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Are vulvas really too rude for pictures?

Image: Ancient Greek Baubo Goddess sculpture
Image: Ancient Greek Baubo Goddess sculpture

The most common cosmetic surgeries are is on breasts, noses, eyelids and stomachs. Would it surprise you to learn that vulvas are also increasingly being subjected to cosmetic surgery?

The number of Australian women aged 15 – 44 seeking cosmetic surgery on their genitals tripled between 2000 and 2010. There hasn’t been any rise in the incidence of diseases that would require such surgery.

Some women need to have surgery because they have injuries or issues that cause them pain, or they were born with congenital abnormalities, but the increasing numbers suggest that many women are having the surgery for ‘aesthetic’ reasons rather than medical ones.

Genital cosmetic surgery can involve

  • Labiaplasty -  the reduction or reshaping of the labia minora (the inner lips) (labiaplasty) or changes to the labia majora (the outer lips);
  • Vaginoplasty – tightening the inside of the vagina and the vaginal opening
  • Hymenoplasty – a procedure to reconstruct the hymen (also called re-virgination)
  • Vulval lipoplasty – the use of liposuction to remove fat deposits in the mons pubis (the pubic mound)
  • G-spot augmentation – collagen injected into the G-spot in order to enhance its size
  • Clitoral hood reduction – to expose the head of the clitoris.

Doctors are becoming concerned about increasing embarrassment among women about how their genitals look, their feeling of not being ‘normal’, and their accompanied interest in labiaplasty.

Some of this is happening because of advertising. Public health researchers warn that Australian cosmetic surgery advertising (via doctors’ websites) is normalising unnecessary surgical intervention. Their research has shown that cosmetic surgeon’s websites do this in three ways.

  1. The websites ‘pathologise’ normal labias. It’s perfectly normal for labia minora to be visible on some women’s bodies, not visible on others. But cosmetic surgery websites describe labia minora that can be seen as ‘hypertrophic’, which sounds alarming, and means showing excessive growth.
  2. The websites normalise surgical intervention, making the idea that surgically modifying your labia is a simple lifestyle choice. Websites promote ‘genital rejuvenation’ and ‘vaginal tightening’ and suggest that for women it promotes choice and empowerment, even improves sexual satisfaction or attractiveness. There is no evidence to suggest this is true.
  3. The websites promote the idea that genital cosmetic surgery is easy; ‘simple’, ‘safe’ ‘one-hour’, but it’s not. Possible complications include surgical risks, scars that can be severe, raised or itchy, nerve damage to the labia (including permanent loss of sensation), too much tissue removed (exposing the clitoris and causing pain). Some of these problems can require further surgery. In the US some plastic surgeons are now starting to specialise in correcting ‘botched labiaplasties’.

There are also suggestions that the popularity in Brazilian waxing is influencing women’s decisions. Removing the bulk of pubic hair means the genitals are more exposed, and it has made some women more self-conscious.

Where would you go for information on what a normal healthy vulva looks like? 

Images of women’s genitals that appear in magazines like Cleo or Cosmo won’t help you. These must meet Australian Guidelines for Classification of Publications and that Classification Board requires that the labia minora and the clitoris are airbrushed out of photographs. (Apparently penises are ok and don’t need to be airbrushed.)

What you see in pornography is not necessarily natural. Images that appear in pornography are airbrushed and porn stars often have had labial surgery.

The effect of airbrushing and Brazilian waxing has been to promote the idea that a normal woman’s vagina looks like that of a pre-pubescent girl.

But there is good evidence out there. Our clever colleagues at Women’s Health Victoria have started a Labia Library to help women have access to images of what healthy vulvas look like. 

And the quick answer to the question of ‘what is normal’ is ‘there is no normal - everyone is different!’

What to do?

Be clear about whether this surgery is medically necessary. Research shows that decisions about cosmetic surgery are heavily influenced by media consumption and socially formed perceptions of women’s physical attractiveness.

And if it’s not medically necessary? Check out the Labia Library – it will help you understand that our bodies are all as unique as our faces.

 

Sources: Women’s Health Victoria Labia Library; Women’s Health Queensland; Chibnall et al, 2018, ‘Pathologising diversity: medical websites offering female genital cosmetic surgery in Australia’, Culture, Health & Sexuality: An International Journal for Research, Intervention and Care.