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Alavi-Arjas F, Nahidi F, Simbar M, Majd HA, Rastegar F. The role of sexual partner in women's seeking for labiaplasty: a systematic review and meta-analysis. J Sex Med 2024; 21:844-852. [PMID: 39104202 DOI: 10.1093/jsxmed/qdae091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/27/2024] [Accepted: 07/21/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND The primary reasons for labiaplasty usually revolve around aesthetic, sexual, and functional concerns. Upon delving deeper into these issues, it becomes apparent that sexual partners play a controversial role in influencing women's decisions to undergo surgery. AIM This study aimed to investigate the impact of sexual partners on women's choices to pursue labiaplasty. METHODS A comprehensive search was conducted across electronic databases covering the period from January 2000 to February 2024. After removing duplicates, a total of 931 articles were retrieved by searching keywords in titles and abstracts. OUTCOMES The meta-analysis revealed that 36.7% of women who sought labiaplasty cited their partners' negative comments as a factor influencing their decision. RESULTS After applying the eligibility criteria and excluding irrelevant articles, a total of 12 articles involving 962 participants were included in the analysis. With the exception of 2 articles, the majority of the studies suggested a discernible influence of male partners on women's decisions to seek labiaplasty. Frequently, sexual partners are not the primary decision makers, nor do they exert significant pressure when it comes to seeking labiaplasty. In certain instances, women seeking labiaplasty acknowledged that their sexual partners did influence their decisions, either by making disparaging comments about their genitalia or by directly pressuring or requesting them to undergo labiaplasty. Additionally, women might opt for labiaplasty out of fear of their partner's negative remarks or to enhance sexual pleasure for their partners. For a more accurate result, a meta-analysis was conducted noting a considerable heterogeneity. CLINICAL IMPLICATIONS The findings of this study can be applied in prelabiaplasty counseling sessions to acknowledge and explore the role of the sexual partner in women's decision making. STRENGTHS AND LIMITATIONS This study stands as the inaugural systematic review examining the impact of sexual partners on women seeking labiaplasty, encompassing all original studies exploring the role of the sexual partner. However, a notable limitation lies in the varied interpretations of the sexual partner's role, that the heterogeneous nature of these interpretations poses a challenge to providing a more precise answer through meta-analysis. CONCLUSION Based on the findings of this systematic review, it is evident that sexual partners exert multifaceted influences on women's decisions to seek labiaplasty. While not serving as the primary decision makers, women opt for labiaplasty with the aim of enhancing attractiveness in sexual relationships and mitigating potential negative comments from their partners.
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Affiliation(s)
- Fatemeh Alavi-Arjas
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1996835119, Iran
| | - Fatemeh Nahidi
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1996835119, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1996835119, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1971653313, Iran
| | - Fereshteh Rastegar
- OB/GYN, Modarres and 17th Shahrivar Hospital Complex, Saveh Faculty of Medical Sciences, Saveh University, of Medical Sciences, Saveh 3919676651, Iran
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Wijaya PE, Fisher J, Kirkman M. Female genital cosmetic surgery in Indonesia: a qualitative analysis of medical advertising on Instagram. CULTURE, HEALTH & SEXUALITY 2024:1-14. [PMID: 38648397 DOI: 10.1080/13691058.2024.2341843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
Research on female genital cosmetic surgery usually comes from Anglophone countries. We investigated female genital cosmetic surgery in the predominantly Muslim South-East Asian country of Indonesia, aiming to identify the procedures offered by medical clinics on Instagram, how they are justified, and what they claim to achieve; and to understand what this means for women and their bodies. The 184 eligible posts from 19 clinics between 1 January to 31 March 2021 offered vaginoplasty, labiaplasty, hymenoplasty, and other procedures. Reflexive thematic analysis yielded three themes: Why you should have female genital cosmetic surgery, Indications for female genital cosmetic surgery, and What you will gain from female genital cosmetic surgery. Posts were similar to those identified in other countries, revealing implicit vulvar aesthetics, expectations that women choose to 'improve' their genitals, the need to please men, and that female genital cosmetic surgery is straightforward. Two differences from Anglophone advertising were the use of euphemisms to describe the vulva and an emphasis on physical 'virginity'. Across countries, female genital cosmetic surgery advertising appears to arise from patriarchal constructs of women's bodies and determination to control them. We contend that Indonesia shares with other countries the need for education-of medical practitioners and the general public-about sexuality and the vulva, and that the advertising of female genital cosmetic surgery should be regulated and rigorously monitored.
