GENTIAL SURGERY - HAVE WE GONE TOTALLY OBSESSIVE??

In the quest for perfection and amid a growing obsession with body image, it seems women now have a new part of the anatomy to worry about - their vaginas. Genital plastic surgery is one of the fastest-growing areas in cosmetic surgery, and one of the most popular procedures being requested - mostly by young women - is a labiaplasty. A labiaplasty - or labial rejuvenation - is a procedure whereby the inner labia, or labia minora, get trimmed back so they look more "tucked in". The surgery is generally done under a local anaesthetic, so the patient is awake while it is being performed. The process takes around 90 minutes and you can walk out of the surgery, returning to normal activities within a few days - except for sex, which you should hold off having for four to six weeks. The reason for the rise: "There has been a huge surge in the past five years of people looking to get genital surgery, and the vast majority of these are getting a labiaplasty, vaginoplasty (vaginal tightening) or liposuction in the pelvic area or labia," says Dr Laith Barnouti, a leading Sydney plastic surgeon. Barnouti says that currently around 20 per cent of his clients are coming in for genital surgery. The youngest to date was 14, the oldest in her mid-60s. A 2010 report also found that the number of clinically necessary procedures - that is, not solely for cosmetic reasons - performed by private practitioners nearly doubled in recent years.

So why are women requesting this procedure? There are a few reasons, says Barnouti, including feeling "socially embarrassed… people can’t wear certain types of bathers, people feel embarrassed in intimate situations". But the reasons go beyond the aesthetic, he claims.

"Labiaplasty and vaginoplasty are often performed due to a medical condition - people actually have it for a functional reason," Barnouti says. "Labial hypertrophy - enlargement or sagging of the labia - can be unhealthy and unhygienic."

Vaginoplasty, which is usually performed on women who have a weakened perineum after giving birth, is a "restorative, reconstructive procedure", says Barnouti. "This is something completely different from, say, liposuction, which is a purely cosmetic procedure."

What is normal? But are women having genital surgery for other reasons - to please a boyfriend perhaps, or because they feel their vagina is not normal? Do women actually hate the appearance of their vulvas so much that they will have parts of them surgically removed? The 2008 UK documentary The Perfect Vagina explored the reasons why women opt for this type of surgery, and found that many do it because they’ve been teased by someone close to them about the way their genitals look, or have just decided their vagina looks abnormal. In the documentary, Professor Linda Cordoza, a leading UK gynaecologist, says while women are much more aware of what’s available in terms of plastic surgery procedures, it doesn’t necessarily mean they know what’s normal.

"There’s been a huge trend towards bikini waxing, doing things with your pubic hair as well as the hair on your head. So [women think] if you can have cosmetic surgery done to your face, you can also have cosmetic surgery done on your genitals," Cordoza says.

"I sometimes get two or three generations of women in the same family coming in saying they want their labia trimmed."

The role of pornography:
Our perception of what is normal is most definitely clouded by the proliferation of pornographic images featuring women with smaller, tucked in - and often heavily airbrushed - private parts.As women, we don’t often see vaginas other than our own, so if the only images we see are of highly airbrushed genitals, naturally many of us are going to assume that what we have is "different" or "abnormal".

Melinda Tankard Reist is a media commentator and author of Big Porn Inc and Getting Real - Challenging the Sexualisation of Girls (Spinifex Press). She believes pornography is a big driver in the rise in cosmetic surgery."Girls are made to feel inadequate and think that there’s something wrong with their perfectly natural, healthy bodies. And boys are expecting girls to provide the porn star experience," Reist says.
Reist adds that it’s important women pass on positive body image messages to their daughters, and that cosmetic surgeons should play their part by refusing to operate on very young women, rather than "capitalising on the body angst of girls".

Barnouti says women contemplating any type of cosmetic surgery should be doing it for themselves, not anyone else. "What we do here is for the patient, not their partner," Barnouti says. "If you’re going to have a procedure, have it for yourself. Just because someone makes a negative comment doesn’t mean you should change your whole body."

"I had this surgery and love the results": Lisa Smith, 23, recently had genital surgery at the Ashley Centre in Melbourne. "Labiaplasty is something I’ve wanted to do for years. I have never had a problem with how I look, nor have I received any negative comments from partners. For me it was about feeling discomfort and swelling in that area, particularly after sex. The procedure wasn’t uncomfortable and I was surprised by how minimal the pain was, especially considering how sensitive that area is. I am a dancer and I’ve talked to a lot of friends about it and many say they have also had it done. It’s just not something people are talking about very openly yet."

Did you know? This type of surgery gets 74,000 global monthly internet searches on Google.