, even with diligent pelvic-floor (Kegel) exercises, which tone muscle but do not tighten tissue that has already stretched. Vaginoplasty works on the stretched tissue and the muscular support surgically. Some procedures also address the vaginal opening and the 'perineum' (the area between the vaginal opening and the anus); exactly what your procedure would involve is defined at consultation, not before.

It also helps to be clear about what vaginoplasty is not. It is a surgical procedure, distinct from the non-surgical 'vaginal rejuvenation' treatments marketed elsewhere, and distinct from pelvic-floor physical therapy, which strengthens muscle but does not tighten tissue that has already stretched. For some women, physical therapy is the right first step, and Dr. Li will say so when it is; surgery is the option when the tissue itself, and not only the muscle tone, is the issue.

For women considering it, the conversation with Dr. Li is private and practical: what bothers you, what surgery can and cannot change, and what recovery involves. She does not oversell it. Vaginoplasty addresses physical tightness and support; it is not a remedy for every intimate concern, and outcomes such as sensation vary from person to person — something she discusses frankly rather than promises.

Some women are focused less on the vaginal canal and more on the appearance or comfort of the external tissue. That is a different operation — labiaplasty — and part of the consultation is simply sorting out which procedure, if either, fits what is actually bothering you.

What this practice does — and does not — offer

LA Breast & Body offers reconstructive and cosmetic vaginal surgery. The practice does not perform gender-affirming procedures. Stating this plainly is not a judgment of any kind; it is so that every patient reaches the right surgeon for what she needs. The term "vaginoplasty" is used for more than one kind of operation, and patients seeking gender-affirming surgery are best cared for by surgeons who specialize in it. Dr. Li's practice is focused on reconstruction after disease and on cosmetic tightening.

Is vaginal surgery right for me?

Whether reconstruction or vaginoplasty is right for you is decided in a consultation, in person — not from a web page. Dr. Li examines, listens to what is actually bothering you, explains honestly what surgery can and cannot change, and says so plainly when something other than surgery is the better answer.

A few general considerations apply to any surgical procedure. Good overall health and realistic expectations matter, and so does understanding what recovery asks of you. Dr. Li also asks that nicotine in every form — cigarettes, vaping, gum, and patches — stop well before surgery, generally for at least eight weeks, because nicotine interferes with wound healing. Beyond that, what guides candidacy differs by path:

• For reconstruction, it is guided by your oncology team and the condition of your tissue after surgery or radiation.
• For vaginoplasty, it is guided by your anatomy, your general health, and your goals.

No one is told on a first visit that they are guaranteed to love the result. You are told what is realistic for you.

What to expect

Both paths begin the same way, with a private consultation. From there the plan is individual: what the surgery involves, where it is performed, the type of anesthesia, and what recovery will look like are all discussed with you and settled before anything is scheduled.

The consultation itself is thorough. Dr. Li reviews your history and, for reconstruction, the details of your cancer treatment; she examines the area; and she explains what she sees and what she would recommend in plain language. For reconstruction patients she coordinates with your oncology team, so that any surgery fits safely within your overall care. Nothing is scheduled until you understand the plan and have had your questions answered.

The setting is deliberately private. LA Breast & Body is an all-women practice, from the front desk to the surgeon, and many patients find that a candid, unhurried conversation about intimate surgery is simply easier to have this way. Like any operation, vaginal surgery carries standard risks — bleeding, infection, changes in sensation, and scarring — and Dr. Li reviews these with you rather than gliding past them. As a plastic surgeon, placing and minimizing scars is part of her training, and that attention carries over to this work.

Recovery is guided by Dr. Li and her team. Most patients return to normal activity gradually, and you are given instructions specific to your procedure along with a direct way to reach the office with questions. Because each procedure and each patient is different, the specifics of your recovery are explained to you personally rather than promised in advance.

Why patients choose Dr. Li

Very few plastic surgeons have deep, sustained experience in this anatomy. Dr. Li built hers over years specializing in vaginal and vulval reconstruction and ten years at a busy cancer center on the West Coast — which is why gynecologic-oncology teams referred their patients to her by name. That reconstructive experience means the cosmetic questions, by comparison, sit on familiar ground; she has handled the hardest versions of these problems.

Dr. Li is a board-certified female plastic surgeon, MD PhD FACS; you can read more about her training and background. Her all-women team is part of why patients, especially for something this personal, tend to feel comfortable speaking candidly. The practice is not in-network with insurance, though reconstruction after cancer may qualify for out-of-network PPO benefits; the office can walk you through how that works at the time of your consultation.

To find out whether reconstruction or vaginoplasty is right for you, book a consultation with Dr. Li in Arcadia or Pasadena, or call 626.888.9728.