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Affiliation(s)
- Pramasari Edie Wijaya
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jane Fisher
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maggie Kirkman
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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3
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Koops TU, Wiessner C, Briken P. Sexual activities and experiences in women who underwent genital cosmetic surgery: a cross-sectional study using data from the German Health and Sexuality Survey (GeSiD). Int J Impot Res 2023; 35:741-747. [PMID: 36192504 PMCID: PMC10709137 DOI: 10.1038/s41443-022-00621-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 11/08/2022]
Abstract
The aim of this study was to compare women who have undergone genital cosmetic surgery (FGCS) with women who have not regarding past sexual activities and experiences. It draws on data from the German Health and Sexuality Survey (GeSiD). The subsample of women who had undergone FGCS (n = 32) was compared to a subsample of women who had not had FGCS (n = 96); the samples were matched for age, education, relationship and marital status, and whether participants had born a child. Variables concerning the present relationship, recent/lifetime sexual activities, sexual orientation, pregnancy-related experiences, health, sexual boundary violations/violence, sexual difficulties, and migration background served as main outcome measures. Women who had undergone FGCS reported more often anal intercourse during their last sexual encounter (13% vs. 1%, p = 0.021), a pregnancy ending in miscarriage (34% vs. 16%, p = 0.016), and not to be satisfied with their own appearance (41% vs. 15%, p = 0.002) than women who had not undergone FGCS. The results indicate women's motivations for FGCS beyond the desire to improve genital appearance or function, and that contributing factors might be clinically relevant regarding more general psychological wellbeing.
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Affiliation(s)
- Thula U Koops
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Wiessner
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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4
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Kirkman M, Dobson A, McDonald K, Webster A, Wijaya P, Fisher J. Health professionals' and beauty therapists' perspectives on female genital cosmetic surgery: an interview study. BMC Womens Health 2023; 23:601. [PMID: 37964236 PMCID: PMC10647082 DOI: 10.1186/s12905-023-02744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/29/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Female genital cosmetic surgery (FGCS) changes the structure and appearance of healthy external genitalia. We aimed to identify discourses that help explain and rationalise FGCS and to derive from them possibilities for informing clinical education. METHODS We interviewed 16 health professionals and 5 non-health professionals who deal with women's bodies using a study-specific semi-structured interview guide. We analysed transcripts using a three-step iterative process: identifying themes relevant to indications for FGCS, identifying the discourses within which they were positioned, and categorising and theorising discourses. RESULTS We identified discourses that we categorised within four themes: Diversity and the Normal Vulva (diversity was both acknowledged and rejected); Indications for FGCS (Functional, Psychological, Appearance); Ethical Perspectives; and Reasons Women Seek FGCS (Pubic Depilation, Media Representation, Pornography, Advertising Regulations, Social Pressure, Genital Unfamiliarity). CONCLUSIONS Vulvar aesthetics constitute a social construct to which medical practice and opinion contribute and by which they are influenced; education and reform need to occur on all fronts. Resources that not only establish genital diversity but also challenge limited vulvar aesthetics could be developed in consultation with women, healthcare practitioners, mental health specialists, and others with knowledge of social constructs of women's bodies.
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Affiliation(s)
- Maggie Kirkman
- Global and Women's Health, Monash University, Public Health and Preventive Medicine, 553 St Kilda Road, Melbourne, 3004, Australia.
