Probably few surgical procedures are as controversial as labiaplasty, which refers to plastic surgery on the labia, the fleshy folds that enclose and protect the rest of women’s external genitals.
“Many doctors claim that women with normal anatomy are unduly influenced by Brazilian waxing, online images, pornography and promotion of designer vaginas to socially vulnerable women,” researchers write in a paper published Wednesday. “Opponents link the procedure to female genital mutilation and manipulation by media images of the adolescent vulva [external female genitals].”
But study coauthor Dr. Heather Furnas says she saw female genital mutilation when she worked at a mission hospital in Kenya, and it looked nothing like labiaplasty, which involves reducing the size of the labia, not removing them completely. Her study found that dissatisfaction with the appearance of their labia and physical discomfort, not some idealized image of the vulva gleaned from viewing pornography, is what drove women to seek labiaplasty.
All but three of the 50 patients she and her coauthors surveyed said they were self-conscious about how their labia looked. They felt they couldn’t wear certain types of clothing, such as bathing suits or yoga pants, because their elongated labia were visible. But virtually all of them also reported physical symptoms, such as pain during intercourse or uncomfortable twisting of the labia.
“Maybe there was one patient in the study who didn’t have a physical complaint,” Furnas, a plastic surgeon in Santa Rosa, Calif., told me. She and her coauthors published their findings in the April issue of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons.
Furnas’s paper cites an Australian study, published last year, that compared 35 women seeking labiaplasty with 30 women who were not considering the operation. The Australian researchers found that the women seeking surgery reported seeing more images of female genitals online than the comparison group of women.