ThermiVA™ Vaginal Rejuvenation

*Individual results may vary

ThermiVa technology has been replaced with Votiva at our office.

Learn more about Votiva and its benefits here.

What is ThermiVA™ and how does it work?

ThermiVA™ is a non-invasive procedure for vaginal rejuvenation that applies radio frequency energy to the feminine tissues. Radio frequency energy are radio waves. They are not X-rays and they are not microwaves, and they are not toxic to human tissue. You can actually read more about the effect of radio frequency energy on human tissue in the ThermiTight™ section of the website. This procedure is a great alternative to surgical rejuvenation surgeries, such as labiaplasty.

What non-invasive vaginal rejuvenation can improve?

Childbirth and time take its toll on a woman’s body. It is very common and mainstream for a woman to seek to improve her deflated and sagging breasts, get rid of excess skin on her tummy or eliminate stubborn deposits of excess fat. However, until recently, the vagina has been totally neglected as a portion of her body that also could benefit from some attention.

Vaginal Laxity

There are several issues that my patients complain about on almost a daily basis. Childbirth contributes to vaginal laxity. When the vagina is no longer fitting snugly around her partner during intimacy, sexual pleasure for both partners is compromised. In the past, there have been surgical treatments to address this problem by cutting away vaginal mucosa, wither with a scalpel or a laser, but they are both associated with pain, downtime, need for anesthesia and complications. Wouldn’t it be nice to have a simple, effective way to tighten the vaginal canal without any of these other issues?

Urinary Incontinence

OK, as a plastic surgeon, my patients do not complain to me about this problem, they usually discuss it with their gynecologist. However, as many of my patients are in the 30+ age group, they still suffer from this problem nonetheless. Again, surgical treatments have been devised to treat this problem, and for some women, surgery remains the only viable option. But would it not be nice to be able to try something non-surgical that does work in the hopes of avoiding surgery?

Vaginal Dryness

Again, not something my patients will generally think to tell me about, but if they are over 30 years of age, the problem is common, and the incidence does rise with age. I have patients in their eighth decade of life who are still sexually active, however, this problem is a hindrance to enjoying sex. I also have several patients in their fourth decade who also suffer from this problem as well. Hormone supplementation may help this and for that I defer to a gynecologist or endocrinologist, but again, wouldn’t it be great to have a non-surgical, non-invasive, painless way to improve vaginal lubrication when it is needed the most?


There, I said it! The big “O”. Some women have no problem achieving sexual climax, but then again, there are others who either do have trouble achieving climax, or would like to more frequently, or maybe more intensely. There are no surgical procedures that I know of that will facilitate the ability of a woman to achieve orgasm*. This is the most commonly achieved benefit that my patients attain from their treatments. Some of my patients transitioned from being unable to achieve orgasm to achieving it with most sexual encounters, some achieved more frequent orgasms and some achieve more intense orgasms. Whatever they get, its all good and both my patient and their partner are extremely happy!

Funny but true story: When I was first introduced to this technology and this procedure, I believed the benefits about vaginal tightening, improvement in incontinence, even increased vaginal lubrication. The part that I found hardest to believe was that this machine could facilitate and improve the female orgasm. I mean, c’mon, that is pretty far-fetched! I tried the technology. The first day I had the machine, I treated three of my breast augmentation patients. About one month later, I was in my reception area and I overheard one of the patients, calling to schedule treatment number two. I was impressed to say the least. I was also very curious. I called her the next day from my car. I asked her how she liked the ThermiVA™ treatment. The conversation went something like this:

Me: So, how did you like the ThermiVA™ treatment?
Patient: I liked it!
Me: Did you notice any changes?
Patient: Um, Yah!
Me: Can you please describe to me what is different now?
Patient: (Verbatim from patient): Well, before the treatment, I could never “get there”, but now I “get there” almost every time, sometimes more than once!
Me: (speechless, then missed my exit on the Long Island Expressway) I am so happy that it helped you. I look forward to more feedback from you after your next treatments.

