Labiaplasty

Labiaplasty (sometimes spelled labioplasty and sometimes referred to as labia minor reduction or labial reduction) [Demand for 'Designer Vagina' Surgery Rising in U.K.", ABC News, 2007-05-25. Retrieved on 2007-05-29] is plastic surgery of the labia majora and/or the labia minora, which are the external folds of skin surrounding the structures of the vulva. The procedure involves reducing elongated labia. When labia are created where there were none, it is usually part of a vaginoplasty.

urgical procedures

Labiaplasty reduces the size of one or both sets of labia. It may also be employed to repair the labia following disease or injury, or especially after childbirth. In addition, a hoodectomy may be performed at the same time, which exposes the clitoris in an attempt to increase sexual stimulation. Hoodectomy is sometimes used to treat sexual dysfunction such as anorgasmia.

As recently as 1999, surgeons usually performed labium reduction by straight amputation of the protuberant sections and then by suturing the edges together. [Maas, Sylvester M. M.D.; Hage J. Joris M.D., Ph.D Functional and Aesthetic Labia Minora Reduction. Plastic & Reconstructive Surgery 105(4)”1453-1456, April 2000] However, this procedure sometimes created a fragile and stiff suture line as well as eliminating the natural contour and pigmentation of the labia minora. Moreover, other procedural and clinical problems existed with amputation that did not ensure a favorable outcome.

Several years later, more surgeons introduced lasers into their armamentarium and began using more refined surgical procedures, such as "inferior wedge resection" and "superior pedicle flap reconstruction". In one outcome study, surgeons studied the results of 20 patients undergoing labiaplasty via the procedure. 95.2 percent of patients at 46 months reported being very satisfied. While five complications cropped up, all but one were handled immediately postoperatively and did not require additional hospital stays or interfere with healing. [Munhoz, Alexandre Mendonca M.D.; Filassi, Jose Roberto M.D., Ph.D.; Ricci, Marcos Desideno M.D.; Aldrighi, Claudio M.D.; Correia, Lelia Domingues M.D.; Aldrilghi, Jose Mendes M.D., Ph.D.; Ferreira, Marcus Castro M.D., Ph.D Aesthetic Labia Minora Reduction with Inferior Wedge Resection and Superior Pedicle Flap Reconstruction. Plastic & Reconstrucive Surgery, 118(5):1237-1247, October 2006]

Labiaplasty is almost always an outpatient procedure performed under anesthesia. It is debated as to whether a local or short general anesthetic delivers better patient comfort. After surgery, patients may experience some mild discomfort and variable swelling, which usually disappear for the most part after one to two weeks. Recovery times ranging from three days to two weeks are claimed on surgeons’ websites.

Risks

While statistics on any botched plastic surgery procedures are rare, the comparable rate of satisfaction for other commonly performed cosmetic plastic surgery procedures in the United States is about the same or slightly less than labiaplasty. According to Jeffrey Rawnsley, an assistant professor and director the UCLA Facial Aesthetic Center at the University of California, Los Angeles, about 90 percent of patients report a positive outcome for breast augmentation. [ [http://www.cosmeticsurgery.com/articles/archive/an~119 Nose Jobs: Art and Science | Rhinoplasty | Nasal Surgery ] ] Experts report about an 85 percent positive outcome for rhinoplasty (the “nose job”), while liposuction patients in the late 1990s suffered a mortality rate of about 20 per 100,000, according to author Christine Rosen. [The Democratization of Beauty,” The New Atlantis, Number 5, Spring 2004] While liposuction outcome rates have improved, many breast augmentations and rhinoplasties are not satisfactory on the first attempt and the patient returns to the operating table for revision.

Labiaplasty—in comparison to other popular rejuvenation surgeries—requires additional treatment in five to seven percent of cases. While the American Society of Plastic Surgeons (ASPS) listed only about 1000 “vaginal rejuvenations” during 2006, the most current year for which U.S. statistics have been compiled, surgeons in both the U.S. and the U.K.—as well as in other developed nations—report that the procedure seems to be growing exponentially. The professional plastic surgery organizations like ASPS, the American Society for Aesthetic Plastic Surgery, the British Association of Aesthetic Plastic Surgeons (BAAPS) and the International Society of Aesthetic Plastic Surgeons do not count labiaplasties among the other yearly statistics of plastic cosmetic procedures.

Patient reports and reactions

According to plastic surgeons, patients often ask for labiaplasty for functional or aesthetic reasons, or a combination of the two.Di Saia, JP M.D. An Unusual Staged Labial Rejuvenation. J Sex Med 2008;5: 1263-1267.] Many patients complain that elongated labia become painful during exercise, or while sitting for long periods of time. A retrospective study conducted by Dr. John R. Miklos and Dr. Robert D. Moore found that close to two-thirds of women seeking labia reduction do so for reason such as pain or discomfort. [Intimate Operations: OB-GYN Organization Issues Warning; ABC News, 08/31/2007 http://abcnews.go.com/Health/WomensHealth/Story?id=3547373&page=1]

Other patients explain to physicians that the elongated lips can be painfully drawn inside them during sexual penetration.Fact|date=June 2007 Some models, dancers, and actors feel embarrassment when wearing swimsuits and other revealing clothing, because their labia are visible through form-fitting clothing, or because their labia slip out of skimpy garments altogether.Fact|date=June 2007 Labiaplasty patients also report feeling embarrassment with their sex partners.

