There's not a lot of research out there about the safety of cosmetic vaginal procedures, and the American Congress of Obstetricians and Gynecologists goes so far as to warn that they're never advisable. This doesn't deter the thousands of women each year who undergo them, especially labiaplasty, which reduces the size of the inner or outer vaginal lips. In fact, it's one of the fast-growing cosmetic surgeries in the U.S. In 2013, 5,070 U.S. women got labiaplasties, up 44% from the year before.
Appearance is one reason people opt for vaginal cosmetic surgery, but it's not the only one. Cosmopolitan.com spoke with gynecologist and surgeon Dr. Ronald Blatt about three procedures he does at the Manhattan Center for Vaginal Surgery and why people get them.
Removes tissue from the labia minora or labia majora, making them smaller.
"When patients come in, they say their labia are excessively large and they were either born that way or their labia got bigger over time," Dr. Blatt says. "Some people note that the labia minora got bigger after vaginal deliveries." While some people say they want labiaplasty purely for cosmetic reasons, Dr. Blatt says they're in the minority: most report that their labia get irritated by clothing or get in the way of activities like exercise and sex—some say their labia are so long they get pulled into the vagina during intercourse (ouch). A labiaplasty takes one to two hours, and at Dr. Blatt's center patients spend an additional hour in a recovery room monitored by an RN. The surgery can be done with local anesthesia, but the center uses general anesthesia—specifically "conscious sedation," meaning that patients are asleep during the procedure and wake up soon after it's over. The surgery costs from $3,000 to $6,000 (Dr. Blatt's center charges $5,900).
Tightens the vaginal canal and is usually performed on women who have given birth vaginally.
"Vaginal birth stretches out the tissues, and then they shrink back down, but never to where they were before," Dr. Blatt says. "Lots of patients complain of lack of sensation during intercourse and them or their partners feeling looseness." The procedure involves joining muscles in your vagina with dissolvable stitches, decreasing the diameter of your vagina. It takes one to two hours, and Dr. Blatts patients are under the same kind of anesthesia used for labiaplasty—again, other centers may use local anesthesia—followed by an hour in a recovery room. It costs from $3,000 to $12,000 (the Manhattan Center for Vaginal Surgery charges $5,900). ("Vaginal rejuvenation" is a vaginoplasty and labiaplasty performed at the same time—at the center, it's $9,900 for the combo.)
3. A CLITORAL HOOD REDUCTION
Reduces and reshapes the clitoral hood.
"For some patients, their clitoral hood is excessively large and covers the clitoris totally," Dr. Blatt says. "They want the clitoris more exposed so they have more sensation during sex." This procedure involves making in incision on the hood and removing tissue from iy to reveal more of the clitoris. It takes about thirty minutes and is done under deep sedation, which is a little less intense than the conscious sedation used for labiaplasty and vaginoplasty. Patients are asleep, but are more responsive to pain and other stimuli while they're under. The cost is generally $3,000-4,000.
SO, ANY OTHER QUESTIONS?
Can anyone get a cosmetic vaginal surgery?
"As long as you have no significant problems in your medical history and you're young and healthy, we just check your blood count," Dr. Blatt says. Older patients or those with medical problems have to first get medical clearance from an internist or cardiologist, and Dr. Blatt does refuse to give treatments to people he just doesn't think need them, for example most teens. (The demand among teens for genital cosmetic surgery is on the rise, with porn and advertising commonly cited as responsible for evolving beauty standards. As if we didn't have enough of those already.) The vast majority of Dr. Blatt's patients are mothers—"97 out of 100," he says.
What are the risks?
If a labiaplasty or vaginoplasty goes wrong, it can lead to bleeding, infection, scarring of the tissue, and even reduced sensitivity, while a clitoral hood reduction can lead to infection. These are all rare, but it's obviously super important to do your research and find an experienced surgeon and a center you trust.
What is recovery like?
After any of these procedures, patients go home with antibiotics, prescriptions for pain meds, and, in the case of labiaplasty, Neosporin to apply to incision lines three times a day for a week. Soreness and swelling aren't uncommon and most people take two to three days off from work or school, during which they take the prescription painkillers; Dr. Blatt recommends they switch from Percocet to Advil after two or three days. People who've gotten both a labiaplasty and a vaginoplasty at once might use pain meds for up to five days. Then, patients come in at two, four, six, and eight weeks for post-op check-ins (sutures take up to eight weeks to dissolve).
Patients should take it easy for a while—the last thing you want to do is pop a suture after a vaginal surgery. "For a labiaplasty, they can do upper-body exercise, but no running, no biking," Dr. Blatt says. "After a vaginoplasty, no heavy lifting, and also, we recommend patients take stool softeners. We don't want them to get constipated and rip a suture that way." Sex and more vigorous exercise can begin again at the six-week mark, but it's definitely not a bad idea to wait eight weeks before putting a healing vagina to the test.
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This article originally appeared on Cosmopolitan.com. Minor edits have been made by the Cosmo.ph editors.