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BJOG Release: Study Raises Concerns About Cosmetic Labial Surgery
(press relase from BJOG)
New research to be published in BJOG: An International Journal of
Obstetrics and Gynaecology reviews the available literature on cosmetic
labial surgery and underlines the striking lack of evidence on the safety and
long-term consequences of such procedures. The authors caution that medically
nonessential surgery to the labia is being promoted to women, while no data on
clinical effectiveness exist. ****************************
Increasing numbers of healthy women are seeking surgery to change the shape and
size of their normal vulva. Once considered the special domain of glamour
models, female genital cosmetic surgery is becoming more common in economically
affluent nations. Many procedures exist in the medical and marketing literature,
including vaginal rejuvenation, designer vaginoplasty, G spot amplification and
revirginisation. A popular request is partial excision of the labia minora.
In this study, the researchers sought to investigate the quality and content of
published reports relating to labial surgery for healthy women. Electronic
databases were searched for relevant articles between 1950 and April 2009. Forty
articles were identified, 18 of which identified patient data. Of these 18
papers, 15 did not specify study design, and 15 did not address gynaecologic or
obstetric problems. No prospective, randomised or controlled studies were found.
While sexual difficulties are often cited as a reason for surgery, the authors
caution that research is needed on long-term sexual function, as surgery may
damage the nerve supply and is associated with impaired sensitivity and impaired
Research to investigate the potential increase in obstetric complications is
also needed. The amount of genital tissue removed in cosmetic labial surgery is
comparable with types I and II female genital mutilation, which are associated
with perineal trauma, postpartum haemorrhage and increased neonatal death. While
planned caesarean section may circumvent these risks, young women seeking labial
surgery should be informed of potential implications for future pregnancies.
Co-author, Lih-Mei Liao, consultant psychologist at University College London,
said "Healthy women are commercially targeted for invasive and irrevocable
surgery to the labia minora. Advertisements promote labial surgery as easy
answers to women's insecurities about their genital appearances - insecurities
that are fuelled by the very advertisements that prescribe a homogenized
prepubescent genital appearance standard for all women."
Co-author, Sarah Creighton, consultant gynaecologist at University College
Hospital, said "This paper offers a critical review of available scientific
knowledge on labial surgery and identifies a shocking lack of solid evidence.
Some studies have laid claims to 'successes' despite suspect methodology, and
some have not bothered to define how the conclusions had been derived. Anecdotes
proliferate in the literature. Risks and complications are rarely documented.
"Labial surgery needs to be rigorously evaluated in future, and for longer term.
Furthermore, quality research is needed to improve our understanding of the
psychological drivers behind women's decision to sacrifice sexually sensitive
tissue that contribute to erotic experiences, for a certain genital appearance
that used to be an obligation only for some glamour models. Alternative
solutions, such as counselling and support, should be developed for women and
Prof. Philip Steer, BJOG editor-in-chief, said "Commercial images and social
pressures often serve to distort public perceptions about what is physically
normal. Healthy messaging about the normal variation in female genitalia, as
well as body shape and size more generally, is needed and important.
"This study underlines the need for multidisciplinary research to investigate
the range of factors that affect women's sexual function and wellbeing. Reliable
information on the risks and benefits of labial surgery, as well as alternative
approaches, is vital to ensuring informed choice for women."
BJOG: An International Journal of Obstetrics and Gynaecology is owned by
the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially
independent and published monthly by Wiley-Blackwell. The journal features
original, peer-reviewed, high-quality medical research in all areas of
obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An
International Journal of Obstetrics and Gynaecology' when referring to the
journal and include the website:
as a hidden link online.
Liao L, Michala L, Creighton S. Labial surgery for well women: a review of the
literature. BJOG; DOI: 10.1111/j.1471-0528.2009.02426.x.
To view an abstract of the paper,
Royal College of Obstetricians and Gynaecologists
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