Nips, Tucks, and…Designer Vaginas?

Variations in the natural female form used to be accepted, even celebrated. Increasingly, however, these variations are seen not as assets, but as problems to be taken care of by plastic surgeons.

As a result, Americans spent almost $11 billion on cosmetic surgery in 2009. Breast augmentation, liposuction and eyelid surgery were the most popular surgical cosmetic procedures. According to Dr. V. Leroy Young, chair of the emerging trends task force of the American Society of Aesthetic Plastic Surgery, the plastic surgery procedure with the highest growth rate is also the newest procedure available – genital reconstruction. Once the domain of sex workers, nude entertainers, swimsuit models, and relatively few women with medical abnormalities, vaginal plastic surgery has gone mainstream.

The Procedures

There are three types of genital reconstruction. Vaginoplasty is the external reconstruction of the vulva. It includes procedures such a trimming the labia minora or majora, elevatins the pubis, and unhooding the clitoris. “Vaginal rejuvenation” refers to tightening the vaginal muscles. This type of surgery has been performed in the United States for over 12 years, but until now was typically performed to treat urinary incontinence, usually as a result of childbirth. Hymenoplasty, a surgery that restores the hymen, is also becoming more popular, particularly among women of Middle Eastern and Hispanic descent. This surgery can restore the appearance of virginity even after a woman has had sex.

The American Society of Aesthetic  Plastic Surgery reported 3,494 vaginal rejuvenation surgeries in 2008 and 2,531  in 2009. The actual figure is probably higher because many doctors who perform genital reconstructive surgery are gynecologists, and the American College of Obstetricians and Gynecologists does not record such statistics. Dr. David L. Matlock, founder and director of the Laser Vaginal Rejuvenation Institute of Los Angeles, says he has performed more than 3,000 of these operations within the past 12 years.

Like any surgery, genital surgery has risks. Serious risks include painful scarring or nerve damage that could result in loss of sensation or hypersensitivity. Another risk is over-tightening of the vaginal walls, which can result in painful intercourse.

Why Do Women Want Genital Surgery?

Advocates and critics agree that the new popularity of these procedures is caused by the desire for heightened sexual pleasure and more youthful looking genitals. Some doctors claim that the demand for genital plastic surgery is being driven by pornography, now more readily available than ever on the Internet and cable television. Dr. David Matlock explains on his website that “… many people have asked us for an example of the aesthetically pleasing vulva [so] we went to our patients for the answer and they said the playmates of Playboy.” Another important factor in many women’s decisions to have genital reconstruction surgeries is pressure from their partners. Surgeons attract patients with discounts and claims that the procedures are “rejuvenating” or “designer.”


Do these procedures work? Like any other type of cosmetic surgery, results can be excellent or disastrous. Genital rejuvenation is still relatively new, and no good data exits on the number or women who get these procedures, complication rates, or how satisfied they felt with their results. For example, Thomas G. Stovall, a former president of the Society of Gynecologic Surgeons, states “there is absolutely zero scientific literature that supports … the notion that firing a laser of any kind will tighten the [vaginal] muscles.” Many women say they seek out these procedures to enhance their sexual experiences, but no research supports claims of increased sexual satisfaction. Importantly, experts say that perceived sexual enhancement as a result of genital reconstruction may be attributed in part to the psychological reaction to the surgery, rather than to physical changes from the surgery itself. Dennis Sugrue, former president of the American Association of Sex Educators, says that, “… before even considering an invasive procedure like vaginal tightening surgery, it’s absolutely critical for a woman to consult with a sexual health professional to make sure that the cause of the sexual dissatisfaction is thoroughly assessed and diagnosed.” Noninvasive treatment procedures should first be employed. Only if all of those steps are taken and fail to bring about satisfaction should surgery even be considered.

What’s Next?

Whether genital plastic surgery will ever become as popular and acceptable as other forms of plastic surgery remains to be seen. The rising rates of cosmetic surgeries suggest that women are more willing than ever to take risks to enhance themselves. Though “genital rejuvenation” may not be fully in the mainstream today, it may well be in the future. And, if so, what will plastic surgeons come up with next?

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

Information from:

The American society for aesthetic plastic surgery, Cosmetic Surgery National Data Bank Statistics, 2009, Retrieved from: