WUNRN
msnbc.com
Newsweek Health
By
Barbara Kantrowitz and Pat Wingert
Newsweek
Sept.
4, 2007
Sept. 4, 2007 - We've become a
society obsessed with the quest for physical perfection. If you don't like the
nose (or ears or lips or breasts) you were born with, there's a solution: find
a doctor and get it fixed. Last year Americans underwent nearly 11 million
cosmetic plastic surgery procedures, according to the American Society of Plastic
Surgeons. That's an increase of 7 percent from the previous year and more than
400 percent from a decade ago. Clearly, the idea of altering nature's plan for
your appearance is now widely accepted. But are there parts of your body that
should be off limits?
Some doctors think so. Last week the American College of
Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice issued
a statement to its members warning about the dangers of trying to create
"designer vaginas" through procedures that purport to trim and slim
the vaginal lips, tighten the vagina or add extra bounce to the G-spot with
injectable materials like collagen. Over the past few years these procedures
have been marketed in magazines and over the Internet largely as boosts to
sexual satisfaction, turning labiaplasty (the technical name for surgery that
snips the vaginal lips, or labia) into one of the fastest-growing procedures.
Labiaplasty is sometimes necessary for medical reasons--if there's a problem
with urination, for example. But doctors say those cases are not the reason for
the surge. Although there are no firm numbers on how many procedures were
performed last year, doctors around the country report more and more requests
from patients for purely cosmetic changes. When there's no medical reason for
these surgeries, they're not covered by insurance and can cost patients as much
as $10,000.
Not so long ago, the main
clientele for cosmetic vaginal procedures was sex workers and nude
entertainers, but with the increasing popularity of bikini waxes, women have
become more aware of the appearance of their vaginas, and a growing number seem
to feel they don't measure up. Others worry that they don't enjoy sex as much
after pushing a baby out the birth canal; they hope that tightening their
vaginas will restore the thrill. In many cases women say that they began to
question the look of their vaginal area after a comment from a male partner who
had been influenced by images in sexually explicit magazines or movies. Doctors
say they're seeing women of all ages--even in their 60s and 70s--who want
vaginal makeovers.
But the peril may be much greater
than prospective patients realize, ACOG warns. "What we're concerned about
is that there is no safety or efficacy data for these procedures," says
Dr. Cheryl Iglesia, a member of the committee that issued the statement and the
director of Female Pelvic Medicine and Reconstructive Surgery at Washington
Hospital Center in Washington, D.C. "There are no studies in peer-reviewed
journals that show long-term outcomes." The vast majority of these
procedures are not medically indicated, Iglesia says, and women could end up in
worse shape than when they started because of complications like severe pain
from scarring by lasers used on the vaginal wall, decreased lubrication or
incontinence. In the statement, the ACOG committee warned that "patients
who are anxious or insecure about their genital appearance or sexual function
may be further traumatized by undergoing an unproven surgical procedure with
obvious risks."
ACOG says that women who are
contemplating this kind of questionable procedure need to understand that
there's a great variety in the appearance of the vaginal area--just as there is
in any other part of the body--and most of those differences are well within
the normal range, which means they do not require medical intervention.
"You can have [vaginal] lips that are a few millimeters to a few
centimeters," Iglesia says. "It's all normal. You don't have to look
like a Playboy bunny down there." And a tighter vagina is no guarantee of
a better time in bed. "There is real potential that you could make your
sex life worse," she says. "You can't just say we will tighten it up
and it will work better." Female sexual satisfaction is dependent on a
wide range of factors. "It's not just the size of the vagina,"
Iglesia says. "There's a lot more involved, including nerves, blood supply
and lubrication" as well as the critical emotional components of sexual
satisfaction.
Women considering cosmetic vaginal surgery might also want to read up on the international campaign against female genital mutilation, procedures among some African, Middle Eastern and Asian cultures that often involve cutting or stretching of the labia and inserting corrosive substances into the vagina to make it tighter or narrower. Sound familiar? The World Health Organization and UNICEF, among others, have been actively lobbying for the elimination of genital mutilation, which may be performed on infants, children and teenagers. While this campaign continues to make progress, women in this country are paying doctors for what many think is a high-tech version of the practice. It's something to think about.
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