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Medical Institute Science Staff: September 2017
If you have teenage girls in your life, or if you have been one yourself, you are already aware that most teen girls would like to change something about their physical appearance. With the affluence of American life, many teen girls actually have the opportunity to make changes with cosmetic surgeries. Nose jobs, breast augmentation and ear- pinnings, are no longer out of reach for many adolescents, especially older ones. More recently, teens are becoming unhappy with the appearance of their female genitalia, especially the labia minora, and some are going as far as having cosmetic surgical procedures to conform to what they perceive as a more desirable appearance.
In the year 2016 in the U.S., over 500 girls under the age of 19 underwent surgical procedures to change their vaginal labia. This is 100 more girls than in 2015 and 278 more than in 2014, representing a definite upward trend. 1 These numbers are not complete, because they do not include the procedures performed by gynecologists, but only plastic surgeons. What could be driving this desire to change such an intimate part of the body?
How many vulvas or vaginas has a teen girl actually seen to compare herself with? How does she know what is a desirable look? The online magazine SELF quotes Dr. Jennifer Wilder as saying, “Girls in this generation…see airbrushed images, they see pornography, and think they should look a certain way or worry that their partners want them to look a certain way – it’s totally unhealthy.”2
Allure magazine quotes Paquita de Zulueta, MD as saying, “Their perception is that the inner lips should be invisible, almost like a Barbie.”3 Indeed, “The Barbie Labiaplasty” is one of the most popular designer vagina procedures! And Quartz media describes the Barbie like this, “The Barbie Labiaplasty involves almost completely removing the inner lips of the vulva, and possibly reducing the outer lips as well. The result, as its website describes it, is a “smooth look” that is “tight and petite” with a “streamlined appearance.”4
To get the “Barbie Look”, adolescent patients are subjecting themselves to a surgical procedure with possible serious side effects such as pain, painful scarring, swelling, bruising, infection and pain with intercourse.5 Additionally, there have been no long term studies to determine what effects the surgery may have on the young woman in the future. Labiaplasty may be performed either with local or general anesthesia, which has another set of risks associated with it. Urologist and plastic surgeon Gary Alter, M.D. is reported to have said that 20% of his labiaplasties are to rectify mistakes made by other surgeons.6
Reportedly, there are reasons other than cosmetic, for teens to seek out labiaplasty. The SELF magazine article quotes a Board-certified ob/gyn, Pari Ghodsi, MD, saying, “Some women have labia that are significantly elongated and it can get in the way of exercise – causing chafing and irritation.”2 However, a survey of current articles overwhelmingly sites the desire for a “designer vagina” as the most common reason for teen vaginaplasty.
The American College of Obstetricians and Gynecologists (ACOG) issued a Committee Opinion on both Breast and Labial Surgery in Adolescents from the Committee on Adolescent Health Care. In essence the Opinion encourages physicians to offer alternatives to surgery while educating the teen about normal variations in anatomy. The doctor is also encouraged to assess the patient for “body dysmorphic disorder” and to refer such patients to mental health professionals.5
The American Society of Plastic Surgeons provides a “Briefing Paper: Plastic Surgery for Teenagers” that states that parental consent is required for all plastic surgery procedures performed on teens younger than 18 years old. The paper goes on to state that the teenager should initiate the request and repeat their desire for the plastic surgery over a period of time and that the teen should be able to show that they have realistic expectations about how the surgery will benefit them.7
Are parents giving permission for their daughters to have labiaplasty, so they can look like porn stars? This researcher finds that more disturbing than desires and decisions coming from an adolescent brain. Moms and Dads are the ones who should be reassuring their daughters that they are beautifully and uniquely made with genitals designed for a loving relationship with a forever husband, who will delight in the one made just for him.