Vaginal beautification surgery
is not medically-indicated and claiming it enhances
genital appearance or sexual gratification is deceptive,
says the American College of Obstetricians and Gynecologists
(ACOG) in a Committee Opinion in September's Obstetrics
& Gynecology.
Cosmetic vaginal procedures —
from rejuvenation to revirgination to G-spot amplification
— are risky and their effectiveness is not scientifically
proven, according to ACOG. Yet a growing number of surgeons
are offering them to women, letting them think they're
routine procedures, and not discussing all the risks,
like infection, loss of sensation or pain during intercourse.
But Canadian surgeons who perform
these procedures think the ACOG should get down off
its high horse. "It's no different from breast enhancement,"
says Dr Bruce Allan, founder of the Allan Centre for
Women, Canada's first vaginal rejuvenation clinic. "Cosmetic
surgery is something one wants, not needs." As for the
lack of scientific evidence — you don't need proof
to tell you that a woman's breasts are bigger after
an implant, he adds. The same goes for vaginoplasty.
Dr Robert Stubbs, a vaginoplasty
pioneer and director of Toronto's Cosmetic Surgicentre,
agrees. These procedures may not be medically necessary,
but they can be psychologically necessary and they can
enhance a woman's quality of life, he says.
THE
VAGINA DIALOGUES
Certain procedures can drastically improve a woman's
sexual experience, insist the surgeons. The labia minora
reduction for example, or the 'Toronto Trim,' as it's
known among Dr Stubbs's patients, makes the clitoris
more accessible. "I've had patients report a three-fold
increase in sexual satisfaction," says Dr Stubbs.
Others, like hymen repair, are
potentially life-saving, he claims. "I had a Middle-Eastern
patient who fell prey to date rape. When she came to
me, she was suicidal, she couldn't go home to her country
like this. She's expected to bleed on her wedding night,"
he says. "I sent her to a psychiatrist, and the psychiatrist
sent her back saying 'Do the surgery.'"
THE
MEDICAL REASONS
Even the ACOG admits there are genuine medical conditions
that would warrant these surgeries. Pelvic prolapse,
relaxation of the vagina due to childbirth or female
circumcision are all good reasons to undergo cosmetic
vaginal procedures. But going under the knife just to
change the look of the genitalia is not, they say.
"Many women don't realize that
the appearance of external genitals varies significantly
from woman to woman," noted Dr Abbey B Berenson, member
of ACOG's Committee on Gynecologic Practice, in a press
release. Doctors should discuss the reason for the request
of these surgeries and check for symptoms that would
require such an intervention, the ACOG report suggests.
That's not news to Dr Stubbs. "If
a woman comes in with perfectly normal genitals and
wants me to reduce them, I read her the risk list. It's
a very sensitive area, and the surgery shouldn't be
taken lightly," he stresses.
Unrealistic expectations are another
reason to discourage a patient, says Dr Allan. "If the
patient has other problems and she thinks this surgery
would change her life, I would say 'No, that's not realistic,'"
he says. "I don't make promises as far as sexual functioning
or success in life — but I would say all my patients
are happy with the results."
BETTER
STANDARDS
Still, both doctors agree with the ACOG on the need
for more studies involving these procedures. "There
are no publications on exact outcome, or the impact
on a woman's life," says Dr Allan.
And as the demand for these surgeries
rises, there should be tighter regulations on the way
the procedures are promoted by certain disreputable
surgeons, Dr Stubbs adds. "It's about time [the ACOG]
spoke out against the marketing of these procedures.
The terminology associated with it is also deceptive.
It's not the vagina that's involved in these procedures
most of the time, it's the vulva," he says. The Society
of Obstetricians and Gynaecologists of Canada agrees
with the ACOG and strongly recommends against these
cosmetic vaginal procedures, they told NRM in
a written statement.
The current controversy reminds
Dr Stubbs that women aren't the only ones to be targeted
by unscrupulous marketing. "Back when penis enhancement
surgeries first became popular, you had doctors who
were advertising in Playboy or Penthouse, preying
on men's insecurities. That's clearly inappropriate
in terms of medical care."
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