Designer Vagina

Designer vagina

Cosmetic surgery of female genitalia, known as elective genitoplasty, has become pejoratively known as ‘designer vagina.’ Labiaplasty [ley-bee-uh-plas-tee] is a plastic surgery procedure for altering the labia minora (inner labia) and the labia majora (outer labia), the folds of skin surrounding the human vulva (external female genitals).

There are two main categories of women seeking cosmetic genital surgery: those with congenital conditions such as intersex, and those with no underlying condition. The size, color, and shape of labia vary significantly, and may change as a result of childbirth, aging, and other events. In a male-to-female sexual reassignment vaginoplasty is used for the creation of a neovagina, and labiaplasty creates labia where once there were none.

A 2008 study in the ‘Journal of Sexual Medicine’ reported that 32 per cent of women who underwent the procedure did so to correct a functional impairment; 31 per cent to correct a functional impairment and for aesthetic reasons; and 37 per cent for aesthetic reasons alone. The risks of the procedure include permanent scarring, infections, bleeding, irritation, and nerve damage leading to increased or decreased sensitivity. ‘The Observer’ wrote in 2011 that medical experts had ‘sounded the alarm’ about the procedure and its soaring rates, blaming increased exposure to pornography images on the Internet. Linda Cardozo, a gynaecologist at King’s College Hospital, London, told the newspaper that women were placing themselves at risk in an industry that is largely unregulated.

Labiaplasty is a controversial subject. Critics argue that a woman’s decision to undergo the procedure stems from an unhealthy self-image induced by their comparison of themselves to the prepubescent images of women they see in commercials or pornography. In the United States, a labiaplasty surgeon can earn up to $250,000 a month, according to ‘Shameless’ magazine. Simone Weil Davis, professor of American studies – author of ‘Living Up to the Ads: Gender Fictions of the 1920s’ (2000), and ‘Loose lips sink ships’ (2002) – told the magazine in 2005 that surgeons are perpetuating the idea that there is a right way for women’s genitalia to look. She argues: ‘Labia are neither inside nor outside, they are gateway tissues, and they kind of represent a part that is confusing.’ Because most women see only their own vaginas, or pornographic images, it is easy to make them doubt themselves.

Although female genital mutilation – the practice in several African countries of cutting off a woman’s labia, clitoris, and in some cases creating a seal across her entire vulva – is illegal in the United States, Canada, Europe and elsewhere, Davis argues that ‘when you really look carefully at the language used in some of those laws, they would also make illegal the labiaplasties that are being done by plastic surgeons in the U.S.’ The WHO writes that the term is not generally applied to elective procedures such as labiaplasty.

The American College of Obstetricians and Gynecologists (ACOG) published an opinion in a 2007 issue of ‘Obstetrics & Gynecology.’ ACOG said 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.

In the UK, Lih Mei Liao and Sarah M. Creighton of the UCL Institute for Women’s Health wrote in the ‘British Medical Journal’ in 2007 that ‘the few reports that exist on patients’ satisfaction with labial reductions are generally positive, but assessments are short-term and lack methodological rigour.’ They wrote that the increased demand for cosmetic genitoplasty (labiaplasty) may reflect a ‘narrow social definition of normal.’ The National Health Service performed double the number of genitoplasty procedures in the year 2006 than in the 2001–2005 period. The authors noted that ‘the patients consistently wanted their vulvas to be flat, with no protrusion beyond the labia majora … some women brought along images to illustrate the desired appearance, usually from adverts or pornography that may have been digitally altered.’

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