Variations in the natural female form used to be accepted, even celebrated. Increasingly, however, these variations are seen not as assets, but as problems to be taken care of by plastic surgeons.

As a result, Americans spent more than $12 billion on plastic surgery in 2004. Liposuction, breast augmentation, and eyelid surgery were the most popular surgical cosmetic procedures.1 According to Dr. V. Leroy Young, chair of the emerging trends task force of the American Society of Plastic Surgeons, the plastic surgery procedure with the highest growth rate is also the newest procedure available – genital reconstruction.2 Once the domain of sex workers, nude entertainers, swimsuit models, and relatively few women with medical abnormalities, vaginal plastic surgery has gone mainstream. Some surgeons report a four-fold increase in demand last year alone, with patients coming from all over the United States and other countries.3

The Procedure

There are two types of genital reconstruction. Vaginoplasty is the external reconstruction of the vulva. It includes procedures such as trimming the labia minora or majora, reconstructing hymens, elevating the pubis, and unhooding the clitoris. Vaginal rejuvenation refers to tightening the vaginal muscles. This type of surgery has been performed in the United States for nearly ten years, but until now was typically performed by gynecologists and urologists to treat urinary incontinence, usually as a result of childbirth.4 Today’s vaginal rejuvenation, however, is increasingly becoming the domain of plastic surgeons.

Like any surgery, genital rejuvenation has risks. Serious risks include painful scarring or nerve damage that could result in loss of sensation or hypersensitivity. Another risk is over-tightening of the vaginal walls, which can result in painful intercourse.

Why do Women Want Genital Surgery?

Advocates and critics agree that the new popularity of these procedures is caused by the desire for heightened sexual pleasure and more youthful looking genitals. Some doctors claim that the demand for genital plastic surgery is being driven by pornography, now more readily available than ever on the Internet and cable television. Dr. David Matlock, founder and director of the Laser Vaginal Rejuvenation Institute of Los Angeles, explains on his website that “…many people have asked us for an example of the aesthetically pleasing vulva [so] we went to our patients for the answer and they said the playmates of Playboy.”5 With encouragement from their partners and offers of discounts from their plastic surgeons, patients often have the surgery in conjunction with breast implants or rhinoplasty. Surgeons attract patients with claims that the procedures are “rejuvenating,” or “designer.”6

Success?

Do these procedures work? Like any other type of cosmetic surgery, results can be excellent or disastrous. Genital rejuvenation is still relatively new, and no good data exist on the number of women who get these procedures, complication rates, or how satisfied they felt with their results. Though many women say they seek out these procedures to enhance their sexual experiences, no research data support claims of increased sexual satisfaction. Importantly, experts say that perceived sexual enhancement as a result of genital reconstruction may be attributed in part to the psychological reaction to the surgery, rather than to physical changes from the surgery itself. Dennis Sugrue, former president of the American Association of Sex Educators, says that “…before even considering an invasive procedure like vaginal tightening surgery, it's absolutely critical for a woman to consult with a sexual health professional to make sure that the cause of the sexual dissatisfaction is thoroughly assessed and diagnosed. Noninvasive treatment procedures should first be employed. Only if all of those steps are taken and fail to bring about satisfaction should surgery even be considered.”7

What’s Next?

Whether genital rejuvenation will ever become as popular and acceptable as other forms of plastic surgery remains to be seen. The rising rates of cosmetic surgeries suggest that women are more willing than ever to take risks to enhance themselves. Though genital rejuvenation may not be fully in the mainstream today, it may well be in the future. And if so, what will plastic surgeons come up with next?

1 http://www.surgery.org/download/2004-stats.pdf.
2 Kobrin, Sandy. “U.S.: More Women Seek Vaginal Plastic Surgery.” Women’s Enews, Los Angeles: 17 November 2004.
3 Navarro, Mireya. “The Most Private of Makeovers.” The New York Times: Section 9, Column 4, Style Desk; pg. 1; 28 November 2004.
4 http://www.augs.org/i4a/pages/index.cfm?pageid=214.
5 http://www.drmatlock.com/home.htm.
6 http://www.labiaplastysurgeon.com/combo-surgeries.html.
7 http://my.webmd.com/content/pages/4/1813_50204.htm.