Vulvar plastic surgery is becoming more commonly requested procedure. There have been negative comments and editorials written suggesting that both the doctors and the patients should not be pursuing cosmetic vaginal surgery. It’s important that the physicians understand that patients suffer from a variety of physical and emotional symptoms. Physical symptoms are usually associated with wearing certain types of clothing, engaging in activities such as walking, jogging, exercise, bicycling, and intercourse. Other patients are afflicted with emotional problems such as embarrassment, anxiety, and a loss of self esteem.
Doctors Miklos and Moore held a retrospective chart review on all patients who had undergone a labia minora reduction surgery at their center between January 2005 and March 2007. The chart review included collecting data on age, parity, and race, as well as standardized questions about motivating factors and influences for patient pursuing labia minora reduction surgery.
Based upon this questionnaire, the results were divided into three different groups: Group I—patients seeking the procedure strictly for aesthetic reasons; Group II—patients seeking the procedure strictly for functional impairment (i.e., pain and discomfort); and Group III—patients who feel they are having the surgery for both aesthetic and functional reasons.
In their discussion, Doctor Miklos and Doctor Moore detailed how labia minor protruding past the distal edge of the labia majora can be of concern to women. This condition can constitute a functional or cosmetic problem, and such an enlargement can be bilateral or unilateral in nature. Labia enlargement can be congenital, or can also be the result of androgenic hormones, manual stretching, and chronic irritation. Despite the cause, labia enlargement remains a problem for some women. The primary reason for patients requesting labia reduction surgery was aesthetic dissatisfaction in 87 percent of cases, discomfort in clothing in 64 percent, discomfort when taking part in sports in 26 percent, and entry dyspareunia by invagination of the protuberant tissue in 43 percent. The results show similarities when considering the primary reasons for requesting labia minora reduction surgery.
The review revealed 131 patients had undergone a labia reduction surgery. They had a mean age of 35.7 years (range 14–57), mean parity of 1.7 (0–6), 95 percent were white, three percent were African American, and two percent Asian. Results of the questionnaire revealed: Group I—those who received labia reduction surgery for strictly aesthetic reasons—equaled 37 percent; Group II—those seeking the surgery strictly for functional impairment equaled 32 percent; and Group III—those seeking the surgery for both functional and aesthetic reasons equaled 31 percent. Of the patients in Group I, 8.2 percent admitted to being influenced by their male partners as reason to seek the procedure. All the patients in Group II had their surgery strictly for functional reasons and had no outside influence. Group III revealed outside influence in 12.3 percent of patients: 7.5 percent by male spouses or partners and 5.0 percent by female partners. In Groups II and III, 54 percent of patients had more than one functional symptom, with 55 percent experiencing discomfort while wearing clothing, 46 percent experiencing discomfort during exercise or activity, and 60 percent having painful or uncomfortable intercourse. Of the patients in this study, 93.1 percent sought surgery because of purely personal reasons and 6.9 percent admitted to being influenced by a male or female partner, spouse, or friend.
Although many people would consider labia reduction surgery a viable option for pain or discomfort associated with activity, clothing, and sexual encounters, many do not feel labia reduction surgery is a viable option strictly for aesthetic reasons. A survey of 3,627 women found that women with positive body images reported more sexual activity, initiation of sexual activity, orgasm, sex with lights on, greater comfort undressing in front of their partners, trying new sexual behaviors, and pleasing their partner. However, little research exists on the relationship between a woman’s genital image and her sexual function. Realizing one’s genital image is part of one’s body image; it is easy to understand how many women might feel sexually inhibited if they are not comfortable with the appearance of their vagina, vulva, or external genitalia.
Cosmetic vulvar surgery is becoming a more requested plastic surgery for various reasons. The article written by Doctor Miklos and Doctor Moore reveals that not everyone undergoing labia reduction surgery is doing it for purely aesthetic reasons. The majority of patients undergoing reduction of the labia minora do so for functional reasons with minimal outside influences affecting their decision for treatment.