One of the world's most prestigious health journals has lashed a fast-growing trend in the United States and Britain for "designer vaginas," the tabloid term for cosmetic surgery to the female genitalia.
The fashion is being driven by commercial and media pressures
that exploit women's insecurities and is fraught with unknowns,
including a risk to sexual arousal, the British Medical Journal
Known as elective genitoplasty, the surgery usually entails
shortening or changing the shape of the outer lips, or labia, but
may also include reduction in the hood of skin covering the
clitoris or shortening the vagina itself.
Anecdotal evidence suggests that the practice is spreading fast
in the United States as well as in Britain, but the picture is
unclear, the BMJ says.
According to Dr Elna McIntosh these procedures are also quite common in South Africa.
Not only is there a disturbing lack of data about the
phenomenon, there has been negligible assessment about surgical
after-effects - and almost zero consideration of whether a labial
"problem" exists in the first place, the BMJ says angrily.
In 2004-5, 800 "labial reductions" were conducted by Britain's
state-run National Health Service (NHS), more than a doubling of
the figure of six years earlier. Other operations were carried out
by the private sector, although the full figures are unknown.
Why women do it
The authors of the article, London gynaecologist Sarah Creighton
and clinical psychologist Lih Mei Liao, conducted their own
small-scale probe into why women sought this surgery.
"Our patients sometimes cited restrictions on lifestyle as reasons for their decision," they say.
"These restrictions included inability to wear tight clothing,
go to the beach, take communal showers or ride a bicycle
comfortably, or avoidance of some sexual practices.
"Men, however, do not usually want the size of their genitals
reduced for such reasons. Furthermore, they find alternative
solutions for any discomfort arising from rubbing or chaffing of
the genitals." Patients who sought genitoplasty "uniformly" wanted their vulvas
to be flat and with no protrusion, similar to the prepubescent look
of girls in Western fashion ads, they found.
"Not unlike presenting for a haircut at a salon, women often
brought along images to illustrate the desired appearance," say
Creighton and Liao. "The illustrations, usually from advertisements
or pornography, are always selective and possibly digitally
Surgery is risky
Plastic surgery to the labia carries risks, for this zone
carries nerve fibres that are highly sensitive and are a key
pathway of sexual arousal, the article warns sternly.
"Incision to any part of the genitalia could compromise
sensitivity," it says.
The BMJ piece suggests genitoplasty is a classic example of
where commercial, media and social pressures artificially create a
problem, fuel concern over it and then put forward a solution for
"There is nothing unusual about protrusion of the labia," it
"It is the negative meaning that makes it into a problem --
meanings that can give rise to physical, emotional and behavioural
reactions, such as discomfort, self-disgust, perhaps avoidance of
some activities and a desire for a surgical fix." – (Sapa-AFP)