A Look at Labiaplasty

By Jen Loy, Fabula
Posted on May 29, 2000, Printed on December 1, 2009
http://www.alternet.org/story/9217/

The first time I caught sight of an ad for "Laser Vaginal Rejuvenation," I knew I was in LA. The ad featured a barely bikini-clad woman with back and neck arched to suggest that summit of all sensations. "You won't believe how good sex can be!" Singing the praises of a Dr. David Matlock of the Laser Vaginal Rejuvenation Center in Los Angeles, the ad invited me to "Call today for a complimentary consultation with our Board Certified Gynecologist." And financing was available. That's a relief.

A few weeks later I had in my hands a press release about a "New Trend in Plastic Surgery for Women," which informed me that "a growing number of women are joining a new trend in plastic surgery to improve the appearance of their outer vaginal area." Curious, and more than a little nauseous, I read on and quickly learned that "Dr. Alter has developed a new procedure for reducing the size and shape of the inner lips of the vagina," called labiaplasty. According to the release, the good doctor was more than willing to tell me all about it.

So now there's a problem with women's lower lips? I'm still threatening to buy the boobs that were supposed to be my birthright, and now I'm invited to grab a mirror and take a good look. As a friend and fellow admirer of the plastic in Pamela said, "but my pussy is perfect!" My sentiments exactly. We'll buy boobs, but get cut near our clits? Hell no! So why all the buzz about modifying muffs?

With a name like Dr. Alter, I figured he was where I'd start my voyage into the apparently budding industry of designer vaginas. Dr. Matlock has a full-page ad, but Dr. Gary Alter has a publicist.

Sexual-Enhancement Surgery

Costing anywhere from $2,500 to $15,000, a sample of the snipping, injecting, clipping, and stitching from the burgeoning world of Female Genital Cosmetic Surgery (or, as Cosmo refers to it, "sexual-enhancement surgery") includes: vaginal tightening (similar to the husband's knot -- the stitching up of the torn or stretched vagina after child birth), the liposuction and lifting of lips that have begun to lose the battle with gravity, the "repair" of the hymen, the clipping of elongated or asymmetrical inner lips, unhooding the clitoris for more friction, and injecting fat (taken from the inner thigh) into lips thought too thin.

According to press material, the most common procedure is labiaplasty. Labiaplasty is the trimming of the labia minora, the flaps of skin that form the inner lips of a woman's genitalia. Based in the Mecca of makeovers, Beverly Hills, Dr. Alter is one of the few board-certified urologists and plastic surgeons practicing in the United States. After 10 years as a urologist, he "saw various problems that were not being addressed by anybody. Plastic surgeons don't know much about genitals."

"The [original] procedure, that's still in all the medical literature, is when you have these labia minora that are sticking out, is to just kinda cut 'em off. So, you have this long suture line and the raggedness of the sutre line simulates the edge of a labia. But to me, that was very unnatural. I thought, as a plastic surgeon, there has to be a better way to do this." So, he developed labiaplasty.

"It's the combined training that makes a difference. You can make an ear smaller without losing the shape by taking various triangles out of the ear, the edge of the ear, and then you bring the ear together, so it keeps the same shape." Ears? The normal edges of the labia are left intact, and according to the before and after shots on his site (www.altermd.com), the new labia look "natural." No, the photos have not been altered, just the flesh. And the after shots do look "natural," but it would be easy to argue that the before shots look natural as well. After all, these women were born with what is bared in the before shots. Isn't that natural? When talking about plastic surgeons and the women who pay them, natural is up for debate.

Was there a biological reason these women came to Dr. Alter? Were these women unable to reach orgasm before the procedure? Not according to Dr. Alter. "You can forget the orgasm part; I don't do this for sexual improvements. It's purely cosmetic." In fact, 90 percent of Dr. Alter's patients have pursued this procedure for cosmetic's sake, while less than 10 percent have what he would consider a "legitimate physical" need to get cut. Some women's labia minora are long enough that they get pulled during penetration, making the act of sex painful, or caught in clothing, making snug panties, tight pants, biking, or horseback riding far from comfortable. But the majority of the women who have had a labiaplasty do not have legitimate biological or physical reason. Psychological, yes.

Vanity may call for such things as a nose job, a tummy tuck, or a face lift. And I'll be honest: I'm not joking when I threaten my busty family with a boob job if my genes don't kick in. But my labia? Isn't it kind of dangerous to go clipping the skin that protects the sensual center of my body?

According to more than a few doctors, yes. In a recent Bitch article, "Vulva Goldmine" (Vol. 11), Dr. Malcolm Lesavoy cautions that "any time you make an incision, you have decreased sensitivity." Lesavoy, who teaches plastic surgery at UCLA (Dr. Alter's alma mater) continues, "I would caution anyone against having genital surgeries for cosmetic reasons. I think they're fraught with dangers. God made us in such a way that things function pretty well left alone."

