As cosmetic surgery becomes more popular, the demand for more unusual procedures such as labiaplasty is also increasing. Labiaplasty is a cosmetic procedure to alter female genitalia by changing the size and shape of the labia minora, often to correct asymmetry. While labiaplasty has long been used by doctors for medically necessary cases, it is becoming more common as an elective procedure for purely cosmetic reasons. Many obstetricians and gynaecologists argue that there is no medically valid reason for labiaplasty to be performed and there are significant potential risks. As there is no data on the long term consequences of these procedures, the ongoing effects later in life are not known.
The media has reported mixed views on this type of treatment. Some doctors refuse to carry out labiaplasty because they fear the potential backlash from its possible association with female genital mutilation (FGM) and genital cutting. Other gynaecological surgeons feel that women should be educated about the variety of ‘normal’ appearances as the demand for labiaplasty is largely driven by the pornography industry and a combination of an unrealistic desire to look ‘perfect’ and biological ignorance. For example, people do not realise that labia naturally shrink during the menopause.
In Canada, the demand for labiaplasty has become such an issue that new guidelines have been drafted to help physicians deal with patients, some as young as twelve, who are interested in getting their labias trimmed or cut off entirely. The Society of Obstetricians and Gynaecologists of Canada released a policy statement on female genital cosmetic surgery in December 2013 which looked at vaginoplasty, hymenoplasty and G-spot augmentation, as well as labiaplasty. It concluded that it did not support these procedures due to lack of data on long term consequences. Similarly, the American College of Obstetricians and Gynaecologists remains cautious about vaginal surgery due to the associated risks and lack of data on safety and effectiveness.
That said, some plastic surgeons believe women have the right to choose what they have done to their body and it is evident that, for some women, labiaplasty is a life line which can offer a solution to a painful or embarrassing problem. For these women, their anatomical make-up is often affecting their sporting ability, sexual relationships or confidence and having a labiaplasty could reduce their level of discomfort and raise their self-confidence.
Sarah Gubbins, an associate in the Penningtons Manches clinical negligence team, commented: “Labiaplasty is a very personal procedure on such an intimate part of a women’s body that anyone considering it for cosmetic reasons should be absolutely sure that it is right for them before they proceed. We appreciate that some surgeons are concerned by its perceived similarities with FGM and we would therefore support the drawing up of careful guidelines to regulate this type of procedure. We appreciate that regulation is difficult but it is vitally important to prevent this type of surgery becoming open to abuse and to ensure that it is entered into only by adult women of their own free will.
“In today’s society, women have the choice to alter almost any part of their body and, as with any cosmetic surgery procedure, potential patients considering labiaplasty should be well aware of the associated risks which include bleeding, infection and the potential to affect function. Given the ‘perfect’ images portrayed by the media and in pornography, it is important to educate women about the wider range of ‘normal’ appearances before they decide to irreversibly change this part of their body. If they decide to go ahead, it is imperative that women consult with someone who is specially trained in this area of practice and that surgeons performing these procedures carefully assess the motives of the women seeking treatment and ensure that they are aware of the associated complications.”