| | - Amy Dobson
- Institute for Advanced Studies in the Humanities, University of Queensland, Brisbane, Australia
| | - Karalyn McDonald
- Global and Women's Health, Monash University, Public Health and Preventive Medicine, 553 St Kilda Road, Melbourne, 3004, Australia
| | - Amy Webster
- Women's Health Victoria, Melbourne, Australia
| | - Pramasari Wijaya
- Global and Women's Health, Monash University, Public Health and Preventive Medicine, 553 St Kilda Road, Melbourne, 3004, Australia
| | - Jane Fisher
- Global and Women's Health, Monash University, Public Health and Preventive Medicine, 553 St Kilda Road, Melbourne, 3004, Australia
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Alavi-Arjas F, Goodman MP, Simbar M, Majd HA, Sharp G, Nahidi F. The Effect of Female Genital Cosmetic and Reconstructive Procedures on Body and Genital Self-Image: A Systematic Review and Meta-Analysis. Aesthet Surg J 2023; 43:1161-1173. [PMID: 37078824 DOI: 10.1093/asj/sjad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/08/2023] [Accepted: 04/19/2023] [Indexed: 04/21/2023] Open
Abstract
Performance of female genital cosmetic and reconstructive procedures (FGCRP) has been increasing over past decades. Appearance and functional concerns are the most common reasons for seeking FGCRP. Poor body and genital self-image may contribute to the increase in demand for surgery. The aim of this systematic review is to explore outcomes of FGCRP in the domains of body and genital self-image. A systematic literature review of PubMed, Web of Science, Scopus, PsycINFO, Embase, and the Cochrane Library was conducted to identify articles that measured body and genital self-image in females after FGCRP. The authors identified 5 articles for a systematic review of body image and 8 studies for a systematic review of genital self-image. The most common procedure performed was labia minora labiaplasty. Instruments for body image evaluation were the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder and the Body Image Quality of Life Inventory. Genital image was assessed with the Female Genital Self-Image Scale and Genital Appearance Satisfaction (GAS) scale. Most of the studies indicated that FGCRP can improve both body image and genital self-image; meta-analysis revealed that FGCRP improved GAS scores by 17.96 (range: 0-33; P < .001). It appears that FGCRP leads to improvements in females' body and genital self-image. Inconsistencies in study design and measures, however, limit this conclusion. Future research should involve more rigorous study designs (for example randomized clinical trials with large sample sizes) for a more accurate assessment of FGCRP's consequences. LEVEL OF EVIDENCE: 4
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6
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Hayes JA, Temple-Smith MJ. Teaching vulval anatomy in the twenty-first century: The Australian experience. ANATOMICAL SCIENCES EDUCATION 2023. [PMID: 36807881 DOI: 10.1002/ase.2264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/12/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Anatomy has often been regarded as an immutable discipline where everything that needs to be known is known. This article focuses on the teaching of vulval anatomy, the diversification of gender in contemporary society, and the increasing popularity of the Female Genital Cosmetic Surgery (FGCS) industry. The binary language and singular structural arrangements contained in lectures and chapters on "female genital anatomy" are nowadays rendered exclusive and incomplete. A series of 31 semi-structured interviews with Australian anatomy teachers identified barriers and facilitators for teaching vulval anatomy to contemporary student cohorts. Barriers included lack of connection to contemporary clinical practice, time and technical difficulty involved in regularly updating online presentations, the crowded curriculum, personal sensitivity to teaching vulval anatomy, and reluctance to introduce inclusive terminology. Facilitators included lived experience, regular use of social media, and institutional initiatives toward inclusivity including the support of queer colleagues.
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Affiliation(s)
- Jennifer A Hayes
- Department of General Practice, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
- Department of Anatomy and Physiology, School of Biomedical Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Meredith J Temple-Smith
- Department of General Practice, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
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Gendered genital modifications in critical anthropology: from discourses on FGM/C to new technologies in the sex/gender system. Int J Impot Res 2023; 35:6-15. [PMID: 35246630 PMCID: PMC9935393 DOI: 10.1038/s41443-022-00542-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 11/08/2022]
Abstract
Since the late 19th century, genital modifications (female and male) have been an important research subject in anthropology. According to a comparative and constructivist perspective, they were first interpreted as rites of passage, then as rites of institutions. In a complex dialogue with feminist movements, 20th-century scholars recognised that the cultural meanings of these modifications are multiple and changing in time and space. Conversely, according to WHO, since the 1950s, Female Genital Mutilation or Cutting (FGM/C) has been considered a form of Violence Against Women and Girls (VAWG). Interpreted as VAWG, FGM/C has progressively been isolated from its complementary male rite, selected for special condemnation, and banned. An order of discourse has been built by WHO and other international organisations. This article provides a genealogic deconstruction of the order of discourse lexicon, highlighting dislocations between anthropology and the human rights agenda. Today, genital modifications encompass FGM/C, male circumcision, clitoral reconstruction after FGM/C, gender reassignment surgery, and intersex and 'cosmetic' genital surgery. I propose to call these procedures Gendered Genital Modifications (GGMo). GGMo implicates public health, well-being, potential harm, sexuality, moral and social norms, gender empowerment, gender violence, and prohibitive and permissive policies and laws. The selective production of knowledge on FGM/C has reinforced the social and political polarisation between practices labelled as barbaric and others considered modern, accessible, and empowering. I suggest an anthropological interpretation for the socio-cultural meanings of health, sexuality, purity and beauty. I propose future interdisciplinary studies of how consent, bodily integrity and personal autonomy bear on concepts of agency and subjectivity in the sex/gender system.