These Women Are So Happy It's Mind Boggling

But according to Dr. Alter and the previously mentioned Dr. Matlock, Lesavoy's and similar God/doctor-knows-best attitudes in the medical world are a major problem. Dr. Matlock maintains that "very few physicians are concerned with the appearance of the female external genitalia. A relative complacency exists that frustrates many women." And Dr. Alter adds the he "see[s] a lot of women who are upset at gynecologists and other plastic surgeons because they have complaints about the appearance of their genitalia, but they have been dismissed by these gynecologists and plastic surgeons. They basically are told, 'Don't worry about it; there is nothing wrong with your labia,' or 'go to a psychiatrist,' or 'go on antidepressants.' This happens all the time. You start to wonder how doctors really view females." Both men herald themselves as doctors, who unlike their peers are willing to listen to women. To give them what they want. According to our Beverly Hills plastic man, his patients are often "so relieved that they're not the only person out there with this problem."

But is this really a problem? Is not having your idea of the perfect pussy
a problem?

There has never been a lot of discussion about what women's vaginas and labia look like. At least, not in the wonderful world of Western medicine. Not that all women are slaves to the demands of our society, but we all feel the effects. We know what society expects of our breasts, our butts, and our legs. But what about our labia? And why does it seem like the labia is suddenly the thing to be tweaked?

In a recent Salon interview, Elizabeth Haiken, author of Venus Envy: A History of Cosmetic Surgery (John Hopkins University Press), points out that "before crotch shots were published nobody was interested in this, but now everyone knows what labia are supposed to look like." Dr. Altar has called it the "Penthouse effect." If Playboy's popularization in the '50s caused the fervor for breast enlargements in later decades, then crotch shots in magazines and porn flicks have heightened women's awareness of their down-theres. So, women are lining up to improve their pudenda.

Not exactly. Canadian Dr. Stubbs, hawker of the Toronto Trim, boasts he's doing the procedure "more than ever" -- he's up to once a month. Dr. Matlock's Web site doesn't give numbers (but he does promise women better orgasms), and Dr. Alter is up from four or five when his press material boasted "many," to 40 or so. For all the hype, it appears that hardly any women are getting this procedure.

Who are these women who think their vaginas should look better? Trophy wives? Plastic surgery junkies?

Dr. Alter offers that for the majority of the women who come to him for this procedure (women in their '20s and '30s) this is not their first surgery. Alter adds that "these women are really good looking" and having labia they don't like becomes an "overwhelming self-esteem thing." Does their self-esteem improve after the $4,000-$5,000 dollar, hour or so long surgery? You betcha.

"Honest to god," gushes Dr. Alter. "I'm telling you, the women are so happy
it's mind boggling."

Mind boggling indeed. These doctors are hawking their shiny plastic wares to their return customers. They are taking ads out in the LA Weekly and hiring publicists to target women's publications. And, no surprise here, women are buying it. Maybe the surprise is that the publicity is painting a picture of a plastic surgeon (with scalpel raised high above well-groomed hair and a Hollywood smile) as crusader for women's rights.

I understand insecurity and body image issues. I think most women do. And hey, we all know our economy is driven by a materialism that often develops out of these insecurities. But considering the risks of losing sensation or gaining increased sensation to the point of constant discomfort, considering that sexual enhancement surgery could possibly rob a woman of the ability to enjoy the act, let alone walk across the bedroom, I have to shake my head. I, who have looked longingly at breasts that burst from blouses, would never stand in the way of a woman who wanted to buy the pussy of her dreams. But I might question her dreams.

With all the press releases, Web sites, and testimonies of labiaplastied ladies, there has been something of a media mania about all this muff modification. Cosmo's "Health Report" (November, 1998) claimed that "A hot trend out of Hollywood promises to prettify and pleasure up your pantie-clad parts. Could one of these below-the-belt snips, nips, or tucks revolutionize your sex life?" (Leave it to Cosmo to ask the tough questions.) Bitch: Feminist Response to Pop Culture asks "What is the standard for vulvas and who sets it?" Also responding to the press releases with articles and airtime are Marie-Claire, Jane, Howard Stern -- you can pretty much guess how each of these media giants covered the trend.

The most surprising and (perhaps) the most woman-positive piece of late was published by Playboy. A concerned hubbie wrote The Playboy Advisor (August, 1999) because his wife thinks her lips are too long. He likes 'em just fine, as they give him more to "nibble on," but nevertheless, inquires if "there is a doctor in his right mind who does this type of operation," because the size of her labia are "really bothering her." The Advisor does describe Dr. Alter's procedure, but also suggests that the concerned nibbler buy a copy of Femalia (Down There Press, 1993) so she can see photos of vulvas and labia of all shapes and sizes. Quite the progressive piece of advice. "And you keep reassuring her that her lips are as beautiful to you as the rest of her." Could it be The Advisor who realizes when a woman is more comfortable with the parts she was born with, she'll get more pleasure out of using them, which in turn means her partner will get more pleasure as well?

© 2009 Fabula All rights reserved.
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