A 'Designer Vagina': who really needs one?

Heather Stephen

The ‘Designer Vagina’ is fast becoming one of the most popular cosmetic surgeries performed. But why, and is it something you really need? Heather Stephen investigates.

Sharon Osborne has admitted to a vagina tightening op and reality star Gemma Collins talked about her own very personal surgery on national TV. But the statistics show it is not only celebrities who are putting their privates under the knife.

Although private hospitals are not obliged to keep figures, if you log onto the search engine Whatclinic.com you will find 141 clinics around the UK advertising vaginoplasty or labiaplasty surgery. And even under the NHS, where this surgery is limited to women whose vaginal lips are genuinely abnormal, labiaplasties rose five-fold to 2000 over the decade up to 2010.

But these procedures aren’t without their critics. The Royal College of Obstetricians and Gynaecologists (RCOG) warns that the procedures are irreversible, the advertising for them can sometimes be misleading and lacking in robust evidence for the claims made, and that these procedures may play on women’s insecurities. Some MPs have even called for these ops to be banned, likening them to female genital mutilation.

They may be controversial but, despite the misgivings of some in the medical community, studies have shown that many people request these operations for quite valid physical or sexual problems.

And there is a very high satisfaction rate as shown in a study published in The Journal of Sexual Medicine where nearly 92 per cent of women who had vaginoplasty and labiaplasty said they were ‘satisfied’ with the results.

According to the ROCG, women have labiaplasty to reduce the labia minora (the flaps of skin around the vagina) when it creates problems during sex and discomfort wearing tight clothes, exercising or using tampons.

But some women also have the surgery, costing £1,000 to £3,000, because they think they look abnormal and the RCOG says this could be influenced by images in advertising and the media which give women the impression the labia minora is normally hidden.

Vaginoplasty, or vaginal tightening, is not available on the NHS and costs between £2,500 to £4,500. It is usually requested by women who feel their vagina has become lax following childbirth or with age, making sex less satisfying for them or their partner.

Sex, myths and misconceptions

Consultant plastic and reconstructive surgeon Navid Jallali MD FRCS (Plast) says he has seen “a huge rise” in the number of women requesting labiaplasty.

“Over the last few years the number of people asking for labiaplasty has tripled and I think this is because people are more aware of the benefits and relatively low risks,” he says. “It is a misconception that most people want this surgery for aesthetic reasons. For the vast majority of patients there is a functional component. For instance, they are unable to wear tight clothing, they find sports such as cycling uncomfortable or their labia interfere with sexual intercourse.

“The surgery can also rectify asymmetry as a result of conditions such as Bartholin’s cyst and it can help those women who are so embarrassed about the appearance of their labia that it stops them from forming a relationship.”

Mr Jallali turns away a quarter of women asking for the procedure if he feels there is no clinical reason or he suspects body dysmorphia.

“Unless people have genuine functional concerns I tell them I don’t think surgery is for them,” he says.

Linda Cardozo, Professor of Urogynaecology and Consultant Gynaecologist at King’s College Hospital, London, says these procedures can be useful but, as with any operation, she warns people should consider the risks.


Risks and benefits

“Tightening a lax vagina can increase sexual pleasure for you and your partner but, on the other hand, an operation can create scar tissue or over-tightening which can lead to discomfort during sex.

“Women have come to see me after labiaplasty distressed because the surgeon has taken away more tissue than they expected or there is a degree of asymmetry but once it’s gone you can’t put it back.”

Professor Cardozo attributes the rise in demand for these operations to greater access to pornography and changing fashions.

“People compare themselves to airbrushed images on pornographic websites and women of all ages are shaving their pubic hair so there is more visibility of the genital area.”

Professor Cardozo only performs labiaplasty when the woman expresses reasonable concerns regarding function or discomfort. Surprisingly, she says she has had had some requests from women who have wanted the operation, along with their teenage daughters.

“The advice from the RCOG is that these procedures should not be carried out on girls under 18 as they are still developing,” she says. “And this kind of surgery could be very damaging for young girls.”

Although Professor Cardozo agrees that every woman has a right to choose surgery if she is distressed about a specific part of her body she concludes: “I would try to persuade anyone who is ‘normal’ to think about whether they really need to undergo surgery which could cause long term scarring and pain.”