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    Labiaplasty: The critics

    Sure, they might think it’s fine to tuck a tummy, broaden a bust or re-engineer a rear end. But some cosmetic surgeons think a single common procedure — the labiaplasty — goes over the line, and they’re not afraid to let their colleagues know it.

    Audience responses to an electronic survey at the 2016 Aesthetic Meeting tell the story: 40% of those who performed labiaplasties acknowledged getting negative feedback from other physicians, with most saying some or all of the flak came from fellow cosmetic surgeons.

    Indeed, there are plenty of critics within the cosmetic surgery industry and beyond. The obstetrician-gynecology establishment, feminists, bloggers and others continue to criticize the rapid growth in demand for labiaplasty.

    But a few years after the procedure entered the public consciousness, are the negative feelings within the profession on the decline? It’s hard to know for sure, but cosmetic surgeons who specialize in the procedure say they’re seeing a change.

    Dr. Jugenburg"The stigma around labiaplasties is evaporating rapidly," Toronto plastic surgeon Martin Jugenburg, M.D., tells Cosmetic Surgery Times. "I feel like the newer generation of plastic surgeons views this procedure as just another cosmetic procedure we normally offer because of the exposure it has been getting the last few years at plastic surgery conferences."

    And there was plenty of conference chatter at this year’s The Aesthetic Meeting, the annual gathering of the American Society for Aesthetic Plastic Surgery, which featured at least four sessions about the topic with titles like "Cosmetic Vaginal Surgery: Labiaplasty and Beyond,” and “Why Patients Request Labiaplasty."

    The session "Incorporating Labiaplasty into Your Practice: Tips for Success" featured a survey-response system that asked hundreds in the audience if they perform the controversial procedure. More than 70% responded via electronic device that they do, but 3% agreed with this arch line: "Wouldn’t touch it if my life depended on it." And 2% agreed that the procedure should “Never be performed ever, don’t ask me again."

    In fact, labiaplasties have long bDr. Streichereen an acceptable surgical procedure to improve comfort and functionality in areas like urination, says Lauren Streicher, M.D., associate clinical professor of Obstetrics and Gynecology with the Feinberg School of Medicine at Northwestern University. "Some women are born with or acquired very long labia which cause urine to spray all over the place and, quite frankly, just get in the way."

    Over the past several years, however, "we’ve gotten much more into doing it for cosmetic reasons" as changes in pubic hair styles have uncovered female genitalia, she tells Cosmetic Surgery Times.

    "Suddenly they are able to see their labia far more clearly, when 10 to 15 years ago, women couldn’t even see their labia, much less be critical of it. That’s when the plastic surgeons got on board."

    Indeed, The American Society for Aesthetic Plastic Surgery estimates that 8,745 labiaplasties (excluding vaginal rejuvenation) were performed in 2015, including 400 in girls under the age of 18. At an average cost of $2,800 per procedure, the procedures accounts for more than $24 million in revenue, still far below the annual $1 billion-plus for breast implant surgery alone.

    According to the 2015 statistics, labiaplasties jumped by 16% over 2014 and now rank as the 21st most popular cosmetic surgical procedure, just below lower body lift. The procedures weren’t ranked in 2010 or 2005.

    NEXT: The Labiaplasty Critics

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    • Dr. Pelosi
      For an excellent summary on the major issues in cosmetic gynecology, search this title on YouTube: Cosmetic Gynecology: An Overview at NJ Ob Gyn Society 06.04.2016 Marco A. Pelosi, III, MD, FACOG, FACS, FICS, FAACS

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