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The Designer Vagina

27 November 2018 9 comments

The worlds fastest growing cosmetic surgery is called labiaplasty, and it involves trimming and shaping of a womans external genitalia. With more and more women desiring the perfect catalogue vagina,this operation is on the rise not merely with adult women, but also teenage girls. One cant help but wonder - will these ladies ever be truly satisfied with the procedure and does fixing something that isnt broken give them the self-esteem boost they crave?

Breasts that are too big - or not big enough, lifted butts, puffy fish lips, perky nipples, and now even the poor vulva is not safe from the surgeon’s knife. Labiaplasty, a surgery which “neatens up” a woman’s vaginal lips, is the new frontier and on the rise. In 2016 the number of labiaplasty procedures carried out spiked an incredible 45% in merely one year, according to the International Society of Aesthetic Plastic Surgery (ISAPS).

It seems the once wallflower is the new “It Girl” with so many of the latest Hollywood trends focussing on the colour, width, length, shape, symmetry, and volume of the vaginal lips.

The Designer VaginaThe Designer Vagina

OK so what exactly are we talking about here?

It all started with a cosmetic surgeon and director of the Los Angeles Laser Vaginal Rejuvenation Institute named Dr. David Matlock. Dr. Matlock pioneered the vaginal surgery market in Los Angeles by claiming he can produce “the perfect vagina.” A promise that, by the way, brings in about $USD12m annually.

Labioplasty is a surgical procedure carried out to reduce the size of one or both sets of labia – the “lips” or folds of skin that surround the vagina (or more technically the vulva). Most frequently, the surgery involves cutting back the inner labia (labia minora) so that they are concealed inside the outer labia (labia majora). The procedure is sometimes accompanied by a hoodectomy, which exposes the clitoris to increase sexual stimulation.

The surgery is often marketed as “vaginal rejuvenation,” tightening the inner and outer muscles of the vagina, as well as reshaping the labia. It is primarily targeted towards older women and women who have given birth; however, gynaecologists are reporting a steep increase in requests from teenage patients.

And women want to get this done - why?

The possibility that some women (let us be frank - most women) may not need to get a labiaplasty is highly likely; however, some women are genuine eligible candidates for the procedure. Which takes us into the murky world of - are we looking at a cosmetic procedure or a functional one? Procedures that once were reserved for congenital malformations, incontinence or childbirth injuries are now being marketed as surgical ways to “enhance” sexual satisfaction and improve the attractiveness of the genitals.

Reasons why women may seek to get a labiaplasty

1. Painful sex; some women have incredibly voluminous labia which can contribute to painful intercourse, especially when they are inflamed (as they tend to be during sexual arousal). In such cases, it can get in the way and even cause chafing.

2. Enhance sex life; if a woman feels a sense of low self-esteem due to the appearance of her vagina, it can impact her confidence and therefore infringe on her ability to enjoy sex.

3. Labia correction; the labia may need correcting following injury, disease or childbirth.

4. Alleviating discomfort; some women report discomfort or embarrassment from clothing or exercise due to large labia minora. You’ve all heard of the nip slip, well there is such a thing as the labia slip - just try wearing skimpy clothing with your voluminous vaginal lips trying to get a peek of the outside world.

5. Appearance; many labiaplasty patients are dissatisfied with the “hanging” appearance of their lips (looking like a turkey chin) and desire the “tucked-in” look. This is a classic case of “less is more.”

The Designer VaginaThe Designer Vagina

What’s involved?

Whilst the procedure is relatively complex, it is relatively quick.

Dr Jayson Oates (Academy Face and Body based in Perth and Sydney) says
"There are two main ways of reducing the labia minora. One is the free edge trim technique where the edge of the labia are trimmed off and then closed with dissolving internal stitches. The other is a wedge resection – that is taking a triangle out each side and closing up usually with external stitches. They may be done with just local anaesthetic (so fully awake) or sedation/general anaesthetic. It only takes about 40 minutes and the patient can go home soon after. Both techniques can give very nice results and the scar line is usually very difficult to see.

Risks include some bleeding or forming an enclosed blood collection (haematoma), infection or breakdown of the stitch line. Generally problems are uncommon and minor. There is a Medicare rebate for labioplasty for discomfort and then private health funds may also contribute. Costs are around $5,000 – $8,000."

Labia are our friends

Why do we have the labia anyway? Its primary function is to protect the entrance of the vagina. Clearly some vaginas need more protection than others and are therefore appropriately equipped (sorry - couldn’t help it!) The labia minora, the one society has deemed as the “ugly sister,” is responsible for covering and protecting the urethra and vagina, preventing infection. Interestingly enough, it also responsible for enhancing sexual pleasure and lubrication during intercourse - which is why many women who have an actual larger than average labia minora report having heightened sexual pleasure and excess lubrication during sex.

So can labiaplasty really improve your sex life?

