Perhaps two years ago a provider posted here that she was concerned  her large labia did not look normal and that she was considering surgery.  I replied that large suckable labia are a big turn-on for me.  

A medical group has just issued a statement advising against "trendy" genital surgery.  I am copying the article because the link may work only for a limited time.
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Women urged to shun trendy plastic surgery
Doctors assail genital procedures
By Judith Graham

Tribune staff reporter

August 31, 2007


Issuing a strong warning to women, a prominent physicians' group stated Friday that there is no evidence cosmetic genital surgery is safe or effective.

The statement by the American College of Obstetricians and Gynecologists (ACOG) says it is "deceptive to give the impression" that these procedures, which by some accounts are among the hottest new trends in plastic surgery, are "accepted and routine surgical practices."

"Vaginal rejuvenation," "designer vaginoplasty," "revirgination" and "G-spot amplification" are being marketed to women on late-night TV, in magazines and on the Internet. Doctors offering the procedures say they can enhance women's sexual pleasure and alleviate uncomfortable symptoms, and many of their patients agree.

But critics say these women are exposing extraordinarily sensitive body parts to interventions with questionable benefits and unknown risks.

"Absence of data supporting the safety and efficacy of these procedures makes their recommendation untenable," the medical group's Committee on Gynecologic Practice concluded in a two-page statement published in the September issue of its magazine.

Other experts express concern that practitioners are offering surgical fixes to problems better addressed by correcting women's misconceptions about their bodies and boosting their self-esteem.

"If someone doesn't like the way they look or their heart is broken, surgery isn't going to fix that," said Dr. Linda Brubaker, professor of obstetrics, gynecology and urology at Loyola University Medical Center. "Those problems are above the belly button, not below."

An Internet search turns up dozens of sites promising to help women by surgically altering their genitals and repairing the after-effects of childbirth. For physicians, the business -- typically cash only -- is a way to supplement income squeezed by cost-conscious insurers.

Many of the sites are accompanied by graphic before-and-after photographs and glowing patient testimonials.

Patients pleased with work

"How grateful my patients are is unbelievable," said Dr. Bernard Stern, a board-certified gynecologic surgeon in Florida who says he's done 850 cosmetic genital surgeries in the last six years. He says he gets 50 e-mails a night from women asking about the procedures.

Yet other medical organizations share ACOG's concerns. "I know of no medical reason to do these surgeries and no scientific data that proves they are beneficial," said Dr. Thomas E. Nolan, president-elect of the Society of Gynecologic Surgeons.

Among the treatments doctors are offering, only labiaplasty, which involves trimming and reshaping part of the external genitalia, is well documented in the scientific literature.

In contrast, many doctors don't even accept the existence of the purported pleasure center known as the G-spot, much less approve of injections meant to enhance it. "I don't know what the G-spot is," said Dr. Melvin Gerbie, chief of gynecology at Northwestern Memorial Hospital.

As for "revirgination," Gerbie said any doctor performing it at Northwestern would be in trouble. Also known as hymenoplasty, the procedure involves reattaching the tissue torn when a woman first has sex. Sometimes, reputable physicians will perform it for women who have been abused or those from cultures who risk a violent reaction from her partner.

Neither vaginal rejuvenation nor designer vaginoplasty have been adequately described or evaluated, according to critics. Practitioners say they tighten women's internal genitalia by making incisions and stitching muscles more firmly together.

"What are the doctors doing? We're not really sure," said Dr. Steven Sondheimer, a professor of obstetrics and gynecology at the University of Pennsylvania and vice chair of the ACOG committee. "We have doctors contacting us and asking, is this something now being taught? And we have to say no."

The risk, of course, is that patients could suffer harm from the surgeries, including bleeding, scarring, infection and altered sensation, while experiencing little or no benefit. Brubaker is among several physicians who said in interviews that they had seen patients suffering from pain and discomfort as well as disappointment after these surgeries.Advocates contend complications are rare. "Is there overwhelming data and evidence? No. But we're gathering it now, and that's why we've gotten involved in this -- to bring legitimacy to the field," said Dr. Robert Moore, a board-certified gynecologist who co-directs the Laser Vaginal Rejuvenation Institute of Atlanta.

The British Medical Journal weighed in on the topic with a May article calling cosmetic genital surgeries an "extreme and unproved intervention" that "could undermine the development of other ways to help women and girls to deal with concerns about their appearance."

Most women don't understand that the size and shape of genitalia vary greatly, leading to "misguided assumptions" about what is normal, said the authors, a clinical psychologist and a gynecologist.

Numbers up in last 5 years

Britain's National Health Service reported a "doubling" in the number of labiaplasties in the last five years, according to the report. Similar data isn't available in this country, though the American Society of Plastic Surgery said its members performed just over 1,000 vaginal rejuvenations last year, a 30 percent rise. That number doesn't include procedures done by other doctors.

Dr. Rigo Mendoza of Chicagoland Plastic Surgery says he performs as many as 70 cosmetic genital operations a year. His specialties are labiaplasties and clitoral hood reductions, a procedure that removes excess skin. More than 80 percent of his patients have persistent symptoms such as irritation or chafing when they exercise or wear tight clothing, he said.

"I'm definitely a very Midwestern person and I can tell you it wasn't easy for me to decide to do this," said a 36-year-old mother of three in Aurora. But her large labia were a source of distress, and after a labiaplasty last October she feels more confident, she said.

Mendoza said he charges $4,000 to $5,000 for the procedure, which isn't covered by insurance. Cosmetic vaginal surgeries can cost $7,500 or more, other doctors said.

In Atlanta, nurse Nina Barge, 41, is frank about changes in her body after childbirth. "I know people don't like to talk about this, but I was huge and sex wasn't as pleasurable for my husband or for me," Barge said.

Her obstetrician and two urologists told her what she was feeling was normal, so Barge tried to ignore her growing sense of embarrassment and discomfort. But eventually, her marriage dissolved and "I knew I had to do something," she said.

Barge had vaginal surgery two years ago in August and concedes the recovery was difficult. But looking back, she said, the procedure "helped me immensely. I feel everything, and I feel normal again."