Vaginal Rejuvenation

The 39-year-old yoga instructor was like a lot of women these days: she was unhappy with her body and thought that a little sculpturing by a cosmetic surgeon would help.  But her goal was not the usual smoothing out of facial wrinkles or expanding her bust.

Instead she wanted to achieve her beauty ideal in the most private part of her anatomy — her genitals. "I was very, very self-conscious about the way I looked," said the woman, who lives in Boston. "Now I feel free. I just feel normal."

As millions of women inject Botox, reshape noses, augment breasts, lift buttocks and suck away unwanted fat, a growing number are now exploring a new frontier, genital cosmetic surgery.

They are tightening vaginal muscles, plumping up or shortening labia, liposuctioning the pubic area and even restoring the hymen, sometimes despite their doctors' skepticism about the need for such cosmetic measures. Procedures that once were reserved for problems like incontinence, congenital malformations or injuries related to childbirth are now being performed by some plastic/cosmetic surgeons to enhance sexual satisfaction and improve the looks of the genitals.

"There's remarkably amazing patient interest in this," said Dr. V. Leroy Young, chairman of the emerging trends task force for the American Society of Plastic Surgeons. "This is at that early stage where there's a lot of enthusiasm for it."

Dr. Young said that while the numbers may be relatively small compared with other surgeries, demand for genital procedures is growing rapidly. The most popular of those are tightening of the vaginal muscles, or vaginoplasty, and reduction of the labia minora, called labiaplasty.

Doctors who perform the surgeries, which are usually done on an outpatient basis in less than two hours, say that the reasons for the procedures are not always purely cosmetic; some women with large labia, the surgeons said, suffer discomfort wearing tight pants or during activities like bicycle riding.

But primarily, doctors say, aggressive marketing and fashion influences like flimsier swimsuits, the Brazilian bikini wax and more exposure to nudity in magazines, movies and on the Internet are driving attention to a physical zone still so private that some women do not dare, or care, to look at themselves closely.

"Now women shave," said Dr. Gary J. Alter, a plastic surgeon and urologist with offices in Beverly Hills and Manhattan, who has come up with his own "labia contouring" technique. "Now they see porn. Now they're more aware of appearance."

Some procedures, like hymen reconstruction, are relatively rare and confined to a minority of women who need to conform to religious or ethnic rules on virginity, doctors said.

A greater number of patients complain of stretched vaginal muscles because of childbirth and ageing, or inner labia that are too big, too uneven or unsightly.

"The women feel undesirable or unpretty," said Dr. Stern of Fort Lauderdale, Fla. "Even if nobody sees it, they see it."

The yoga instructor from Boston, who had labiaplasty surgery four years ago, said she was "asymmetrical": part of her inner vaginal lips extended about half an inch beyond the outer labia. "The only women I could compare myself to was women in pornographic movies," she said. "They were tiny and dainty and symmetrical. Nobody looked like me."

A 34-year-old housewife from Long Island said a similar problem nagged her through adolescence, marriage and three children. Like other women interviewed for this article, she would speak only on the condition of anonymity because of the private nature of the subject and fear of ridicule. "It never bothered my husband," she said, "but it was always like `Yuck!' All I know is that what I had I didn't like." Now, after Labiaplasty surgery, she said, "I look down and I say, that's the way it should be."

But, some doctors warn, buyer beware. Vaginoplasties are often touted as a way to improve sexual satisfaction for women, but Dr. Thomas G. Stovall, president of the Society of Gynaecologic Surgeons, the principal group for gynaecologic surgeons with academic appointments, said there is no scientific data to back up the claim. The opposite is true, he said; painful intercourse can result if the vaginal muscles are too snug.

Other possible risks from genital procedures are painful scarring or nerve damage that could result in loss of sensation or hypersensitivity, according to some doctors. But they added that the procedures have a low rate of complications and that their happy customers reject those qualms.

A 41-year-old police officer in Fort Lauderdale who saw Dr. Stern for vaginal surgery last June said that after having four children she thought her vaginal muscles needed improvement, both for her and for her partner.

Like many other genital surgery patients, the officer has had other cosmetic surgeries, including breast augmentation and liposuction. "I just felt that I keep myself in shape everywhere else, and this would make me feel better," she said, adding that the surgery has given her more intense sexual enjoyment.

One patient, a 22-year-old college student from Toronto, said she had never had intercourse until after her labiaplasty because she felt "insecure and ugly" about excess labia tissue. "It's just that when you feel bad about your body, especially this part of your body, it's kind of impossible to let your true feelings and passions show," she said. Now, after the surgery last May, she said, "I have nothing to hide."

Dr. Laura Berman, director of a treatment clinic for female sexual dysfunction in Chicago, the Berman Center, who this year completed a national survey on the effect of women's "genital self-image" on sexual function, said most women "walk around with a feeling of anxiety about their genitals" because women are not usually brought up feeling confident about that part of the body. She said her research showed that a woman's comfort level with her genitals affects her sexual enjoyment.

Some cosmetic surgeons, who note that there is no such thing as "normal" female genitals, are scratching their heads. Even people in the pornographic film industry say there is no universal standard of beauty for genitals and that, in any event, men fantasise about the woman, not any one body part. Mark Kernes, a senior editor with the trade magazine Adult Video News, said, "I really don't think most men care."

Some doctors said men would be flocking to their offices for their own genital surgery if such procedures as penile enlargement were not fraught with complications and unintended outcomes.

Dr. Alter, the plastic surgeon and urologist, who performs genital surgery on both women and men, said, "With female genital surgery it's predictable, and women are extremely happy."

The housewife on Long Island agreed. "I'm not saying you should do it on a whim," she said. "But if you think it'd make you feel better, why wouldn't you do it?"

Article by Mireya Navarro @ NYT - www.edstrong.blog-city.com

Vaginoplasty

Labiaplasty