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8
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Rasul TF, Schwartz KR, Qureshi F, Eachus E, Henderson A. The Potential Cutaneous Effects of Pornography Addiction: A Narrative Review. Cureus 2022; 14:e33066. [PMID: 36721540 PMCID: PMC9883107 DOI: 10.7759/cureus.33066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Pornography addiction is an area of increasing concern, particularly due to the ubiquitous nature of pornographic material on the Internet. Even so, there is no formal Diagnostic and Statistical Manual of Mental Disorders (DSM-5) inclusion of compulsive pornography use as a behavioral addiction. Although the psychosocial impacts of pornography addiction have been studied, the risk of direct skin injuries and behavioral changes brought about by excessive pornography usage remain to be seen. Adult males constitute the majority of cases of engaging in risky and violent sexual behaviors with an unclear association with pornography consumption. Adult females may be likely to copy pubic hair trimming patterns analogous to those seen in pornographic content, even though attitudes towards labiaplasty are unclear. Finally, adolescents regularly exposed to pornography have been found to replicate sexual activity seen in pornographic material and have earlier sexual activity. In the literature evaluated, an association between pornographic material and direct cutaneous disease remains a major area of further research.
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Affiliation(s)
- Taha F Rasul
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Kayla R Schwartz
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Farhan Qureshi
- Department of Urology, University of Miami Miller School of Medicine, Miami, USA
| | - Emily Eachus
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Armen Henderson
- Department of Internal Medicine, University of Miami Health System, Miami, USA
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9
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Beni R, Fisher L, Longhurst GJ. The importance of diverse and accurate descriptions of genital anatomy in textbooks. ANATOMICAL SCIENCES EDUCATION 2022; 15:985-988. [PMID: 35593013 DOI: 10.1002/ase.2200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/31/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Rebecca Beni
- Medicine M.B.B.S. Program, Institute of Medical and Biomedical Education, St George's University of London, London, UK
| | - Lauren Fisher
- Department of Anatomical Sciences, St George's University of London, London, UK
| | - Georga J Longhurst
- Department of Anatomical Sciences, St George's University of London, London, UK
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10
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Tootoonchi Tabrizi M, Öztürk SA. How cosmetic surgeons portray cosmetic procedures through Instagram? A content analysis on cosmetic surgeons' posts on Instagram. Health Mark Q 2021; 39:43-60. [PMID: 34693884 DOI: 10.1080/07359683.2021.1993115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study intends to explore the visual and textual content of posts cosmetic surgeons shared on Instagram pages in order to present their cosmetic surgical or non-surgical procedures. To do so, this study employed a qualitative approach using textual and visual content analysis on 200 Instagram posts shared by cosmetic surgeons. The results demonstrated that the content of analyzed posts can be categorized as 12 sub-themes which are clustered around four main themes; "You have got some body imperfections," "Body imperfections are worrisome," "Cosmetic procedure is the solution; we provide it for you" and "It's not a real surgery!."
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Affiliation(s)
| | - Sevgi Ayşe Öztürk
- Faculty of Economics and Administrative Sciences, Department of Business Administration, Anadolu University, Eskisehir, Turkey
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11
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Agrawal N, Singh P, Ghuman NK, Sharma C, Yadav G, Gothwal M, Jhirwal M. The anatomical measurements of vulva in Indian women: A cross-sectional prospective study. Int J Gynaecol Obstet 2021; 158:153-161. [PMID: 34541664 DOI: 10.1002/ijgo.13936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To measure the anatomical dimensions of the vulva in adult Indian women. To analyze their correlations with age, body mass index (BMI), parity, and mode of delivery. METHODS This cross-sectional study was conducted in a tertiary care university hospital in India, among 400 women aged 18 years and above. Various vulval measurements were taken, and Pearson's correction was applied to variables like age, BMI, parity, and mode of delivery. RESULTS Mean length of glans of clitoris was 5.2 ± 1.43 mm, the labia minora width was 2.6 ± 0.74 cm, length of introitus was 1.3 ± 0.59 cm, and perineal body length was 2.3 ± 0.60 cm. The range of some measurements was extensive, for example labia minora width ranged from 0.7 to 4.9 cm. Normal centile curves were constructed for vulval measurements according to age groups. Statistically significant positive correlations of age, BMI, and obstetrical history were seen with labia minora width (r = 0.165, P = 0.001; r = 0.284, P < 0.001; r = 0.246, P < 0.001, respectively). CONCLUSION The centile curves can be used as a reference for the Indian population of different ages. These can be used when counseling women coming for female genital cosmetic surgery.
