Chicago Plastic Surgeon

The Chicago Tribune published an article focusing on a recent statement by the “American College of Obstetricians and Gynecologists (ACOG) stating that Cosmetic procedures billed as "vaginal rejuvenation," "designer vaginoplasty" or "revirgination" are not medically necessary and are not guaranteed to be safe. [Obstet Gynecol 2007;110;737-738]

I applaud ACOG’s efforts to review this topic and look out for women’s best interests. Labiaplasty has received widespread attention in the media. It is true that individuals who are interested in these procedures in order to correct other problems in sexual relationships, may be misguided. However, I do find it ironic that a specialty, designated to manage and address women’s complaints, has chosen to neglect women’s valid complaints regarding pain and discomfort attributed to prominent, enlarged, asymmetric or distorted female genitalia.

Contrary to their comments which suggest that women are being coerced into undergoing labiaplasty procedures, the vast majority of patients present with discomfort or pain and are seeking relief without asking for third party payors to cover the procedure. It is my impression that this is evidence that they are experiencing sufficient pain because they are willing to pay out of pocket and not seek insurance reimbursement. The patients, I have consulted with have not typically sought the procedure to repair a relationship or enhance sexual gratification.

In the instance that labiaplasty is being carried out for cosmetic indications, Gynecology is not a specialty accustomed to performing elective surgical procedures. When it does, these issues have historically generated great controversy and rift amongst its practitioners. Tubal ligation is one example. Plastic surgery is accustomed to conducting interventions which are not medically indicated. These include common procedures such as breast enlargement, abdominoplasty, botox or other facial filler injections. Perhaps this explains our comfort level with these patients and offering these procedures. Clearly certain trends in grooming (such as the thong and brazilian) expose a women’s genitalia to closure scrutiny. Any criticism of these procedures would certainly be applicable to any cosmetic intervention: are they suggesting that all cosmetic procedures be banned?

On a serious note surgery is surgery, and its risks should not be taken lightly. Patients with the help of their physician should consider the risks, alternatives, and benefits of any procedure. No procedure is free of risk.

http://www.chicagotribune.com/news/local/chi-cosmetic_31aug31,0,7734462.story
August 31, 2007:

The statement by the American College of Obstetricians and Gynecologists (ACOG) says it is "deceptive to give the impression" that these procedures, which by some accounts are among the hottest new trends in plastic surgery, are "accepted and routine surgical practices."

"Vaginal rejuvenation," "designer vaginoplasty," "revirgination" and "G-spot amplification" are being marketed to women on late-night TV, in magazines and on the Internet. Doctors offering the procedures say they can enhance women's sexual pleasure and alleviate uncomfortable symptoms, and many of their patients agree.

But critics say these women are exposing extraordinarily sensitive body parts to interventions with questionable benefits and unknown risks.

"Absence of data supporting the safety and efficacy of these procedures makes their recommendation untenable," the medical group's Committee on Gynecologic Practice concluded in a two-page statement published in the September issue of its magazine.

Other experts express concern that practitioners are offering surgical fixes to problems better addressed by correcting women's misconceptions about their bodies and boosting their self-esteem.

"If someone doesn't like the way they look or their heart is broken, surgery isn't going to fix that," said Dr. Linda Brubaker, professor of obstetrics, gynecology and urology at Loyola University Medical Center. "Those problems are above the belly button, not below."