New warning on 'perfect vaginas'
Labioplasty involves cutting excess tissue that protrudes from the vagina
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Women are undergoing surgery to create
perfect genitalia amid a "shocking" lack of information on the
potential risks of the procedure, a report says. Research
published in the British Journal of Obstetrics and Gynaecology also
questions the very notion of aesthetically pleasing genitals. Operations to improve the appearance of the sex organs for both psychological and physical reasons are on the rise. But surgeons said the report overplayed the risks of an established procedure. Researchers
from University College London reviewed all the existing studies on
cosmetic labial surgery - which generally involves reducing the amount
of tissue that protrudes from the vulva, the lips which cover the
vagina. They found there had been little work to document any
longer-term side effects. Labioplasty, as it is known, costs
about £3,000 privately and is offered for a variety of reasons: some
women complain that wearing tight clothes or riding a bike is
uncomfortable, while others say they are embarrassed in front of a
sexual partner.
But consultant gynaecologist Sarah Creighton and psychologist
Lih-Mei Liao challenged the ethics of offering women surgery to address
such insecurities, suggesting it was adverts for a "homogenised,
pre-pubescent genital appearance" which created these anxieties in the
first place. They also suggested that any pain apparently
caused by protrusion may well have a psychological root - noting that
male genitalia protrude far further without causing major discomfort. Counselling and support could therefore be a preferable alternative to surgery, they argue. Female circumcision The
number of women undergoing labioplasty nationwide is unknown as the
majority of the operations are performed privately, but last year
procedures on the NHS increased by 70% on the previous year to 1,118. In
studies dating back to 1950, examined by the researchers,
dissatisfaction with the way the vagina looked was the primary reason
for surgery, with patients also speaking of low self-esteem and sexual
difficulties.
But rather than curing sexual problems, Dr Creighton suggested
surgery might exacerbate them by damaging the nerve supply to the area,
impairing sexual sensitivity and satisfaction. She also
suggests that women who undergo this procedure might experience similar
problems in childbirth as those who have experienced female genital
mutilation, in which parts of the vagina are ritualistically removed. It
is now well documented that women who have undergone such circumcision
are more likely to experience significant tearing and bleeding after
labour and even the death of their babies, problems which are overcome
by Caesarean delivery. "Labial surgery needs to be rigorously evaluated in future, and for longer term," said Dr Creighton. "Furthermore,
quality research is needed to improve our understanding of the
psychological drivers behind women's decision to sacrifice sexually
sensitive tissue that contributes to erotic experiences, for a certain
genital appearance that used to be an obligation only for some glamour
models." 'Terrorising' patients Douglas McGeorge,
past president of the the British Association of Aesthetic Plastic
Surgeons, rejected the comparison with female circumcision, arguing it
was a relatively minor operation with few possible complications. "They've
gone a bit over the top. Essentially this is just about removing a bit
of loose flesh, leaving behind an elegant-looking labia with minimum
scarring. The procedure won't interfere with sexual function. "Women
want this for a number of reasons - some find it uncomfortable to ride
a bike for instance, but for the majority it is aesthetic, that's true.
"Lads' mags are looked at by girlfriends, and make them think
more about the way they look. We live in times where we are much more
open about our bodies - and changing them - and labioplasty is simply a
part of this." Angelica Kavouni, a cosmetic surgeon who carries
out labioplasty, said it was wrong to "terrorise patients" with
suggestions of long-term consequences. "This is a procedure
which we have been doing since the 1970s. Any operation performed
poorly carries risks, but when it's done properly there are very few
issues at all. "I have seen women who I have sent away because
I don't think they have a problem, but for women with serious
hypertrophy - when the tissue is dark and hangs down - there is a
simple way to deal with it. The feedback I receive is very positive
indeed." BJOG editor Professor Philip Steer said the study
"underlines the need for multidisciplinary research to investigate the
range of factors that affect women's sexual function and wellbeing. "Reliable
information on the risks and benefits of labial surgery, as well as
alternative approaches, is vital to ensuring informed choice for
women."
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