Revealed, the REAL reason why women have 'designer vagina' surgery

                                                   

They’re labelled as vain or obsessed with pornography.

But women who have cosmetic surgery on their vagina are not obsessed with the latest beauty trend or having porn-star like genitalia, a leading surgeon has said.

Instead, they have surgery to reduce the size of their labia – the inner ‘lips’ of the vagina – because they suffer problems ranging from pain and tearing to extreme psychological distress.

                             

The labia are lips which protect the vagina.

There are inner labia – the labia minora - which are thinner, and the outer labia – the labia majora, which have more tissue and fat.

They naturally vary in size and shape, but some women are dissatisfied or distressed about the appearance of their labia, even when they are classified medically as perfectly normal.

NHS figures for 2010 show a five-fold rise since 2001 and one London-based surgeon has seen an 80 per cent rise in labiaplasty procedures between 2013 and 2014.

The surgery involves reducing the size of a woman's labia minora to make them more symmetrical and smaller than the labia majora.

This is done by cutting away the ‘excess’ skin with a scalpel, or possibly a laser, and stitching up the loose edge with dissolvable stitches, until it heals.

Mr Miles Berry, a consultant plastic and aesthetic surgeon at the Weymouth Street Hospital, London, chalks the rise in operations down to an increase in awareness and availability of the procedure.

While many people believe these women are simply seeking a ‘designer vagina’, he says most are having the procedure for functional reasons or because they have been traumatised by having labia that are misshapen or low-hanging.

WHAT IS A LABIAPLASTY? 

A labiaplasty is a surgical procedure to reduce the size of the labia minora – the flaps of skin either side of the vaginal opening.

Most labiaplasty operations are done by private clinics as cosmetic surgery, to change the appearance of the female genitals.

Occasionally, there may be a medical need for the operation (for example, because the tissue is affected by disease), in which case it might be covered by the NHS. 

However, the NHS doesn't routinely provide this operation.

It's natural and normal for a woman to have noticeable skin folds around the vaginal opening and, in most cases, this shouldn't cause any problems.

Some women are dissatisfied with or distressed about the appearance of their labia, even when they look perfectly normal to the health professional examining them.

A labiaplasty involves shortening or reshaping the vaginal lips, a bit like shortening a hem on a dress. 

It is usually performed by a gynaecologist or plastic surgeon.

The unwanted tissue is cut away with a scalpel or possibly a laser, and the loose edge may be stitched up with fine, dissolvable stitches.

It can be carried out using either a general anaesthetic or local anaesthetic with sedation, and the whole procedure takes about one to two hours.

However there is a lack of research investigating how effective this procedure is. 

This means there's no guarantee it will achieve a long-lasting desired effect, and there are short- and long-term risks to consider.

Source: NHS Choices

Some will never enter into a relationship for fear of a partner seeing their genitalia, while others cannot undress in public or wear a bikini, he told MailOnline.

Other women have labia that are so long that horse riding, cycling or having sex is painful.

‘One woman was part of the cycling team, she had persistent swelling and chafing. It stopped her cycling,’ Mr Berry said.

There are also women who have torn their labia during intercourse, or while horse riding, which as well as being excruciatingly painful, causes bleeding. 

‘When women with this condition wear tight clothes, like jeans, they experience chafing,' added Mr Berry.

‘One lady used tampons to keep her labia inside because they were hanging down below her underwear.

‘I saw another lady who was getting recurrent thrush as she had all this extra tissue down there that was moist.’

His clinic carried out 49 procedures in 2014 compared to 27 in 2013 – an 80 per cent rise - while NHS figures show there were 2,000 labiaplasties performed in 2010 – a five-fold rise since 2001.

Many women who come for a consultation with Mr Berry are so insecure about the way their labia looks it is impairing their life, he said.

Women can be born with naturally long labia or that are shaped in a way that their owners deem unattractive, he explained. 

In some women, they stretch naturally over the course of a lifetime, while others experience stretching or tearing as a result of childbirth, and are embarrassed by the result.

This is usually due to hormones associated with pregnancy, the stretching of the vagina during the birth or due to the loss of the pelvic floor muscles.

Most women who visit his surgery – who haven’t had children - started noticing their labia weren’t ‘normal’ at 11-12 years old and it has caused them years of psychological distress.

He said: ‘I’ve got one girl who is 19 who has never had a boyfriend because she thinks “If things go further with this chap then he will see it, and no one can see it”.

‘So you have people who aren’t having relationships because of it.’

Some women have asymmetry. I saw one lady and one labia was 4cm long, the other was 1.5cm long

Other women say insecurities over their labia mean they cannot wear shorts and skirts or swimming costumes.

Some avoid going swimming, going to the gym, or getting changed in public, because they believe their labia are abnormal and ugly.

‘Some people have asymmetry,’ Mr Berry explains.

‘I saw one lady and one labia was 4cm long, the other was 1.5cm long. She said “the difference is bugging me. They would look normal if they were the same.”’

He wants to dispel myths that an obsession with pornography, or male influence, causes women to feel this way about their vaginas.

This idea has been much discussed, so in the last five years he began asking his patients whether pornography had influenced their decision to opt for surgery.

‘The last couple of years I’ve started asking these 45-year-old women how much pornography they watch. They all say “doctor are you crazy?”

                        

The surgery involves shortening or reshaping the vaginal lips. The unwanted tissue is cut away with a scalpel or possibly a laser, and the loose edge may be stitched up with fine, dissolvable stitches

‘You might want to blame it on waxing, but just to blame it on pornography paints women in a bad light, as if they sit around all day watching porn. They don’t.’

