Not so long ago, the main clientele for cosmetic vaginal procedures was sex
workers and nude entertainers, but with the increasing popularity of bikini
waxes, women have become more aware of the appearance of their vaginas, and a
growing number seem to feel they don't measure up. Others worry that they don't
enjoy sex as much after pushing a baby out the birth canal; they hope that
tightening their vaginas will restore the thrill. In many cases women say that
they began to question the look of their vaginal area after a comment from a
male partner who had been influenced by images in sexually explicit magazines
or movies. Doctors say they're seeing women of all ages--even in their 60s and
70s--who want vaginal makeovers.
But the peril may be much greater than prospective patients realize, ACOG
warns. "What we're concerned about is that there is no safety or efficacy data
for these procedures," says Dr. Cheryl Iglesia, a member of the committee that
issued the statement and the director of Female Pelvic Medicine and
Reconstructive Surgery at Washington Hospital Center in Washington, D.C. "There
are no studies in peer-reviewed journals that show long-term outcomes." The
vast majority of these procedures are not medically indicated, Iglesia says,
and women could end up in worse shape than when they started because of
complications like severe pain from scarring by lasers used on the vaginal
wall, decreased lubrication or incontinence. In the statement, the ACOG
committee warned that "patients who are anxious or insecure about their genital
appearance or sexual function may be further traumatized by undergoing an
unproven surgical procedure with obvious risks."
ACOG says that women who are contemplating this kind of questionable procedure
need to understand that there's a great variety in the appearance of the
vaginal area--just as there is in any other part of the body--and most of those
differences are well within the normal range, which means they do not require
medical intervention. "You can have [vaginal] lips that are a few millimeters
to a few centimeters," Iglesia says. "It's all normal. You don't have to look
like a Playboy bunny down there." And a tighter vagina is no guarantee of a
better time in bed. "There is real potential that you could make your sex life
worse," she says. "You can't just say we will tighten it up and it will work
better." Female sexual satisfaction is dependent on a wide range of factors.
"It's not just the size of the vagina," Iglesia says. "There's a lot more
involved, including nerves, blood supply and lubrication" as well as the
critical emotional components of sexual satisfaction.
Women considering cosmetic vaginal surgery might also want to read up on the
international campaign against female genital mutilation, procedures among some
African, Middle Eastern and Asian cultures that often involve cutting or
stretching of the labia and inserting corrosive substances into the vagina to
make it tighter or narrower. Sound familiar? The World Health Organization and
UNICEF, among others, have been actively lobbying for the elimination of
genital mutilation, which may be performed on infants, children and teenagers.
While this campaign continues to make progress, women in this country are
paying doctors for what many think is a high-tech version of the practice. It's
something to think about.