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Nip, Tuck and Rejuvenate

"Designer" Vaginas Come Under Fire


By CosmeticSurgery.com Staff
Medically Reviewed by Dolores Kent, M.D., F.A.C.O.G

At a time when more women are asking about -- and having -- some form of vaginal area rejuvenation such as labiaplasty or vaginoplasty, medical societies on three continents are criticizing the procedures as unwarranted and possibly unsafe. We asked some top cosmetic providers for their views on a trend in cosmetic surgery that consumers can only find puzzling.

G. K., a 34-year-old programmer in California, picked up a woman's beauty magazine in her gynecologist's office and spotted an article about labiaplasty, the cosmetic surgery that shortens elongated or stretched labia minora and majora.

Vaginoplasty

G. K. (who asked to remain unidentified for privacy) liked the results shown in the before and after pictures and identified with the interview subject, a woman who complained about larger labia showing through clothing, causing soreness when exercising and creating some difficulties and pain during intimate moments.

The article also contained information about a surgical method, vaginoplasty, which was popular among mothers who felt the tissues in the vaginal canal had been stretched by child birth.

Female Plastic Surgeon
(Stock.xchng.com Photo)

Labiaplasty

When G.K. was ushered in to see her physician, she asked about the labiaplasty and vaginoplasty. "Oh, we don't recommend those," replied the gynecologist. "The American College of Obstetricians and Gynecologists' (ACOG) official position is there is no science behind them."

Later that evening, G.K. searched for "vaginoplasty" on the Internet and was amazed by the 130,000 pieces of information returned. A similar search on "labiaplasty" returned 201,000 sites, including many plastic surgeons with top credentials offering the procedure.

"The Perfect Vagina"

Additionally, G.K. discovered that the highly personal cosmetic surgeries have become so popular that British television offers a weekly, late night show, The Perfect Vagina, which bills itself as a program that peers into the world of surgical vaginal augmentation.

ACOG is not alone in its criticism. At a time when millions of women worldwide are more interested in some type of vaginal enhancement, two more major medical bodies on two other continents urge patients to dismiss the notion of cosmetic surgery "down there."

In July, 2008, the Royal Australian and New Zealand College of Obstetricians and Gynecologists issued a position statement, labeling such procedures "dangerous, expensive and unwarranted."

G-Spot Enhancement

A year earlier, in 2007, ACOG cautioned its members to be wary of any cosmetic vaginal enhancement like labiaplasty or the G-spot enhancement, yet another increasingly popular female procedure.

Looking at her computer searches left G.K. thinking, "If the procedures are so bad, why are so many women inquiring about them and then going ahead with the surgeries and being satisfied with the outcome?"

A very good question.

Other genitoplasty procedures include liposuctioning the pubic area of excess fat, and restoring the hymen for women in extremely conservative families that insist on virginity before marriage. Many women also ask for reduction in the hood of skin covering the clitoris, a procedure known as clitoral unhooding.

Female Plastic Surgery Patient
(Garrison Photo)

Also in 2007, the British Medical Journal (BMJ) carried an article by two, non-M.D. researchers concerned about cosmetic vaginal procedures which were then doubling every year in the United Kingdom.

The authors surveyed several hundred elective genitoplasty patients and concluded that commercial forces were exploiting women's insecurities through such surgical procedures which could be "fraught with unknowns, including risk to sexual arousal."

Cost of Vaginoplasty

The trend is somewhat new in the United States. According to the American Society of Aesthetic Plastic Surgery (ASAPS), vaginal rejuvenation was tracked among its members for the first time in 2007. Results? 4,500 cases done by ASPS members were reported, at an average surgeon's fee of $2,434.

Money For Cosmetic Surgery
(Penywise Photo)

Fifty percent of ASAPS's cases were performed on 35 to 50-year-old women, while another 38 percent were requested by 19 to 34-year-old patients. The remaining 12 percent were done on women under 18 or those in the 51 to 64 age bracket. The American Society of Plastic Surgeons (ASPS) and the other major national and international plastic surgery societies do not count the number of procedures performed --yet, anyhow.

But what about the concerns of the medical societies? Are they valid? And how do patients like G.K. resolve the conundrum?

To test the waters, we asked three, experienced board certified surgeons who perform several types of rejuvenation surgery on women's most personal areas to comment.

For instance, consider the charge of British Medical Journal authors Lih Mei Liao, a clinical psychologist, and gynecologist Sara Creighton, who say that genitoplasty is a classic example of exploitation "wherein commercial, media and social pressures artificially create a problem, fuel concern over it and then put toward a solution."

Do evil marketers and clever advertisements really drive the procedures?

