Even Stovall, of the Society of Gynecological Surgeons, acknowledges that many ob-gyn specialists are wary of asking about vaginal function after childbirth because women's sexuality is such a complex matter. "Most doctors don't have the expertise," he says, adding "since they don't have anything to address the problem, they'd just as soon not ask.
"That may be a problem," says Stovall. "But getting your vagina lasered is not going to solve that problem."
But for every woman like Sokey, there is probably at least one like Holly, the 50-year-old medical assistant from Southern California.
Holly conceived the idea that her labia didn't look right while in her late teens, just as she became sexually active. Looking furtively at adult magazines or at her friends convinced her "this didn't look normal."
For almost 30 years, her sense that her labia minora were too long "constantly made me sad and not [feel] good about myself." When she would confide the cause of her sexual shyness to a man, he would invariably tell her she was fine, but she never bought it. Now, with her labia reduced by Alter, "there's a little jump in my step because I just feel so good about myself."
A range of normalcy
A plastic surgeon must always consider whether a patient's request is reasonable or is a symptom of an unhealthy body image. To do so requires an understanding of what is normal and what is, by society's current definition, beautiful. When it comes to female genitalia, the standard of beauty, at least, is an evolving standard. And that leaves plastic surgeons little firm basis for deciding which patients are unstable and should be turned away.
Matlock is perhaps clearest in his definition of female genital beauty. The porn stars his patients most frequently hold up as exemplary, says Matlock, sport "a nice, clean look," with a smooth clitoral hood hugging the clitoris like "a piece of paper draped tightly around a pencil" and petite, wrinkle-free labia flanking a "slit-like introitus" (or vagina) that appears never to have endured the indignities of childbirth.
But that is hardly the norm among American women, and physicians such as Stovall argue that before they reach for plastic surgery, women should be made to understand that "there are a multitude of normal variations." In plastic surgery, however, that's often a tough sell -- not to mention a low priority. Young says he often tries to reassure women who seek him out that their genitals "are in the range of normal." Most often, he adds, "they don't want to hear it. They want the problem fixed."
