Plastic reconstructive surgery of the perineum may include any of the following procedures: resection of inflamed vestibular glands, resection of perineal scar, reconstruction of chronic perineal tear, perineoplasty for narrow introitus, and advancement & grafting of vaginal mucosa.

Surgery is usually reserved for severe VVS (Vulvar Vestibulitis Syndrome) cases refractory to conservative therapy, patients with scarring of the perineum or chronic tear syndrome usually associated with a narrow perineum, a small introitus, and /or ridging of the vestibule.