Mr Miles Berry, Plastic and Aesthetic Surgeon from Weymouth Street Hospital talks us through the so called ‘designer vagina’ and its appeal for women who want to look good down there.
What is a labiaplasty?
Usually taken to indicate some form of surgical intervention to the labia minora (inner), lately women are seeking surgery to the majora (outer) too if they are particularly lax or enlarged.
Why has porn had a dramatic effect on this surgery?
I may have an entirely different referral base, but I am not convinced it has. I now routinely ask all patients about their experience with pornography and almost all deny watching it. Having dated the odd woman in my time, I can quite believe it. Most of my patients (and at least half are in their 40s and older) became aware of it around the time of puberty when comparing with others in changing rooms. It may therefore be more related to current depilatory trends. We will be able to confirm that if the recent trend back towards pubic hair is maintained and coincides with a reduction in labiaplasty rates. I also suspect that people are now more aware that there is something that can be done 'down there'.
Is there a psychological impact of having a labia that looks different from those in the media?
If one is markedly different from all others then, yes a psychological impact often occurs. Do not forget though that there are probably just as many who rejoice in not being 'part of the herd' and cherish it. Such patients do not reach us, of course.
What functional reasons are women getting this procedure for?
Appearance, pain and chafing with tight clothing. Inability to ride horses or bicycles. I have seen women with severe tears after childbirth and 2 patients who actually managed to tear long labia during intercourse.
What are the negative preconceptions and myths surrounding the procedure?
Many people are labelled as vain or obsessed with pornography. While many people believe these women are simply seeking a ‘designer vagina’, most are having the procedure for functional reasons or because they have been traumatised by having labia that are misshapen or low-hanging.
Are there any side effects from having the surgery?
Yes, the usual of any anaesthesia and surgery e.g., scars, bleeding, infection, sensitivity alterations and so forth. On occasion, women can pop a stitch or two, but this is invariably related to excessive exercise. I strongly recommend overnight stay and a week off as people seem to forget (or shut their mind) to it being real surgery that needs post-op recuperation.
The most important part of our job is expectations and I have seen 3 poor results recently where clearly the original surgeon had little concept of the normal vulval anatomy and, as is usual in such cases, removed too much. In addition to not taking care of asymmetry: it is not simply chopping similar amounts off, but reconstituting the tissue to take account of natural anatomical variations in addition to concealing the scars optimally
What is the best move if someone is thinking about having this done?
Research. Knowledge is power so do not simply go for the first surgeon. Also try to see examples of previous work and avoid 'bargain basement' prices. Often local anaesthesia is touted (and it does have advantages in some situation), but sometimes by those who are not sufficiently qualified surgically to gain admitting rights to quality hospitals so have to offer something of lesser quality.