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Monday, January 16, 2012

Cosmetic Vaginal Surgeons Clueless

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Cosmetic Vaginal Surgeons Clueless

By Angela Bonavoglia
At a “first-ever” conference on what they hope is a growing field, surgeons showed an appalling indifference to how women experience sexual pleasure.
Some 150 gynecologists, urogynecologists and plastic surgeons met last month to observe, in bloody still shots and loops of video, the signature ways that the fathers of vaginal cosmetic surgery—and they’re all men—carve, burn, cauterize, and stitch the female labia, clitoral environs, vaginal canal, and other points south. They cut in order to create supposedly longed for “designer” vaginas and thereby “enhance sexual gratification.”
Those physicians were gathered for the “first-ever Global Symposium on Cosmetic Vaginal Surgery.”  It was the opening salvo in a worldwide effort by the symposium’s sponsor, the nascent International Society of Cosmetogynecology, to set standards for and promote this “new subspecialty.”
Actually, cosmetogynecology is not a real subspecialty (yet) nor is vaginal cosmetic surgery all that new.  Fourteen years ago, the star of the symposium—gynecologist David 90210 Matlock—began aiming his lasers at women’s genitals, performing and promoting his “Laser Vaginal Rejuvenation” techniques, which he trademarked and refuses to publish.
Since then, we’ve seen a blizzard of popular press; an explosion of websites for cosmetic vaginal surgery, complete with explicit “before” and “after” vulva shots; and well earned criticism, most notably, from the American Congress of Obstetricians and Gynecologists (ACOG).
I decided to head for the Rosen Shingle Creek Resort in Orlando after perusing the symposium’s agenda online and discovering a presentation entitled:  “The Great Controversy: Does Vaginal Rejuvenation Enhance Sexual Gratification?”  Following more than a decade of female genital slicing and dicing, I was stunned that they might not know the answer to that question.  After 11 hours of presentations by 20 male physicians from five countries (Chile, Greece, the Dominican Republic, Brazil and the U.S.), I can tell you with confidence:  They don’t have a clue.
“Will it be a Rim or a Barbie?”

In a world where internet porn, Brazilian waxes, and celebrity flashers are ubiquitous, it’s not surprising that one of the most spotlighted procedures of the day was labiaplasty.  That’s surgery to reduce the inner (minora) or outer (majora) vaginal lips because they are, to quote the doctors, “too large, loose, floppy, bulky, excessive, uneven, redundant, or overpigmented.”
California urogynecologist Red Alinsod—who believes he is the busiest aesthetic vaginal surgeon on the West Coast—proudly presented his signature labiaplasties.  They include the “Rim,” wherein he leaves just the edge of the inner labia, and the “Barbie,” wherein he cuts the entire inner labia off.
A few of the presenters acknowledged that no data exist on whether a labiaplasty will burst during childbirth—a major issue since many of the women having labiaplasties are younger, including patients under 18.  But not a single speaker raised the issue of the potential impact of labiaplasties on female sensation or sexual stimulation.
Asked for a comment by email on this missing question, Leonore Tiefer, clinical associate professor of psychiatry at NYU and Albert Einstein College of Medicine and a sex therapist, wrote me:  “In the opinion of most sexologists, the labia are part of the arousal structures of the genitals and their loss impairs sexual experience.”
Matlock and his disciples (most of the presenters) insisted that for a labiaplasty to provide “a complete aesthetic look,” some of the skin around the clitoris has to be excised.  Yet, this can be the cruelest cut, leaving the woman to experience pain, not pleasure, when the clitoris swells and she is sexually aroused.
So inconsequential is this issue that the physicians, including several presenters, who conducted a soon-to-be published, first ever, U.S. multi-center study on outcomes of cosmetic vaginal surgery did not separate out the women who had a “clitoral hood reduction,” much less attempt to assess the impact of that procedure on pain during sexual arousal.