Female Genital Aesthetic Surgery
Aesthetic surgery of the female genitalia includes a number of
surgical procedures designed to improve their appearance. It is
claimed that, occasionally, sexual function may be enhanced. The
availability of such surgery in the UK is limited.
With a growing acceptance of surgery designed to alter
appearance, and the increasing availability of explicit images of
naked women, a number of women are requesting surgery to alter
their intimate appearance feeling that they compare unfavourably.
There are other women who claim that the size or shape of their
vagina or external genitalia prevent them or their partner from
achieving full sexual satisfaction.
The most commonly requested procedures are labial reduction
('labiaplasty') and vaginal tightening ('vaginaplasty') operations.
Other procedures include liposuction to the mons pubis; fat
injections to the labia majora or mons in order to give a more
youthful appearance to these areas; removal or reduction of skin
around the clitoris ('hoodectomy'), to improve clitoral
sensitivity; and reconstruction of the hymen for cultural reasons.
Laser therapy has been prescribed for the removal of labial
wrinkles; and hair transplantation for hypotrichosis of the mons
pubis.
Labial reduction includes a number of operations designed to
decrease the size and degree of protruberance of the labia minora,
or 'inner lips' of the vagina. The most common reason for women to
request this operation is because the labia are perceived to be
toolarge and aesthetically un-pleasing. A small number of women
state that the large size of their labia make them noticeable in
tight clothing, or make sports such as cycling uncomfortable.
Others have problems with penetration.
The procedure is relatively simple, excising an area of the
labia minora using a variety of incisions; and can be performed
under local anaesthetic. Careful placement of the scar is
important, however, in order to prevent painful scar contracture
along the rim of the labia.
Vaginal tightening operations are requested by some women who
feel that their vagina has become lax following childbirth, or with
age. As a consequence, they claim that sex is less satisfying for
them or their partner. The procedure may be as simple as placing
sutures at the introitus (vaginal opening), or may involve excising
excess vaginal mucosa together with tightening the muscles of the
posterior vaginal wall.
The former procedure is not widely offered. The second procedure
is usually performed under general anaesthetic, more commonly by
gynaecologists. Perforation of the bowel is one of the more serious
complications which may occur.
Liposuction or 'liposculpture' of the mons pubis may be an
isolated procedure or performed in conjunction with liposuction of
the abdomen or thighs. The appearance of the mons is enhanced by
improving its definition. In contrast, fat injections to the
mons or labia majora plump out these structures, giving them a more
youthful appearance.
Hoodectomy, or removal of the fold of skin around the clitoris,
is performed to expose the clitoris and make it more
sensitive. However, there is little information on outcome,
other than anecdotal.
As with many aspects of human anatomy, there are a wide variety
of shapes, sizes and appearances of the female genitalia, all of
which are within the limits of normal. Before undergoing any
surgery, it is important to determine whether there really is a
problem with the genitalia or whether another solution would be
more rewarding.