The 'Perfect' Porn Vulva: More Women Demanding Cosmetic Genital Surgery

Type "labiaplasty," "vaginoplasty" or any of nearly a dozen female genital cosmetic surgeries into any search engine, and a flurry of doctors' Web sites will pop up touting the self-esteem, sexual enhancement, comfort and fashion benefits of female genital cosmetic surgery.

These sites, typically decorated with airbrushed pictures of lovely women in various states of undress or even nude, are replete with before-and-after photos of trimmed-down labia and gushing quotes from satisfied customers.

Many of these sites promise ecstasy, plus: "Laser vaginal reconstruction can accomplish what ever [sic] you desire."

Some patients seem happy with the results.

"When my husband and I had sex, well, it was like nothing I've ever experienced before," a 40-year-old woman reports, six weeks after a three-hour combination labiaplasty, vaginoplasty and clitoral unhooding, costing at low estimate of $15,000 (a high estimate: at least double that). "I had an orgasm probably within three minutes. … I feel like I've found what I had lost ... I feel like I'm 25 again!"

Her surgeon reports this case study as "Strengthening Our Love For Each Other."

Dig a little deeper though, and you find stories tinged with grief and regret about genital "enhancement" surgeries gone wrong.

"Had the surgery 1/07," one woman reports. "Can't say enough [about] how much I regret it. The problems I had it done for can't even compare to the pain and discomfort I'm having now. The surgeon, who has extensive experience, doesn't know why this is happening."

One of the newest wrinkles in the business of sex is the explosion of genital cosmetic surgery.

Not surprisingly, women constitute 90 percent of patients requesting these surgeries. Both physician and popular Internet sites prey on women's sexual insecurities by promoting appearance and alleged sexual benefits, but pay scant attention to the wide range of normal genital appearance, the variability of sexual response and possible harm.

The New View Campaign Working Group on Female Genital Cosmetic Surgery, a project that I participated in, identified unresearched claims made about female genital cosmetic surgery (FGCS) and analyzed how the rhetoric used by the body-modification and sexual-medicine industries has co-opted core feminist concepts of empowerment, self-determination and choice for profit.

Our review of medical, academic and popular literature, and a survey of physicians' promotional materials provides a disturbing picture.

There are nearly a dozen genital "remodeling" procedures.

The most popular by far is labiaplasty, the trimming of one or both sides of the inner lips or labia minora, or cutting out a V-shaped wedge. As a part of the clitoral system, the inner lips are sexually sensitive, so removal of this densely innervated tissue to get better sex seems, well, counterintuitive.

The next most popular surgery is vaginal tightening: vaginoplasty or vaginal rejuvenation, which involves removal of part of the vaginal lining and tightening tissue and muscles surrounding the vaginal opening.

The question about the development of scar tissue and disruption during future vaginal births is typically left unaddressed.

Reduction of the glans or tip of the clitoris (clitoropexy) for is done for purely aesthetic purposes. The only function of the glans is sexual sensation, so trimming can in no way enhance sexual pleasure. The protective clitoral hood (or "unhooding") is rarely requested, but is often offered (for additional cost) along with labiaplasty. The idea that reduction or removal may enhance clitoral sensation is pure mythology.

Hymen restoration or repair (hymenoplasty) is done to provide the illusion of virginity when the hymen has been broken through normal activities or intercourse. Some women are having hymenoplasty as a "Valentine's present" to their lovers.