Physicians and mainstream mass media report that the widespread use of pornography has increased demand for labiaplasty. [The Most Private of Makeovers; The New York Times, 12/28/04 http://www.stayfreemagazine.org/public/nyt_vaginal_surgery.html] Consequently, many more people have seen pornographic actresses with shortened labium, and come to regard that as an ideal. Those who consider labiaplasty for this reason may not be aware that the actresses have had surgery, but may wish to get the surgery to appear what they believe to be "normal".Fact|date=April 2008 Trends like thong underwear, bikini waxes, or shaved pubic hair add to the noticeability of protruding labia. The procedure is often the subject of articles in women's magazines, complete with before-and-after pictures.Fact|date=June 2007

Writing in the May 2007 British Medical Journal, psychologist Lih Mei Liao and gynecologist Sara M. Creighton, noted that demand for cosmetic genitoplasty is increasing and that the National (U.K.) Health Service (NHS) has apparently doubled the number of labiaplasty procedures performed in the last five years. Liao and Creighton interviewed healthy adults who had the procedure to learn their motivations for electing for labiaplasty. Many seemed to be moved by appearance. Wrote the authors:

“Patients consistently wanted their vulvas to be flat with no protrusion beyond the labia majora... some women brought along images to illustrate the desired appearance, usually from adverts or pornography that may have been digitally altered.” [Lih Mei Liao, Sarah M. Creighton; Requests for cosmetic genitoplasty: how should healthcare providers respond? British Medical Journal 2007;334:1090-1092 (26 May)]

A study over nine years on 163 labiaplasty patients who underwent reduction of the labia minora showed a 93 percent rate of satisfaction. [Rouzier, Roman MD; Louis-Sylvestre, Christine, MD; Paniel B.J., Haddad, B: Hypertropohy of labia minora: experience with 163 reductions. Am. J. Obst, Gyn 200 Jan;182 (1 Pt 1):35-40]

Controversy

Labiaplasty is controversial amongst some professionals and nonprofessionals who raise concerns that the desire for this procedure is driven by marketing, and by an unhealthy self-image derived from media images of what the "ideal" female genitalia should look like. The increasing attention this procedure is receiving in various media is believed to be generating a growing market for this surgery. For most women, it is cosmetically unwarranted, and constitutes a needless exposure to the risks inherent in any surgery. Some have likened the procedure to other forms of genital modification and mutilation.cite news
last = Cormier
first = Zoe
coauthors =
title = Making the Cut
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publisher = Shameless
date = fall 2005
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Another concern about choosing this surgery for cosmetic reasons is that the ring of scar tissue created at the vaginal opening can later cause pain and complications during childbirth. As this surgery is more and more frequently performed on younger women, a concern is that surgeons are not warning women of the long-term physical risks they may undertake by electing for labiaplasty. Fact|date=June 2007

In May 2007, an article published in the British Medical Journal blasted the "designer vagina" craze, citing its popularity being rooted in commercial and media influences.cite news | title = Top medical journal blasts "designer vagina" craze| publisher = AFP via breitbart.com| date = 2007-05-24| url = http://www.breitbart.com/article.php?id=070524230339.aha5xr5x| accessdate = 2007-05-29] cite journal | last = Liao | first = Lih Mei| coauthors = Sarah M Creighton| title = Requests for cosmetic genitoplasty: how should healthcare providers respond?| journal = BMJ| volume = 334| issue = 7603 | pages = 1090–1092| publisher = British Medical Journal| date = 2007-05-26| url = http://www.bmj.com/cgi/content/extract/334/7603/1090| doi = 10.1136/bmj.39206.422269.BE| accessdate = 2007-05-29| pmid = 17525451] Similar concerns have been expressed in Australia. [http://www.google.com.hk/url?sa=t&ct=res&cd=2&url=http%3A%2F%2Fwww.breitbart.com%2Farticle.php%3Fid%3D080801145404.zfnnx1i6%26show_article%3D1&ei=6MudSLC_MoOY6gPv2sGIBQ&usg=AFQjCNHkwP_2EfywJIXhD5eIX7w8Fgm5og&sig2=ADmzyAyRVSR-47E8JeFSbA]

Recently, the appropriateness of the procedure has come into question among academics, feminists, and health care providers, especially in the U.S. and the U.K. Because some critics argue that women were reporting to plastic surgeons only to have more "acceptable" genitalia created, six scholars, including the heads of two women’s centers and the chiefs of four departments of obstetrics and gynecology at major U.S. universities, gathered for a list-serve discussion sponsored by The International Society for the Study of Women’s Sexual Medicine. The participants took a serious look at elective vulvar plastic surgery, among other topics such as female genital cutting in Third World nations, and assigned six experts with special or strong, evidence-based opinions about vulvar health. Several noted that variations in the appearance of the vulva are normal but that labiaplasty, like any medical treatment, is a woman's right. The group concluded that vulvar plastic surgery may be warranted only after counseling if it is still the patient’s preference, provided the procedure is conducted safely and not solely for the purpose of performing surgery. [Goodman MP, Bachmann G, Johnson C, Fourcroyo JL, Goldstein A, Goldstein G, and Sklar S. Is elective vulvar plastic surgery ever warranted and what screening should be done preoperatively? J Sex Med 2007;4:269-276]

Labiaplasty as part of sex reassignment

In the case of transwomen, labiaplasty is frequently the second part of a two-stage vaginoplasty, where labia and a clitoral hood are created. This is often performed a few months after the first part of the procedure. In some cases, labiaplasty is an elective procedure to improve appearance after a one-stage vaginoplasty.

References

ee also

*Labia stretching
*Vaginoplasty
*Genital modification and mutilation
*Female genital cutting‎

External links

* [http://www.smh.com.au/articles/2004/02/26/1077676899589.html?oneclick=true Sydney Morning Herald] "Designer vaginas are now on offer" ... "including restoring hymens, vaginal rejuvenation, repairing damage from giving birth, liposuction and labial reconstruction."
* [http://observer.guardian.co.uk/uk_news/story/0,6903,1020342,00.html Guardian] "The new nose job: designer vaginas"