I called the second patient who told me that she had no problem achieving orgasm, but that they are now more intense. She ended up getting five treatments. The last patient, well, she was a divorced mother, unattached. She told me “I don’t’ know, I am not sexually active right now. I think I need to be more promiscuous”.

Is Votiva an alternate to ThermiVa?

Dr. Epstein now offers Votiva for non-surgical vaginal rejuvenation, which has replaced ThermiVa at his practice. Votiva is a medical device developed to improve vaginal wellness using radio frequency technology. The device combines fractional tissue coagulation with gentle volumetric heating to achieve optimal outcomes with minimal downtime. Votiva can address concerns both internally and externally, all without the need of surgery and its inherent risks.

Benefits of Using Votiva

  • Votiva is a more gentle treatment than ThermiVa, so it is tolerated better by patients.
  • The device works more efficiently with shorter treatment time.
  • The results of Votiva are great, comparable to the results of a surgical procedure.

How is a ThermiVA™ treatment done?

The ThermiVA™ treatment is easy, painless, requires no anesthetic of any kind, takes approximately thirty minutes and has no downtime nor any post procedure instructions. Best part is that you can have intercourse when you get home, if you are so inclined! The treatment is done in a private room and is performed by my nurse aestheticism. You are placed on an examination chair with your feet in stirrups, just like at the gynecologist. A smooth, naturally curved probe is lubricated and gently inserted into the vagina. The probe has an electrode on the side that emits the radiofrequency energy. This is placed against your labia minor (small lips) and your labia majora (larger, outer lips) using an up and down motion, for about ten minutes. The purpose of this portion is to give you some tightening of the lips.

Next, the probe is inserted further into the vagina. The probe is moved up and down the sidewall of the vagina for about five minutes. Next, the other side wall is addressed. Lastly, the upper and lower walls of the vaginal wall are treated in a similar fashion. The radio frequency energy will cause the vaginal wall to tighten. As the underside of the top wall is treated, there is tightening produced of the tissues around the urethra, which will improve urinary incontinence*. The radio frequency energy also has an effect on the nerves that stimulates the mucous glands in the vaginal wall. These nerves are stimulated such that production of mucous to lubricate the vagina during intimacy is improved. Lastly, the radio frequency energy also has an effect on the nerves to the clitoris, the nerves to the front vaginal sidewall (similar nerves to those running to the clitoris) and even the G-spot (if you are a believer that there really is a G-spot). These nerves become more reactive during intimacy, thus facilitating climax and the enjoyment of the sexual encounter overall. At the end of the procedure the probe is withdrawn, and no dressings or other care is needed. You are good to go!!!

How many ThermiVA™ treatments will I need?

Most women need between one to three treatments, one month apart. I would say two to three is probably most common. I also have seen women obtain as much as five treatments. In this particular patient, she was noticing her orgasms continued to improve with each treatment, so she just kept undergoing additional monthly treatments. You cannot “over-treat” yourself here!

Will ThermiVA™ replace the need for surgical labiaplasty?

I perform many labiaplasties in my surgical practice. Although ThermiVA will produce some degree of tissue tightening of the labia minora, most all of my patients have far too much tissue to achieve a good result both in tissue tightening and overall aesthetic appearance from a non-invasive treatment. If the amount of excess tissue is mild, then you may benefit nicely from ThermiVA&trade: rather than surgery.

Are Thermiva results permanent?

You can anticipate from one to two years of continued benefit following treatment with ThermiVA™*.

How does Votiva compare to ThermiVA?

Votiva and ThemiVA are both non-invasive procedures for vaginal rejuvenation using radio frequency(RF) energy. Votiva is a better RF technology for vaginal rejuvenation because it is bipolar and not unipolar like ThemiVA. Unipolar radio frequency penetrates the body deeper and more intensely which will cause more discomfort. Shorter treatment times are a key benefit of the Votiva treatment which is why Dr. Epstein prefers this method. If you were previously considering ThermiVa, schedule a consultation with Dr. Epstein at our Hauppauge office to discuss the benefits of the Votiva treatment.

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