Labiaplasty... Where's The Line Around Genital Cosmetic Surgery

labiaplasty surgery

What's going on with the growing trend of labiaplasty and genital surgery?

There's been a pretty dramatic increase in genital aesthetics in the last decade. What's up with that? Is it market demand or are aesthetic clinic just getting better at marketing to a deeply personal fear.

In the United States, it's being circulated that a labiaplasty surgeon can earn up to $250,000 a month (which seems unrealisticly high). Simone Weil Davis, professor of American studies, told Shameless magazine in 2005 that surgeons are perpetuating the idea that there is a right way for women's genitalia to look; because most women see only their own vaginas or pornographic images, it is easy to make them doubt themselves, and for cosmetic surgeons to provide an answer.

But not everyone is on the hooha beautification bandwagon.

In Australia, the Royal Australian College of General Practitioners has issued guidelines on referring patients with dissatisfaction with their genitals to specialists. A change in requirements of publicly funded Australian plastic surgery requiring women to be told about natural variation in labias led to a 28% reduction in the numbers of surgeries performed. Unlike public hospitals, cosmetic surgeons in private practice are not required to follow these rules, and critics say that "unscrupulous" providers are charging to perform the procedure on women who wouldn't want it if they had more information

The American College of Obstetricians and Gynecologists (ACOG) published an opinion in the September 2007 issue of Obstetrics & Gynecology that several "vaginal rejuvenation" procedures were not medically indicated, and that there was no documentation of their safety and effectiveness. ACOG argued that it was deceptive to give the impression that the procedures were accepted and routine surgical practices. It recommended that women seeking such surgeries must be given the available surgical-safety statistics, and warned of the potential risks of infection, altered sensation caused by damaged nerves, dyspareunia (painful sexual intercourse), tissue adhesions, and painful scarring.

A 2007 A.C.O.G. committee opinion on cosmetic vaginal procedures for adults, which was reaffirmed in 2014, said the procedures were not medically indicated, had not been proved safe or effective, and could cause serious complications.

The American Society for Aesthetic Plastic Surgery says that 400 girls 18 and younger had labiaplasty last year, an 80 percent increase from the 222 girls who had cosmetic genital surgery in 2014. While the overall numbers remain small, the data probably understates the trend because it does not include procedures performed by gynecologists. A 2013 British report found the number of labial reductions on girls and women done by the National Health Service had increased fivefold over 10 years.

Girls 18 and younger account for less than 2 percent of all cosmetic operations, but almost 5 percent of all labiaplasties.  What’s driving the trend for labia surgery? According to a 2012 study, more than 70 percent of girls and young women ages 12 to 20 said they routinely shaved or waxed the pubic area, coupled with readily available imagery of 'perfect' genitals, there's pressure to look perfect below the wast as well as above.

One of the main reasons is social media. Sites like Instagram, Facebook, and Snapchat allow their users to update their friends or followers about their lives. Celebrities are also rampant on social media, and some could be seen as a model of perfection for some teenagers, and in turn want to look like them or have a similar appearance.

Their peers are also a huge factor, as it could affect their self-esteem whenever they have discussions of physical appearances. After all, it all boils down to the psychological aspect. Teenagers want to look better so they could feel better and secure about their outward appearances.

Despite the risks involved after going under the knife, most teenagers find themselves better psychologically (Singh, 2015), and ost patients are satisfied with their treatments, regardless if it was surgical or non-surgical.

So far, there is a debate in the UK about classifying labiaplasty as a form Female Genital Mutilation (FGM), which is illegal, but that is more of a straight political debate, not a moral one.

Eventually, surgeons may need to discuss the matter with the teenager. The ASPS encourages the patients to withhold until they reach adulthood. They must carefully explain any risk associated after getting the surgery. Nejadsavari, Ebrahimi, Ebrahimi, and Hashem-Zade (2016) recommends that surgeons or physicians outline all outcomes and expectations associated with the procedure.

Studies Referenced:

Singh, 2015

Nejadsavari, Ebrahimi, Ebrahimi, Hashem-Zade, 2016