An influential Flinders University study conducted in Australia examined the psychological implications of the labiaplasty procedure. Whilst it found that many of the women experienced “significant improvements in satisfaction with their genital appearance from pre- to post-surgery,” not a single one of the women reported an improvement in self-esteem and confidence during sex.

Dr Jayson Oates (Academy Face and Body based in Perth and Sydney) says
"In a paper published in Plastic and reconstructive Surgery 2017 agreed that there was no significant improvement in self esteem (no one should judge themselves on the apprearance of their vulva) but did find –

A signifcant improvement in the enjoyment domain of the Female Sexual Function Questionnaire was found at 3 months postoperatively. This may be attributed to the psychological improvement and gain of confidence of these patients after surgery.

Also –

A signifcant improvement in the pain domain of the Female Sexual Function Questionnaire was also found at 3 months postoperatively, suggesting that the excess skin and mucosa of the labia minora and the redundant tissue that increase friction may be the cause for diffcult and painful sexual encounters.

And –

This study is in concordance with the study by Goodman, Journal of Sexual Medicine 2010 that women’s sexual satisfaction improves and increases in the first 6 months after surgery and was maintained at 12 months ."

This leads one to think that perhaps whilst labiaplasty may prevent women from obsessing over the appearance of their vaginal lips, it does not alter the foundation of their problem - that is, how they perceive themselves and their intimate relationships.

The Designer VaginaThe Designer Vagina

Great expectations?

Many medical experts believe that women may have unrealistic expectations for how labiaplasty might improve their psychological well-being. When they, inevitably, experience dissatisfaction, they are likely to pursue another labiaplasty failing to understand there is no evidence this is a helpful treatment for what they are looking to “fix.”

What is The Perfect Vagina anyhow?

The BJOG: An International Journal of Obstetrics and Gynaecology published a recent study which found that women have a most skewed notion of what a normal vulva looks like.

Leading psychologists and researchers at our very own Monash University and UCLA believe the concept of the perfect vaginastems from the homogenous images of womens genitalia found in media, particularly on the internet. Such images may promote an unrealistic genital ideal and negative criticism of genitals that fall outside of such a “norm.”

Medical textbooks, pornography, women’s magazines, sex shops, and the internet all show one kind of vagina. Are there no dark, hairy, vulva hanging vaginas out there?! Even when shown in lingerie or bathers, women’s genitals are often depicted as a “smooth curve.” Ironic, as the appearance of the healthy vagina is highly variable - no two vulvas are the same.

Australian Classification Guidelines state: "Realistic depictions of sexualised nudity should not be high in impact. Realistic depictions may contain discreet genital detail, but there should be no genital emphasis.” It is for this reason that protruding inner labia are often airbrushed to a single crease in order to avoid being hit with an R18+ classification. How an Australian Government statutory body deems that genitalia in their natural state are more offensive and inappropriate than the unrealistic Photoshopped way a vagina “should” look is beyond me.

Dr. Gemma Sharp, a Monash University clinical psychologist, specialising in body image and cosmetic surgery post-doc research, plans to develop online resources to educate teenage girls and women about the normal variety of body types and offer assistance in the form of cognitive behavioural therapy.

Let's talk cognitively

Body dysmorphic disorder is characterised by constant negative thoughts about one’s (real or imagined) flaws in physical appearance. If patients are pursuing labiaplasty because they are mentally unwell, health professionals need to ask whether its ethical to proceed.

In 2015, the Royal Australian College of General Practitioners (RACGP) introduced world-first guidelines to assist medical staff navigating women's concerns about their genital appearance. The guidelines stress that “women's motivations for seeking surgery should be thoroughly examined, and that they should be informed of the serious risks involved — including infection, scarring, bleeding, and loss of sensation, particularly during sex.” The guidelines place weight on women being educated about the wide range of normal female anatomy, and rightly so.

Dr Jayson Oates (Academy Face and Body based in Perth and Sydney) says
"The Victorian Health Dept has the to show women a range of normal. There is also the art installations “The Great Wall of Vagina” to show the range of appearances. But even after getting them to check those out I find if a woman wants to alter their appearance telling them “it look just like many others does” not dissuade them. All cosmetic surgery is about being confident and comfortable with your body. This is just the same. It is not an area that someone wants to feel concerned about.

Everyone is doing something to make them feel confident, comfortable and better about themselves. Maybe it is losing weight and working out (great in itself), maybe it is fashion, accessories, hair or makeup, maybe it is the car you drive. But what makes what one person does acceptable and what another is doing to and for themselves not? Where does anyone get the right to tell someone else what to do with their body. Supporting women to be happy as they are I support. Shaming women for doing something deeply personal I don’t."

I get it - I really do.

