Author: Estella M Janz-Robinson, Dermatology Trainee, Department of Dermatology, Canberra Hospital, and Research Registrar, Woden Dermatology, Canberra, ACT, Australia. DermNet New Zealand Editor in Chief: Adjunct A/Prof Amanda Oakley, Hamilton, New Zealand. Copy Editor: Gus Mitchell. July 2017.
Female genital cosmetic surgery incorporates a range of procedures performed on the female genitalia to alter its aesthetic appearance and/or function. The procedures are usually classified by the anatomical structure undergoing change. Terminology is non-standardised.
Vulvoplasty refers to augmentation or more frequently, reduction of the external female genitalia, and may include:
Vaginoplasty refers to alteration of the internal female genitalia, and may include:
It should be noted that many of these techniques vary considerably between practitioners due to lack of evidence-based standardised procedures.
The incidence of vulvoplasty has increased dramatically over the last two decades, notably in high-income Western countries. The Australian Government’s 2014 Vulvoplasty report reported a 105% increase in Medicare claims for vulvoplasty and labiaplasty from 2008 to 2013. Similar statistics have been reported in the United Kingdom and the United States.
A large population-based study from 2001 to 2013 in New South Wales, Australia, revealed the following facts about women undergoing vulvoplasty.
Female genital cosmetic surgery may be performed by anyone with a medical degree as no formal training is required. However, it is most commonly performed by:
In Australia, approximately half of all vulvoplasty surgical procedures are performed by gynaecologists and one third by plastic surgeons.
Medically indicated female genital cosmetic procedures (and those covered by Medicare in Australia) include:
Non-medically indicated female genital cosmetic surgery may be pursued for a diverse range of reasons, which can broadly be divided into three categories:
Until quality peer-reviewed evidence of efficacy and risk profiles are available, numerous professional bodies including the Royal Australian and New Zealand College of Obstetricians and Gynaecologists have advised against non-medically indicated female genital cosmetic surgery, including Laser Vaginal Rejuvenation®, hymenoplasty, and G-spot amplification, to avoid unnecessary harm. In particular, they recommend that these procedures should not be performed in children.
Few studies have assessed the long-term satisfaction, safety, and complication rates for non-medically indicated female genital cosmetic surgery procedures.
Potential risks and complications include:
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