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Intimate makeover

In a quest to look younger, feel prettier and have better sex, women are turning to genital plastic surgery. And the look many want is that of a porn star.

March 13, 2006|Melissa Healy | Times Staff Writer

SINCE the dawn of its days as a medical specialty, plastic surgery has been marching inexorably down women's bodies, straightening, slimming, tucking as it goes, restoring the appearance of youth to features sagging with age and smoothing those marked by eccentricity.

Plastic surgery's southward expansion has now entered territory long thought sacred. Today, the vagina and its neighbors -- the labia majora, the labia minora, the clitoral hood -- are the latest bit of feminine real estate considered to be blighted by age or otherwise in need of renovation, beautification and rejuvenation.

Across the country, post-pubescent and peri-menopausal women alike are having their vaginas tightened, their mons pubis liposuctioned, their labial folds nipped and their clitoral hoods tucked. Most are seeking to restore what plastic surgeons are calling "a more youthful look" to this long-secreted corner of the female anatomy and often to improve their sex lives in the process. (In some cases, women with few pretensions to virginity are surprising their partners by having their hymens surgically restored.)

Other women, bothered by the imperfect proportions of their genitalia, undergo surgery just to bolster their self-image -- a boost that often pays sexual dividends as well.

"I was the type who always wanted to have the lights down low" when having sex, says Holly, a 50-year-old medical assistant who recently had surgery to trim her labia minora and who asked that her last name not be used to maintain her privacy. "Just being comfortable with my body, this was huge for me. I was able to be sexually confident."

Even as the small but growing group of genital plastic surgeons devise new and better surgical techniques, they acknowledge the standards women hope to achieve are set mostly by adult film actresses, strippers and nude denizens of the Internet.

"I know what women want," says Dr. David L. Matlock of Los Angeles, an obstetrician turned plastic surgeon who has been a pioneer in devising and popularizing the procedures. He knows, he says, because so many of his patients tote their husband's or boyfriend's magazines into his office and point to photos almost as explicit as the before-and-after ones posted on many surgeons' websites.

More traditional plastic surgeons and gynecologists may be reluctant to endorse such procedures, but the demand is undeniable. Vulvar and vaginal plastic surgery is one of the fastest-growing areas in plastic surgery, say some in the field.

Many of the techniques have been practiced for decades by obstetricians and gynecologists to repair childbirth-related injuries, and by urologists and reconstructive surgeons who repair birth defects or perform sex-reassignment surgery. But in the late 1990s, a few surgeons began offering the procedures as a means to enhance the aesthetic appearance of women's genital organs and, in some cases, to improve sexual function.

Today, in a field that assiduously tracks the demand for tummy tucks, butt lifts and breast implants, there is no data to gauge the scale of demand for these procedures. But there are signs that genital plastic surgery has appeared on the radar screens of social trend-watchers and the medical profession itself.

Next year, the American Society of Plastic Surgeons expects to begin collecting data on the number of vulvar and vaginal procedures its members are performing. Several practitioners of the new procedures, including a pair of Los Angeles plastic surgeons, have been profiled on cable TV shows pitched to viewers hungry for news of the beautiful and famous. And members of the American College of Obstetricians and Gynecologists have begun grumbling that it's an issue on which they need to weigh in.

But Dr. V. Leroy Young, who chairs the Emerging Trends Task Force of the American Society for Aesthetic Plastic Surgery, says the true gauge of these procedures' popularity may lie precisely in the fact that, far from either coast, conservative heartland women are paying doctors like him to perform them.

Young performs about two to three vulvar procedures a month on women who "would never dare ask the question at a church social," but who can now learn about such procedures on the Internet and on TV. "It's right here in middle America," says Young, whose practice is based in Creve Coeur, Mo., a suburb of St. Louis.

Porn-star standards

Southern California -- the seat of the adult entertainment industry -- is undeniably the birthplace of this fledgling field of surgical alteration.

In 2000, many Americans learned about a new procedure called labiaplasty when a porn star known as Houston had her labia-reduction surgery filmed and distributed to subscribers, then later auctioned off the excised flesh over the Internet.

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