Wearing sexy tight yoga pants might not be so hot if your camel toe is distracting everyone in the room. Inserting your tampon may be a tad more fiddly than usual. You are standing there naked and instead of feeling sexy you are obsessing about your guy noticing your asymmetrical vag lips (I have news for you - his testicles aren’t symmetrical either and he doesn’t care.) The discomfort and shame some women feel because of their large labia minora are, undoubtedly, real. However is it a solid enough reason to put your lady bits under the knife? As a prominent gynaecologist from Melbourne once told me “No operation - no complication.”

The Designer VaginaThe Designer Vagina

In women’s insatiable quest to have the perfect looking vagina (whatever that means), they have somehow missed the fact that enhancing sexual satisfaction cannot be done by cutting our vaginal lips.

I have never been one to meddle and tell people what to do (or more appropriately what not to do) with their private parts - and I am not about to start now. The appropriateness of the labiaplasty is not for me to judge. It is a woman’s, and man’s, right what they do with their bodies. But if you’re thinking of giving your curtains the snip, ensure you have the appropriate counselling and risk assessment. If you are doing it for your partner or any else other than yourself - it’s the wrong reason to get it done.

Now before you go and start peering and analysing the normality of your vagina, go and stand naked in front of the mirror and say to yourself “I love my vagina!” It can’t hurt. And know that perhaps an operation cannot enhance ones confidence in this area; perhaps the answer lies within.

Girls I’d love to hear from you. Have you ever had an issue with your vaginal lips? Guys - do you even notice the symmetry/size of our vulvas?

Written by Maggie May
Maggie May is a sexologist and a writer. She is a lover of all things sensual and sexual.

Ashlee 27 November 2018 at 3:48 pm
I could understand why someone might get it done for medical reasons (childbirth, deformity), but as for cosmetically I have no idea. We are all different and girls should never compare themselves to others. Unfortunately society isn't like this and shun anything that is too out of the ordinary. My question is this though, how are these teenagers getting approved and convincing their parents to do this? And if they are under the legal age to drink, getting approved to do this? how and why are these parents instead of confidence boosting their children are so easily persuaded to say yes and sending their kids to go under the knife. Teaching people to love the way you are is so important. I feel if done cosmetically, the person will feel regretful later in life because they've done something so personal all because it was at one stage a fad. :(
Maggie May 6 February 2019 at 10:07 pm
Ashlee - it will appall you I'm sure, as it did me, to find out that it is the mothers who bring in the teenage girls to the medical clinics to discuss surgery. We are going through interesting times at the moment, with so many mothers putting their kids through discomfort just so they can have that perfect Instagram family. I know women who have put their 1-year-olds under general anesthesia in order to have their milk teeth professionally cleaned by a dentist (some babies get a very faint off white discoloration due to milk.) I have friends who put their toddler girls through so much pain and screaming (from both the mum and the daughter) just so they can get that 1 photo which makes them look like they've got the best family life. Makes you wonder, doesn't it, what those toddlers will be like when they grow up? Will their vanity be boundless or will they be resentful towards their parents? I guess time will tell...
Jason Day 27 November 2018 at 5:22 pm
Having a "catalogue vagina"? what catalogue are you referring to? I dont mean that in a sick/seedy way.
Maggie May 6 February 2019 at 10:08 pm
Hi Jason. Your question is not sick at all. By catalogue vagina I meant The Perfect Vagina - like one you would find in a catalogue. Basically, one that doesn't really exist.
lisa 27 November 2018 at 6:00 pm
seriously why would u bother females please this is ridiculous be proud of your body i so agree with ashlee
Alan 27 November 2018 at 7:12 pm
I'm a guy and I've seen my fair share of vulvas and labia. I have absolutely no problem with prominent labia. Personally, I think it's sexy. To me, natural is best - and that goes for pubic hair also. Only young children have no pubic hair.
Jack S 8 December 2018 at 10:02 pm
This just sounds really strange to a bloke. Why would you want to get this done ladies? You don't know where to stop. I don't get it. It was a really interesting topic. I have never heard of this before and got a lot out of the article. Its well written also. Jason I think Maggie meant catalogue vagina like you can order the kind that you want if your a lady like if you want small lips or whatever.
Maggie May 6 February 2019 at 10:11 pm
Often times, as we can see above, men don't see the reason nor the fuss behind women seeking to surgically reduce their labia. I suppose, it is easy for us to judge and perhaps we don't have a right. A woman's body is hers and hers alone, and what she does with it is her business. It would be nice, however, if we lived in a more empowered world where we didn't feel so "broken" (this applies to both men and women) and that we sought that feeling of being complete and good enough from within. I thank you all for your comments, I enjoy hearing your views very much.
alex p. 8 February 2019 at 10:22 am
i have never heard of this before. i like how maggie may had a differnt view from the plastic surgoen. of course he was all like "its up to the women we shouldnt judge" but thats becaue its his business i wonedr what he would say to his wife and daughter? i like that mm outlines all the points and then encourages women to love themselfes.if we had more people loving themselfes for who they are depression anxiety suicide and such things wouldnt be so high. love you maggie may.
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