Most women don’t believe that male influence has been a factor in their decision either, he said.

‘Not many girls have boyfriends at 11-12 years old when they say they start noticing their labia,’ Mr Berry said, ‘so that dispels the idea that boyfriends shame their girlfriends about it.

‘Normally they’ve looked at other people in the changing room, on the internet.

‘I’ve had a few girls who have had comments from their boyfriends, but not many.’

                            

Mr Miles Berry, a consultant plastic and aesthetic surgeon, says notions that women considering the surgery are vain, self-obsessed, or following a fad for a 'designer vagina' are false

While some people might find it hard to understand why women would be insecure about an area that is hardly ever on show, Mr Berry says these feelings are very real and very distressing for those that experience them.

‘If you don’t have a problem with it you think “why do people care” but we get people who can’t do normal things like go swimming.

‘They won’t wear bikinis, because they’re so embarrassed of their labia.’

Surgery might seem like an extreme solution, but it can free them of this distress and allow them to live normally again, he said.

‘If you can ascertain that someone who is not doing something normal, like changing, like wearing a bikini and you’ve got a safe operation, you can make them happy,’ he said.

‘As long as they’re competent to consent, you can return their lives to normal.’

He currently carries out around two labiaplasties a month, performing the procedure on women who have labia he deems ‘outside the normal range’ and whose lives he feels could be improved by the procedure.

‘I do it on people whose labia are big enough, outside of the normal range.

‘If you’ve got red tissue which is thickened because it’s been rubbing on jeans, if it’s hanging outside the labia majora.

But what is considered normal?

‘The labia minora should be one cm long, and lower than the labia majora lower. The biggest I’ve seen is 5cm.

‘Of course “normal” is a difficult concept and there is a cultural element here, because the Japanese consider long labia minora appealing.’

The procedure takes about an hour and Mr Berry always performs it under general anaesthetic.

He uses a ‘superior flap’ technique, in which he cuts away the wedge of the labia minora found behind the labia majora.

‘This means I maintain and preserve the skin edge, the skin appearance, and the sensitivity’ he said.

You might want to blame it on waxing, but just to blame it on pornography paints women in a bad light, as if they sit around all day watching porn. They don’t 

The incisions are kept in this area so that the clitoris - found at the hood of the labia minora - is not damaged, which could decrease sensitivity and sexual pleasure, or in rare cases, increase sensitivity.

The urethra could also be damaged, which could lead to problems with urinating.

It is possible to carry out the procedure under local anaesthetic, which makes it cheaper as there is no need to hire an anaesthetist, but Mr Berry believes this can lead to a poor result.

He said: ‘You distort the labia with local anaesthetic. Then how is the surgeon supposed to get a good results when they’re cutting an area that’s distorted?

‘I’ve seen cases where people have taken too much because of the distortion. When the swelling goes down it’s overdone, they’ve taken too much and then the women aren’t happy with the result.’

The procedure does carry side effects, including infection and deep vein thrombosis – as in any operation.

                       

Mr Berry says some women experience pain, swelling and chafing, which means they are unable to cycle, horse ride or have sex. Others are so distressed about the appearance of their labia they cannot wear a bikini, go swimming or go to the gym. The procedure allows them to 'return to normal', he says (file photo)

It can also lead to abnormal scars, changes in sensitivity and bleeding.

Then there is the risk of the surgeon overcutting or undercutting and patients being unhappy with the result.

Mr Berry advises women undergoing the procedure to have a week off work, and tells them they cannot wear tampons, have sex, or go to the gym for six weeks afterwards.

He said: ‘It’s not a lunchtime procedure. Two people who had breakdowns after the procedure had a local anaesthetic then ran off to work too early.

‘I advise people to wear Bridget Jones underwear, no thongs, and have a daily saline bath.

‘The scarring is not too painful. But it’s uncomfortable going up the stairs and sitting down.

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Mr Berry says has seen women so embarrased by their labia they have never had a relationship for fear of a partner seeing it (file photo)

‘You need lots of bags of frozen peas. You need a good week off with no one hassling you.’

After explaining the risks, and the discomfort people might feel while recovering, many decide not to go ahead.

‘I’ve got a range of photographs I show people when they come in and I tell them about the operation some people say “Oh I’m not as bad as that - fine I won’t have the procedure.”

In fact, labioplasties for cosmetic reasons are rarely carried out on the NHS, and should never be carried out on women below the age of 18 under any circumstance, as their labia might grow well past puberty.

Discomfort can sometimes be relieved by avoiding harsh soaps and shower gels, and using emollients, NHS doctors say.

There are other, less invasive procedures available privately, such as various forms of vaginal rejuvenation.

Some doctors recommend strengthening the pelvic floor, or Kegel muscles, which can strengthen the muscles of the vagina and possibly change its appearance.

Other doctors believe counselling or psychotherapy should be offered to women, to help tackle their insecurities over their labia at the root, helping them to feel more confident about their body and equip them with tools to deal with specific occasions, such as helping them relax during sex.

Mr Berry accepts these approaches, but feels people who dismiss those considering surgery as vain or shallow stops women whose lives are blighted by their insecurities exploring potential solutions.

‘It still seems to be considered one of the taboos of women’s health, with prejudice preventing many talking openly about it,’ he said.

‘These women aren’t opting for surgery on a whim. You find they’ve made several appointments and bottled out at last minute.

‘The thought of showing their worst part and taking their clothes off in front of a stranger – and surgeons are usually male - is too much.

‘They have a lot of courage and the procedure can really help them.’

‘While it’s not for everybody, it seems a shame that negative pre-conceptions may prevent women who would greatly benefit from coming forward.’