Elongated Labia

"The trend is totally women-driven," contends Gary Alter, M.D., a Los Angeles board certified plastic surgeon and urologist. "True, marketing spreads the word about available practitioners but, time after time, women sit down in my office and carefully explain what they want…and for their own reasons."

Female Plastic Surgery Patient
(Iofoto)

Moreover, according to Dr. Alter, only several years ago, most women did not know where to go to correct the appearance and feel of elongated labia, a vagina loosened by multiple child births or a clitoris covered by too much skin.

Ted Weaver, M.D., chair of the women's health committee at the Royal Australian and New Zealand College of Obstetricians and Gynecologists, complained of a case wherein a couple brought a photo of a model from a Brazilian pornographic magazine and requested the surgeon to make the female partner's private area, "look like this." Additionally, many critics charge that women seeking some form of vaginal rejuvenation bring in magazine pages of nudes that show possibly air brushed photos.

Labial Reduction

Responds Tom Pousti, M.D., a San Diego board certified general, plastic and reconstructive surgeon who offers labial reduction: "If a photo, regardless of the source, aids in communication between a surgeon and the patient, I don't see a problem. Is that any different than, say, a patient bringing a magazine picture of a famous woman's bosom to her plastic surgeon for a discussion on breast augmentation?"

Adds Robert Moore, D.O., a board certified laparoscopic and vaginal reconstructive surgeon in Atlanta, Georgia: "There are medical, in addition to cosmetic, reasons for reducing the size of labia. Women daily complain of decreased sexual sensation, a more difficult time reaching orgasm and of excess tissues getting in the way of exercise and showing through some clothing."

131 Labiaplasty Patients

Dr. Moore and his partner, John Miklos, M.D., at the Atlanta Center for Laparoscopic Urogynecology, once surveyed 131 labiaplasty patients over 27 months, asking why they chose the procedure. Results? 37 percent responded that they only wanted to look better "down there" while 32 percent said they underwent surgery due to some functional impairment. Thirty-one percent revealed they had the surgery for both reasons. The article, Labiaplasty of the Labia Minora: Patients' Indications for Pursuing Surgery, was printed in a 2008 edition of the Journal of Sexual Medicine.

Female Plastic Surgery Patient
(Photo by Maedi)

"We also asked if any other person -- like a husband, boyfriend or significant other -- asked the patients to get the operation," says Dr. Moore. "Almost every patient said she asked for the surgery just for herself.

Better Sex Lives

"Overall, we don't see manipulated patients," he says. "After labiaplasty, patients report more self-confidence about their bodies, more self-esteem and better sex lives."

Chilean doctor Jack Pardo Schanz, M.D. surveyed women at the Clinica Las Condes in Santiago and found 90 percent who underwent vaginal tightening surgery reported their sex lives were either greatly or significantly improved.

Cost of Vaginoplasty

In Los Angles, David Matlock, M.D., the plastic surgeon who claims to have invented the G-shot, says a similar survey showed 87 percent of his patients were satisfied with the procedure.

The procedures range in price from about $3,500 to around $8,000 and are done on an outpatient basis, usually in less than two hours. (That excludes transgender procedures, which are much more expensive and take much longer.)

Possible risks are the same as those found in any surgical procedure, including scarring, nerve damage that might lead to reduced sensation, and infection. All experts recommend putting at least as much research and homework into going ahead with surgery as you would before purchasing a new car. Selecting a highly qualified surgeon you can trust is crucial to having a successful procedure.

A Board Certified Plastic Surgeon

John Di Saia, M.D., is an Orange County board certified plastic surgeon who has performed labiaplasty for seven years and writes "for fun" the top-rated blog, Truth in Cosmetic Surgery. Dr. Di Saia wrote an April, 2008, press release responding to ACOG's position paper that noted the concerns of the College.

But he emphasized that "reduction labiaplasty performed by an experienced surgeon on the external genitalia alone is safe and effective...but my patients have of course been concerned with appearance. Why else would they seek the services of a plastic surgeon?" More.

Almost all experts agreed several other reasons for the rise in popularity of cosmetic surgery on female genitalia include:

More pubic hair shaving
Because popular swimwear and some sportswear have become so abbreviated, more women shave -- or substantially trim back -- pubic hair. That allows any imperfections in the labia majora or minora to be easily viewed by not only the women themselves but their intimate partners. Plus, more women are having Bikini waxes.
More viewing of pornography
With more adult sections of film rental stores offering adult only areas, more couples are renting pornographic films in which adult actresses are showing personal areas, which have had the best cosmetic female surgery has to offer.

About our reviewer: Dolores Kent, M.D. is a Beverly Hills board certified cosmetic surgeon and gynecologist who offers many genitoplasty procedures, including the G-shot (she is the co-developer,) labiaplasty, vaginoplasty, and other gynecological surgeries.




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