Why girls need to ‘love their labia’ before seeking ‘designer vaginas’

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Marc Pacifico talks about the trend for a tidy-up ‘down there’ — and why the millennial generation needs to know there’s no such thing as perfection when it comes to a labiaplasty

Cosmetic surgeon and comaprethetreatment.com expert Marc Pacifico has noticed a trend towards more women requesting labiaplasty. And, whilst the clinic gets a wide age range of ladies seeking the procedure, there are certain spikes in interest, such as post-pregnancy and — increasingly — the millennial generation.

He says: ‘Occasional telephone enquiries are from young women under 18, on which we don’t take any further action. However, I wonder if the younger generation are influenced with their perceptions of “what is normal”. In reality, of course, “normal” covers a very wide range of appearances.’

Of course, labias come in all shapes and sizes and sometimes the reasons are less aesthetic than functional.

Marc says: ‘Functional reasons for labiaplasty (such as chafing or discomfort when riding a bicycle) are perfectly understandable. Some women have aesthetic concerns about marked asymmetry and significant protrusion but, again, we feel these are reasonable to address if the patient is well informed about the risks and realistic outcomes. Complications can occur with labiaplasty surgery, some of which can be aesthetic complications such as under and over correction, so it is important to understand these risks too.

‘Of more debate’, he adds, ‘are the group that seems to be seeking “perfection”.

The younger generation of women and their relationship with their bodies is currently a concern for the cosmetic surgery industry.

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In the States so many teenagers are seeking cosmetic surgery to trim or shape external genitalia that the American College of Obstetricians and Gynaecologists has issued guidelines to doctors.

It suggests that when adolescents seek medical treatment, the first step is to educate and reassure when it comes to normal variation in anatomy, growth, and development.

It urges them to suggest alternatives to surgery such as supportive garments, personal hygiene measures (such as use of emollients), arrangement of the labia minora during exercise, and use of form-fitting clothing. It also suggests psychiatric screening regarding obsession about perceived physical defects.

Marc agrees that the millennials need education regarding anatomy when related to their own bodies.

He says: ‘The perception of normality by the younger generation regarding many parts of their body is a real challenge, and is a complex issue. I have spoken before to young audiences on “what is normal” and, if more people of influence did the same, it would be a good start.

‘One thing we frequently do, as plastic surgeons, is to have a range of photographs available to demonstrate to patients the wide range of “normal”. Of course, we can only do this once they are with us in a consultation.’

Marc believes the important areas of a consultation are:

  • Understanding the reasons why the patient is seeking labiaplasty — and why at this time
  • Understanding how the patient feels about the appearance and function of their genital area.


A thorough medical history should be taken, and then the patient is examined.  This is very much like having a smear, but the examination is on the outside.

Depending on the complexity of the procedure in the individual, it can take anything from 40-75 minutes.

And, can there be complications? Marc explains: ‘Like any operation, complications can occur. Whilst complications are uncommon, the more frequent to occur are bleeding and infection, so following the post-operative instructions carefully is important.’

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