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Affiliation(s)
- Neha Agrawal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
| | - Pratibha Singh
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
| | - Navdeep Kaur Ghuman
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
| | - Charu Sharma
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
| | - Garima Yadav
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
| | - Meenakshi Gothwal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
| | - Manisha Jhirwal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, India
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Abstract
Genital dissatisfaction in healthy young women is on the rise. Pubic hair removal reveals genital tissue previously hidden, while social trends promote the absence of any protruding genital tissue as the feminine ideal. Information with regard to the natural diversity of external genitalia anatomy, and lifestyle changes to improve physical symptoms related to labial tissue may suffice to reassure a distressed adolescent. Female genital cosmetic surgery is rarely supported, before attaining genital maturity. However, genital dissatisfaction may lead to significant embarrassment and anxiety, requiring formal psychological counselling. Sexual education needs to counterbalance perceived normal anatomy, portrayed in pornography or female genital cosmetic surgery advertisements.
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13
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Lowe J, Black KI. Female genital cosmetic surgery. Aust N Z J Obstet Gynaecol 2021; 61:325-327. [PMID: 34109617 DOI: 10.1111/ajo.13363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Jessica Lowe
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten I Black
- Specialty of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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14
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Turin SY, Kearney A, Placik OJ. Anterior and Posterior Commissuroplasty: Taking Labiaplasty to the Next Level. Aesthet Surg J 2020; 40:1111-1121. [PMID: 32926100 DOI: 10.1093/asj/sjz287] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As the popularity of female cosmetic genital surgery has grown, so has the number of publications detailing surgical techniques, particularly regarding labiaplasty. As a nascent surgical field, much room remains for finesse and exploration of new techniques to optimize outcomes and patient satisfaction. We present the techniques for anterior and posterior commissuroplasty the senior author (O.J.P.) has developed. Anterior commissuroplasty is efficacious in addressing a number of anatomic variations to achieve the appearance of a single midline cleft, which is commonly requested by patients. Posterior commissuroplasty was developed to address skin excess at the posterior fourchette that may develop as a result of labiaplasty. Either technique may be used in combination with labiaplasty or as a stand-alone procedure. These tools may be a useful addition to the repertoire of a surgeon practicing female genital surgery. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Sergey Y Turin
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Aaron Kearney
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Otto J Placik
- Northwestern University Feinberg School of Medicine, Chicago, IL
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15
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Chibnall K, McDonald K, Kirkman M. Pathologising diversity: medical websites offering female genital cosmetic surgery in Australia. CULTURE, HEALTH & SEXUALITY 2020; 22:64-80. [PMID: 30794088 DOI: 10.1080/13691058.2019.1574029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Female genital cosmetic surgery (FGCS) is increasingly popular. Medical organisations report concern about adverse outcomes and inadequate clinical indications. Given the Internet's role in health decisions, we aimed to discover what was being communicated about FGCS on Australian provider websites. Thematic analysis of 31 prominent websites identified six themes: seeking aesthetic perfection; resisting natural diversity; gaining from FGCS; indications for surgery; a simple procedure; and ethical practice. Desirable vulvas were represented as 'neat' and 'youthful'. Sites promoted a discourse in which to be 'feminine' means having no visible sex organs, consistent with the historical repression of women's sexuality. FGCS was constructed as a simple and empowering solution, improving women's comfort, hygiene, self-esteem and sexual relationships. The apparent primary concern was commercial. Attention was rarely paid to ethics. Sites reinforced women's responsibility to strive for aesthetic perfection, implied that vulvar diversity is pathological, made unfounded claims for the benefits of FGCS and downplayed adverse consequences. Findings have implications for public health and medical authorities in countries where FGCS is practised and advertised. Enforcing the first do no harm principle would reduce websites' capacity to promote discourses and practices that damage women's bodies and wellbeing.
