Surgery where? Women aim to boost sex lives

'She was completely deformed'
"I can't believe I let someone do this to me," a 21-year-old college student named Beth tells me, digging into an egg-white omelet in a New York City diner. A pretty, petite woman from Long Island, New York (who asked SELF not to publish her full name), Beth is dressed in jeans and a T-shirt, her brunette hair in a messy ponytail. "I've never wanted my boobs done or any kind of plastic surgery," she says. "But my labia made me very uncomfortable." The self-consciousness began about two years ago, when she started having sex. She had previously noticed that her labia minora (the inner folds of the vagina) were longer than those of other girls. But lying naked with a man embarrassed her to the point where she would turn off all the lights and cover herself with blankets. Last summer, she asked the man she was dating what he thought. "Well, I've been with women whose labia are smaller," she recalls him responding. Then he referred Beth to a magazine where he had seen advertisements for labiaplasty.

Beth spoke with her regular gynecologist. "You're obsessing. Don't do it," he told her, warning her that the procedure could be dangerous. Undeterred, Beth consulted with a gynecologist she had found through the advertisement. "She told me that my labia weren't that long but that she could fix them, no big deal, and it would take 15 minutes and cost $5,000," she says. Not telling anyone — her parents, her friends or even her boyfriend — Beth dipped into her student-loan money and returned to the doctor five days later.

The procedure took 15 minutes, as promised, but left her in pain for much longer. Not only was she in agony afterward, "but I bled for days and was incredibly swollen. I couldn't walk, and I could only sit cross-legged," she remembers, adding that she was bleeding so much she had to change her sanitary pad every hour. The suffering might have been worthwhile had Beth liked the results. But she was horrified. "My right lip was completely gone, and my left lip was just hanging there, cut off at an angle," she says. As she healed during the next month, her surgical scars became "rigid, bumpy and rough; they were painful and uncomfortable." She told her boyfriend that she had a cyst and couldn't have sex, and the two of them have since split up.

"She was completely deformed," confirms Gary Alter, M.D., the plastic surgeon in New York City whom Beth consulted to repair the damage. "Often a physician's concept of doing a labia operation is to cut them off. As these surgeries are growing more popular, I'm seeing more disastrous results from cavalier doctors who aren't paying attention to detail and symmetry." And if someone is already self-conscious about her genitals, a botched surgery can make the problem much worse. "It can be very traumatic both physically and psychologically," Dr. Alter says. "It can really screw up someone's head."

Today, Beth is happy with her labia. Dr. Alter did his repairs by bringing together the upper and lower labia and sculpting them, a procedure Beth says was bloodless and pain-free. "They're not perfect, but they're also not mutilated," she says. Now her biggest concern is how she's going to recoup the money she spent — not only the $5,000 for the initial surgery but also another $8,700 for Dr. Alter's reconstruction. "I don't know why it mattered to me what my labia looked like; I mean, it's not like they were a huge problem in my life," she says, anger and remorse filling her light brown eyes. "If I didn't learn that this kind of surgery was available, I never would have had it done, and I would have been fine. The surgery was totally unnecessary — and a really stupid thing to do."

No such thing as perfect
What on earth is driving this trend? Vaginal surgery has long been performed on women to treat urinary stress incontinence or pelvic prolapse, when weakened muscles cause the uterus or other nearby organs to fall through the pelvic floor into, and sometimes out of, the vagina. (Both conditions can affect women after they bear children.) And gynecologists may recommend surgery if labia minora extend beyond two inches in length and cause discomfort during sex or exercise. But the procedures that today are growing more common have less to do with function than with form — how a woman's genitalia look and feel as opposed to the way they work. In an unscientific poll of about 275 women at Self.com, more than 1 in 10 respondents said they'd consider surgery that made their private parts look and feel sexier. (On the other hand, 53 percent declared the idea "gross.") "The cosmetic trend concerns me," says Elizabeth G. Stewart, M.D., assistant professor of ob/gyn at Harvard Medical School and coauthor of "The V Book: A Doctor's Guide to Complete Vulvovaginal Health" (Bantam). "There are bad reasons to do labial surgeries, and attempting to be pretty and homogenous is one of them," she says.

The BJOG study attributed the attention toward all things vagina to the everyday, online availability of pornography that portrays "idealized, highly selective images" of female genitalia. And with Brazilian waxing and laser hair removal more routine, women simply see more of themselves — and one another — than they did before. The problem with searching for the perfect genitals is that there is no such thing, says Virginia Braun, Ph.D., senior lecturer in psychology at the University of Auckland in New Zealand and one of the world's few experts in the sociocultural aspects of women's genitalia. Like faces, no two vaginas are exactly the same. Women seeking to model their private parts, particularly their labia, after pornographic images are fixating on "one end of a very wide spectrum of genital anatomy, one that might have been altered by surgery or airbrushing," Braun says. "Some women do naturally look like that, but the majority don't."

Dr. Alter — who, like Dr. Matlock, appears on Dr. 90210 — argues that many women have long been uncomfortable with their labia, but until now didn't know they could change them. "I've treated patients between the ages of 14 and 60 who cross every socioeconomic boundary, and all of them have been very self-conscious about how they look down there and won't wear a bathing suit at the beach or shower in a communal setting," he says. "Patients constantly tell me they don't mention these issues to their regular gynecologists because they fear feeling trivialized and embarrassed. I get women who are so self-conscious, they wouldn't have oral sex, and now they feel normal and not like a freak of nature." Dr. Alter says he performs more than twice as many labiaplasties today as he did five years ago. "Doing these procedures on a hit TV show makes people aware that they are available to them," he adds. "It's become more acceptable."

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