Intimate Passions

Dear Dr. Laurie,

I recently saw an advertisement for surgery in the vaginal area to make it look “more youthful, more esthetically pleasing”.  I didn’t realize that women could get such procedures done.  Do you know of any doctors who perform these surgeries and how much they cost?

Vaginally Challenged

To tell you the truth, I am a little reluctant to send you off to a clinical for what has now been dubbed a “designer vagina”.  Unless you suffer from great physical discomfort due to large, or hanging labia, then I would not recommend such surgery.  You will see more and more of these ads and plastic surgeons offering all kinds of procedures such as reducing the inner labia, injecting fat into the outer labia, liposuction of the mons pubis, removal of the clitoral hood, collagen injections inside the vaginal walls (known as the “G-shot”), and even anal bleaching.  If you Google “designer vaginas” you will get over 230,000 hits with hundreds of plastic surgery clinics offering these services.  Recently, the American College of Obstetricians and Gynecologists and the British Medical Journal have warned against these types of surgeries.  They state that there is not sufficient scientific evidence to warrant such cosmetic procedures.  Furthermore, possible dangers include infection, scarring, nerve damage and loss of sensation.  So why are women even considering these procedures?  Maybe for the same reason so many women have gone under the knife for breast augmentation.  Many women believe that by “beautifying” their genitals, their self esteem will improve.  The reality is that such procedures do little to alleviate such body image preoccupations.  Self esteem issues are psychological and should be dealt with first and foremost in psychotherapy, not in the operating room.

One question we should all ask ourselves is WHY?  Why this preoccupation with youthful looking genitalia?  We can blame pornography for this one.  One third of visitors to porn sites are women.  Pornography has now become our reference point for female beauty.  I spoke to several plastic surgeons about this and they told me that many of their patients come to them with a picture, usually taken out of a porn magazine, asking to look just like them……..genitally speaking. I truly believe that the media, commercialism and social pressures have created a problem that now makes women question the normalcy of their genitals, and the same people who created the “problem” are offering a solution---costly plastic surgery.  Remember one thing: genitals come in all shapes, shades and sizes.  No two vulvas are the same.  The problem is that many women have never even had a good look at their genitals, nor do they have enough information about the normal range and variability of female genitalia.  This leaves them vulnerable to such advertisements that lead them to question their natural beauty.  As one young man put it: “Don’t touch them! Vaginas are beautiful and unique works of art.  We don’t want women who have vulvas that look like those of a 12 year old.”

So to answer your question,  Vaginally Challenged: if you have a condition that makes your daily living or your sex life difficult, then see your gynecologist first and discuss your options.  A visit to the plastic surgeon will surely cost you hundreds if not thousands of dollars. 

Dr. Laurie Betito is Clinical Psychologist and Sex Therapist.  She is the President of the Sexual Health Network of Quebec (www.shnq.ca).  She can be heard weeknights on CJAD800 on her radio talk show Passion (10 to 11PM).  You can write to Dr. Laurie at laurie@drlaurie.com