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Affiliation(s)
- Kimberley Chibnall
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karalyn McDonald
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Maggie Kirkman
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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17
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Learner HI, Rundell C, Liao LM, Creighton SM. 'Botched labiaplasty': a content analysis of online advertising for revision labiaplasty. J OBSTET GYNAECOL 2019; 40:1000-1005. [PMID: 31826680 DOI: 10.1080/01443615.2019.1679732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A new development in female genital cosmetic surgery (FGCS) is the promotion of revision surgery for 'botched labiaplasty'. This content analysis study reviews the quality of information offered on websites specifically advertising revision labiaplasty. Twelve websites were identified through online searches and were examined for the quality of their clinical information. All sites defined botched labiaplasty as unsatisfactory appearance after labiaplasty. Four gave no further details and five listed asymmetry, irregular labial edges or removal of too much or too little tissue. Four websites described primary botched labiaplasty as 'mutilation'. Inadequacy of the primary surgeon was cited as the cause of botched labiaplasty in 11/12. Only two websites mentioned risks of surgery. Good outcomes were not defined and no website provided outcome data although guaranteed satisfaction was implied in two websites. This study highlights the existence and promotion of services for botched labiaplasty using non-specific and emotive descriptions. These findings suggest that unsatisfactory results from consumers' perspectives are far from uncommon. The same women whose expectations have not been met by primary surgery are now being targeted for repeat surgery with online advertising capitalising on their unchanged motivations.Impact StatementWhat is already known on this subject? Female genital cosmetic surgery (FGCS) is mainly advertised online with labiaplasty as the most commonly performed procedure. A market for labiaplasty revision to correct 'botched' primary procedures is developing. Academic literature and advertising materials are inconsistent when defining indications and determinants of success for labiaplasty or revision.What the results of this study add? A content analysis of websites specifically advertising revision labiaplasty describes the emotive and nonspecific terms used online to promote revision labiaplasty.What the implications are of these findings for clinical practice and/or further research? The existence of services for botched labiaplasty suggests dissatisfaction is common. Women whose expectations have not been met by primary surgery are targeted for repeat surgery through online advertising capitalising on their potentially unchanged motivations. This study demonstrates the need for clearer outcome data for labiaplasty and highlights the need for better advertising standards for FGCS promotion.
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Affiliation(s)
| | | | - Lih-Mei Liao
- Department of Women's, Health University College London Hospitals, London, UK
| | - Sarah M Creighton
- Department of Women's, Health University College London Hospitals, London, UK
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Crépaux V, Legendre G. [Labiaplasty: Motivations and post-surgery satisfaction]. ACTA ACUST UNITED AC 2019; 47:489-496. [PMID: 31003016 DOI: 10.1016/j.gofs.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES In France, the number of labiaplasty increased by 57% between 2008 and 2016. To date, only one prospective study with low-power evaluated postoperative satisfaction has been performed. This observational prospective study aims to evaluate the motives and post-surgery satisfaction of patients who had a labiaplasty. METHODS This observational prospective study include all patients over 18 years old operate at the hospital of Angers during an 18-month period. The exclusion criterion was a positive screening test to the Body Dysmorphic Disorder Questionnaire. Patients were interviewed by a written questionnaire on the day of the surgery and by phone 3 and 6 months after the surgery. RESULTS A total of thirty patients were included in the study, with an average age of 31.5 (± 10.58). Twenty-three patients answered 3 months after and 19 answered 6 months after. Eighteen patients (95%) expressed satisfaction at 6 months and 16 (84%) "extremely" satisfied. Functional discomfort improved in 18 patients (94%) at 6 months. Eighty-four percent have felt an improvement regarding esthetical discomfort. All patients would recommend the surgery. The main motive was the discomfort when getting dressed for 27 patients (90%). CONCLUSION The patients expressed a real functional discomfort and are mostly very satisfied with their surgery at 3 and 6 months after.
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Affiliation(s)
- V Crépaux
- Service de gynécologie-obstétrique, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - G Legendre
- Service de gynécologie-obstétrique, 4, rue Larrey, 49933 Angers cedex 9, France.
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Laemmle-Ruff IL, Raggatt M, Wright CJC, Carrotte ER, Davis A, Jenkinson R, Lim MSC. Personal and reported partner pornography viewing by Australian women, and association with mental health and body image. Sex Health 2019; 16:75-79. [PMID: 30611315 DOI: 10.1071/sh18037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/06/2018] [Indexed: 11/23/2022]
Abstract
Background Personal and partner pornography viewing may affect health and wellbeing. This study aimed to improve understanding of the effects of pornography on mental health and body image, given emerging evidence of increasing use, particularly among young people. METHODS A cross-sectional survey was implemented, targeting people who had accessed health and fitness content via social media. Convenience sampling was used and participants were recruited via advertising on social media. RESULTS Overall, 76% (75/99) of women reported having ever viewed pornography, and 21% had viewed pornography frequently (monthly/weekly/daily) in the prior 12 months. The association between frequent viewing and higher-risk Kessler 10 Psychological Distress Scale scores lost significance once controlled for age (adjusted OR 2.30, 95%CI 0.82-6.49, P=0.11). There was an association with frequent reported partner pornography use (monthly/weekly/daily) and increased Drive for Muscularity scores (adjusted OR 2.20, 95%CI 1.01-4.80, P=0.048). There were no other associations found with pornography use (personal or partner) and body image or mental health, although this was limited by the small sample size. Most women (85%, 41/48) reported being happy with their partner's pornography use, and in qualitative responses, indicated that pornography had minimal effect on their lives. Nevertheless, multiple qualitative responses indicated a multiplicity of perceived effects of pornography, including negative effects on body image. CONCLUSIONS Pornography had a minor effect on mental health and body image in this study. Additional research is required to improve understanding of the effects of pornography on body image and mental health, particularly among vulnerable individuals.
