Young Women & Genital Cosmetic Surgery: The Need for Informed Decision Making

A recent New York Times article entitled “More Teenage Girls Seeking Genital Cosmetic Surgery” was published on on April 25th. As a medical professional who takes women’s health issues, especially those of reconstructive and cosmetic surgery seriously, I am saddened to read words like these.


Cosmetic and reconstructive surgery is not to be taken lightly. While it is a viable option for those who need and elect it, it is not something that should be done flippantly or at a time in a female’s life when the body is still developing naturally.

The article states this:

Fat thighs. Hairy arms. Muffin tops. Breasts that are too big or not big enough. To the long list of body parts that adolescent girls worry about and want to tinker with, the Internet age has added a new one: the vulva.

So many teenagers are seeking cosmetic surgery to trim or shape the external genitalia that the American College of Obstetricians and Gynecologists issued guidance from its Committee on Adolescent Health Care to doctors last week, urging them to teach and to reassure patients, suggest alternatives to surgery that may alleviate discomfort, and screen them for a psychiatric disorder that causes obsession about perceived physical defects.

As for why there has been an increase in demand for the surgery among teenagers, physicians are “sort of baffled,” said Dr. Julie Strickland, the chairwoman of A.C.O.G.’s committee on adolescent health care

A defining characteristic and mark of a professional cosmetic surgeon is that they will always offer clear, concise consultation to every individual that seeks out cosmetic surgery. This should be done with every single patient that walks in the door of an office. It is even more important to do when the potential patient is a young female. I am glad that the American College of Obstetricians and Gynecologists are pushing for more intensive education in this area. It is crucial to the long term health of the woman.

The article goes on to give these statistics:

The American Society for Aesthetic Plastic Surgery says that 400 girls 18 and younger had labiaplasty last year, an 80 percent increase from the 222 girls who had cosmetic genital surgery in 2014. While the overall numbers remain small, the data probably understates the trend because it does not include procedures performed by gynecologists. A 2013 British report found the number of labial reductions on girls and women done by the National Health Service had increased fivefold over 10 years.

Labiaplasty is a procedure that I have conducted many times. It is a procedure that allows women to tighten the muscles of the vagina,, as well as to give a more pleasing aesthetic look to the labia. For women who have experienced child birth, injury or who understand the risk factors involved in the cosmetic approach of this surgery, this may be an appropriate procedure. However, for individuals that allow trends and fads to dictate their participation in this, I would advise extreme caution. Sexual sensitivity can be lost, as well as the general risk factors that come from any major surgery.

As a cosmetic surgeon, I make my living by conducting these procedures. However, I want women, especially young women, to make educated decisions when participating. 

The entire NY Times article an be read here.

An Introduction to Genitoplasty and Labia/Vaginal Reconstruction

A woman’s vagina is the most sensitive place on her body. On both a physical and emotional level, it is an area that affects not only their physical health, but their self esteem and self identity. When it is not functioning properly, pains them, is not aesthetically pleasing or in some cases is non existent, women can experience feelings of discomfort and pain.

When this happens, a viable option is often Genitoplasty. Genitoplasty is defined in a number of different ways depending on the focus of the surgery. However, it can easily be defined as “ plastic surgery on the genital organs( 1) ” or “surgical alteration of external genitals, as in neonatal sex reassignment (2) ”

For women, this often shows up as Labiaplasty or more widely, Vaginoplasty. Some very clear and concise definitions of these two terms come from Webmd

Vaginoplasty is a procedure that aims to “tighten up” a vagina that’s become slack or loose from vaginal childbirth or aging. Some surgeons claim it can even improve sensitivity — a claim the American College of Obstetricians and Gynecologists (ACOG) has strongly challenged.

While it’s true that vaginal tissues can stretch, surgically tightening the vaginal tissue in itself cannot guarantee a heightened sexual response, since desire, arousal, and orgasm are complex, highly personal responses, conditioned as much by emotional, spiritual, and interpersonal factors as aesthetic ones. In addition, sexual “sensitivity” doesn’t automatically lead to more pleasure – it can actually lead to pain.

Labiaplasty, plastic surgery on the labia (the “lips” surrounding the vagina), can be performed alone or with vaginoplasty. Surgery can be performed on the labia major (the larger, outer vaginal lips), or the labia minor (the smaller, inner vaginal lips). Labiaplasty changes the size or shape of the labia, typically making them smaller or correcting an asymmetry between them.

Both surgeries require a lot of consultation from trained professional doctors who are educated specifically within women’s health. Part of these consultations will be to evaluate the nature of the procedure, whether is reconstructive or cosmetic. Knowing the difference between these will be crucial to reaching the patients ultimate goal.

Lastly, it is important to understand how deep the personal nature of these procedures go. Women seek out genitoplasty and labia/vaginoplasties for a number of reasons:

  • Incontinence: This can be the result of having children. Muscles become looser than normal and can lead to urine incontinence.
  • Purely Cosmetic Motivations: Many women desire to fix asymmetrical labias or other cosmetic issues. Doing so can lead to heightened levels of comfortability during sexual relations.
  • Damage Repair: when the vagina is damaged, surgery might be the best option in order to restore functionality and healthy appearance. Damage can come from accidents, childbirth, tears, etc.
  • Sexual reassignment: many intersected or other individuals choose to have a vagina constructed for them. This can help foster positive feelings of self identity and worth.

It cannot be reiterated that these surgeries are not to be taken lightly. When considering any of these options, it is important to receive thorough consultation from a licensed professional.


(1) Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

(2) Farlex Partner Medical Dictionary © Farlex 2012