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

Women are risking their lives to achieve an unrealistic and unnecessary ideal.

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Removal of a tough or "imperforate" hymen for functional reasons is variously called hymenotomy or hymenectomy.

The wildly controversial "G shot" is an injection of a quarter-sized dollop of human-engineered collagen through the vaginal wall into the urethral sponge, the spongy tissue surrounding the urethra.

Developed and franchised by Dr. David Matlock of Dr. 90210 fame, this procedure must be redone every few months. According to Matlock's Web site, and unpublished data, this injection results in "enhanced sexual arousal and sexual gratification for 87 percent of normal sexually functioning women."

Many women sing the praises of the shot: "After my G shot, I get sexually aroused performing yoga." But comedian Margaret Cho reported no sexual enhancement at all and says it felt like she was "sitting on a hemorrhoid donut."

Other procedures include pubic mound reduction, reducing or poofing up the outer lips or labia majora and "building up and strengthening" the perineal body.

Regarding the ecstatic reviews, psychologist Carol Tavris notes that "One of the most well-documented findings in sociology is called the 'justification of effort' effect: The more time, effort, money and pain that people invest in a procedure, program, surgery, or other activity, the more motivated they are to justify it.

"How easy would it be for you to find a Marine willing to say that cadet hazing and suffering were unnecessary and brutal?" Or "… to get George Bush to say 'Gee, I guess going to Iraq was a bad decision?' "

All women by far are not enthused. "Perhaps the only rejuvenation going on is the doctor's wallet," an anonymous contributor to the Wall Street Journal blog opined. On Women's Health News, Rachel Walden observed "… spending $3,500 to $20,000 cutting up your hoo-ha isn't going to fix what's wrong with you."

The American College of Obstetricians and Gynecologists noted in 2007 that these "procedures are not medically indicated, and the safety and effectiveness … have not been documented. No adequate studies have been published assessing the long-term satisfaction, safety and complication rates," although the college dropped the ball by failing to institute regulations or sanctions.

The American Society of Plastic Surgeons informally agrees with this policy, but does not have a formal policy of its own.

Women may believe that their doctors are proficient in these techniques, but ob-gyns, family-practice physicians and urologists are promoting and performing these lucrative surgeries with minimal training.

By Matlock's estimation, doctors in all 50 states, and around the world, operate as "franchisees" of his business. Although he has been asked repeatedly for documentation on safety and effectiveness, Matlock has refused to publish any outcome studies, citing his need to "protect his intellectual property."

The most reliable evidence of the possible negative after-effects of genital surgeries is reported in follow-up reports on children with intersex conditions. In many cases, labia reduction removes sexually sensitive tissue, may cause lifelong hypersensitivity or numbness, pain on intercourse, infection, adhesions and scarring.

Some doctors acknowledge the downside of these putative enhancement procedures.

"We have seen many unfortunate examples of terrible, scarred, uneven results of labiaplasty from other physicians who have attempted labia-reduction surgery with typically poor results, which are usually permanent," Dr. Robert Roh, a New York City gynecologist, reports on his Web site.

Dr. Red Alinsod, an Orange County, Calif., gynecologist, concurs: "The numbers of patients requiring labiaplasty revisions have dramatically increased over the past several years. It is not a common procedure but one that is steadily on the rise as more surgeons attempt to perform labiaplasty surgery without knowledge of the basic tenets of aesthetic vaginal surgery."

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