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Affiliation(s)
| | - Michelle Raggatt
- Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | | | - Elise R Carrotte
- Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Angela Davis
- Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Rebecca Jenkinson
- Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Megan S C Lim
- Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
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International Society for the Study of Vulvovaginal Disease Recommendations Regarding Female Cosmetic Genital Surgery. J Low Genit Tract Dis 2018; 22:415-434. [PMID: 29994815 DOI: 10.1097/lgt.0000000000000412] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Female genital cosmetic surgeries (FGCSs) and procedures are increasingly being advertised as common, simple, and complication-free, capable of not only improving aesthetic appearance but also increasing self-esteem and sexual pleasure.Guidelines for physicians and clear, scientifically correct information for patients must be made available, to minimize the number of ineffective or deleterious procedures.The International Society for the Study of Vulvovaginal Disease positions/recommendations regarding FGCS are as follows:1. There is a wide variation regarding genital normalcy; providers must be able to explain this to women.2. There are no data supporting FGCS including, G-spot augmentation, hymenoplasty, vulvar and perianal bleaching/whitening, vaginal tightening procedures, and other procedures aimed at increasing sexual function.3. Women should not be offered FGCS before the age of 18 years.4. Women undergoing FGCS should be evaluated by a provider with expertise in vulvovaginal diseases, including attention to their psychological, social, and sexual context. Evaluation by an experienced mental health provider should be considered when the motivation for seeking surgery and/or expectations are not clear or realistic.5. Female genital cosmetic surgery is not exempt from complications.6. Informed consent must always be obtained.7. Surgeons performing FGCS should refrain from solicitous advertising or promoting procedures without scientific basis, including on Web sites.8. Surgeons should not perform surgery that they do not agree with and explain their rationale/position when pressured by patients.9. The genital surgeon must be adequately trained in performing FGCS including knowledge of the anatomy, physiology and pathophysiology of the vulva, vagina and adjacent organs.
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Barbara G, Facchin F, Buggio L, Alberico D, Frattaruolo MP, Kustermann A. Vaginal rejuvenation: current perspectives. Int J Womens Health 2017; 9:513-519. [PMID: 28860864 PMCID: PMC5560421 DOI: 10.2147/ijwh.s99700] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Female genital cosmetic surgery includes several procedures aimed at reaching better female genital appearance and/or improved sexual functioning. Among these procedures, vaginal rejuvenation is considered as one of the most controversial genital cosmetic surgical interventions and involves a range of surgical procedures performed by gynecologists or plastic surgeons to decrease the average diameter of the vagina, mainly for sexual reasons. In this narrative review, vaginal rejuvenation outcomes are examined in order to clarify the current scenario of the different vaginal rejuvenation techniques, as well as their effectiveness and associated complications. Psychological and ethical issues linked to these procedures are also addressed.
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Affiliation(s)
- Giussy Barbara
- Department of Obstetrics and Gynecology, Service for Sexual and Domestic Violence (SVSeD), Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico
| | | | - Laura Buggio
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Daniela Alberico
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Maria Pina Frattaruolo
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Alessandra Kustermann
- Department of Obstetrics and Gynecology, Service for Sexual and Domestic Violence (SVSeD), Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico
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Antoniou A, Yassin A. ‘Vaginal Rejuvenation’ and the Regulation of New Technologies: Controls Are Still Lacking. EUROPEAN MEDICAL JOURNAL 2017. [DOI: 10.33590/emj/10311830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Simonis M, Manocha R, Ong JJ. Female genital cosmetic surgery: a cross-sectional survey exploring knowledge, attitude and practice of general practitioners. BMJ Open 2016; 6:e013010. [PMID: 27678547 PMCID: PMC5051499 DOI: 10.1136/bmjopen-2016-013010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/11/2016] [Accepted: 09/01/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore general practitioner's (GP) knowledge, attitudes and practice regarding female genital cosmetic surgery (FGCS) in Australia. DESIGN Cross-sectional survey. SETTING Australia. SAMPLE GPs who attended a women's health seminar and GPs who subscribed to a non-governmental, national health professional organisation database that provides education to primary care professionals. METHOD A national online survey of GPs was conducted for the 10-week period, starting 1 week prior and 2 months after a Women's Health seminar was held in Perth on 8 August 2015. 31 questions prompted GPs' knowledge, attitudes and practice in managing patients asking about FGCS. RESULTS The survey was fully completed by 443 GPs; 54% had seen patients requesting FGCS. Overall, 75% (95% CI 71% to 79%) of GPs rated their knowledge of FGCS as inadequate and 97% (95% CI 94% to 99%) had been asked by women of all ages about genital normality. Of those who had seen patients requesting FGCS, nearly half (44%, 95% CI 38% to 51%) reported they had insufficient knowledge of risks of FGCS procedures and 35% (95% CI 29% to 41%) reported seeing females younger than 18 years of age requesting FGCS. Just over half (56%, 95% CI 51% to 60%) of the GPs felt that women should be counselled before making a referral for FGCS. More than half the GPs suspected psychological disturbances in their patients requesting FGCS such as depression, anxiety, relationship difficulties and body dysmorphic disorder. CONCLUSIONS GPs see women of all ages presenting with genital anatomy concerns and in those who request FGCS, GPs often suspected a range of mental health difficulties. GPs require greater education to support their patients who request FGCS.
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Affiliation(s)
- M Simonis
- Department of General Practice, University of Melbourne, Carlton, Victoria, Australia
- Royal Australian College of General Practitioners, Expert Committee Quality Care, Melbourne, Victoria, Australia
| | - R Manocha
- Sydney Medical School Northern, The University of Sydney, Sydney, New South Wales, Australia
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
| | - J J Ong
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Melbourne Sexual Health Centre, Carlton, Victoria, Australia
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Sharp G, Mattiske J, Vale KI. Motivations, Expectations, and Experiences of Labiaplasty: A Qualitative Study. Aesthet Surg J 2016; 36:920-8. [PMID: 26912581 DOI: 10.1093/asj/sjw014] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The demand for labiaplasty has increased rapidly over recent years; however, very little is known about the experiences women have undergoing this surgery or the subsequent effects it has on their well-being. OBJECTIVES To explore women's reasons for undergoing labiaplasty, their expectations, and preoperative and postoperative experiences. METHODS One-on-one semi-structured interviews were conducted with 14 adult women who had undergone a labiaplasty procedure. The women were asked about their reasons for having labiaplasty, the processes of accessing and undergoing surgery, and how various aspects of their lives were influenced after having surgery. The interviews were audio recorded then transcribed verbatim. The interview transcripts were analyzed using thematic analysis owing to the exploratory nature of the study. RESULTS Themes reflecting "media influence," "negative commentary," "physical vs appearance reasons," "satisfaction with surgery," and "sexual well-being" emerged from the analyses. Online media representations of labial appearance, and negative past experiences, primarily sexual in nature, contributed to women's concerns about their labial appearance. Issues of physical discomfort were also common and were sometimes emphasized to potentially legitimize women's requests for surgery. Most women were generally very satisfied with their surgical results, although some noted that their labia were not as small and/or symmetrical as they had expected. Most women reported significant improvements in their sexual well-being after surgery, however, some noted that their emotional discomfort around sexual intercourse had not improved. CONCLUSIONS These new insights into why women seek labiaplasty, their experiences and outcomes may assist clinicians in enhancing their communication with prospective patients. LEVEL OF EVIDENCE 4 Therapeutic.
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Affiliation(s)
- Gemma Sharp
- Ms Sharp is a Clinical Psychology PhD Candidate, Dr Mattiske is a Senior Lecturer, Dr Vale is a Lecturer in Clinical Psychology, School of Psychology, Flinders University, Adelaide, SA, Australia
| | - Julie Mattiske
- Ms Sharp is a Clinical Psychology PhD Candidate, Dr Mattiske is a Senior Lecturer, Dr Vale is a Lecturer in Clinical Psychology, School of Psychology, Flinders University, Adelaide, SA, Australia
| | - Kirsten I Vale
- Ms Sharp is a Clinical Psychology PhD Candidate, Dr Mattiske is a Senior Lecturer, Dr Vale is a Lecturer in Clinical Psychology, School of Psychology, Flinders University, Adelaide, SA, Australia
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