Surgery where? Women aim to boost sex lives

A lucrative industry
It has also become highly profitable. At a time when professional liability premiums are soaring and insurance reimbursements are dipping, aesthetic genital enhancements are a lucrative business indeed. Dr. Matlock charges between $3,500 and $9,000 for each laser vaginal surgery; a combination of procedures can cost as much as $18,000. Or one can get Dr. Matlock's trademarked Wonder Woman Makeover, which for around $45,000 includes the vagina overhaul plus breast implants, liposculpting and a "Brazilian butt augmentation." In April, he began selling his G-Shot to colleagues in the United States, Europe, Japan and the Philippines for $450 per injection. Doctors may then sell the shots to their patients for as much as $1,850, a 300 percent markup. "Medicine is a business, and sex is what sells," Dr. Matlock says.

Like the face, breasts and virtually every other visible body part, the previously hidden vagina has fallen into the grip of a cosmetic surgery culture in which just about any "imperfection" — both real and imagined — can be nipped and tucked into the perceived ideal, regardless of how unrealistic. "People never used to ask for these surgeries," says Wendy Lewis, a cosmetic surgery consultant in New York and London who charges $350 an hour to help clients decide which procedures and doctors are right for them. Lewis says her clients who request vaginal surgeries are often mothers in their 30s or 40s who miss the feel of their pre-childbirth vaginas; a few are middle-aged women who are divorced or getting divorced and have younger boyfriends they worry about satisfying. "In the last two years, I've gotten many more requests. Makeover television makes them ask, 'What more can I do?' Women are so insecure about everything; now they have one more thing to be insecure about."

"I grew up with some of the same feelings a man with a small penis might have," says Abby, a 31-year-old mother of two from Colorado Springs. Her labia were perfectly symmetrical, she says, but in her high school locker room days, she noticed that they were about a half inch longer than anyone else's. As a woman married for 12 years, she says, her anxiety eventually faded: "What I may have felt about my labia when I was 15 was not what I felt when I was 30." Still, intercourse sometimes pulled the labia into her vagina, which was painful. In the spring of 2006, she raised the issue with her gynecologist, who, she says "offered to make an appointment to scalpel them off right there in her office. That's when I realized that these kinds of procedures were fairly common."

'This will be fun!"
Curious, she began to research the idea on the Internet, where she stumbled onto another intriguing possibility: laser vaginal rejuvenation to tighten her vagina. "After two childbirths, my vaginal opening had gotten much bigger," Abby says. She could achieve orgasm, "but there wasn't as much friction. When I realized I could have the vagina of my early days, I thought, I'm going to love that; my husband is going to love that; this will be fun!"

Abby sought out a specialist, gynecologist John Miklos, M.D., of Atlanta, who offered to reduce her labia and tighten her vagina but was clear that neither surgery was medically necessary. When Dr. Miklos (who trained with Dr. Matlock) was done with her, Abby says, "my vagina had basically been restored to its virginal state." As for her labia, they "were icing on the cake ... flat and flush and very juvenile-looking." Her recovery was longer and more painful than she expected — "much worse than when I had my gallbladder removed," she says. She knew she couldn't have sex for eight weeks after the surgery; what she didn't know was how uncomfortable it would be when that time was up. It took another two months of using a vaginal dilator before she could again have painless, "full, free-flowing penetration."

The pain was worth it, Abby says, as today with the increased friction "my sex life is definitely better. People say these kinds of surgeries demean women, but for me it was completely selfish and self-serving. I don't get the controversy around this. If people don't want to get it done, they don't have it. But it's there for them if they do."

Better sex life?
For now, it's impossible to know if vaginal surgery is more likely to improve a woman's sex life or devastate it. One person who would love to answer that question is Debby Herbenick, sexual health education coordinator at the Kinsey Institute for Sexual Research in Bloomington, Indiana. During the past several years, she has approached specialists in the field of cosmetic genital surgery about gathering patients to participate in a long-range study of sexual enhancement related to these surgeries. Not one has agreed. So far, the only studies are two surveys by Chilean doctor Jack Pardo Schanz, M.D., another graduate of Dr. Matlock's class. In surveys at the Clinica Las Condes in Santiago, he found that 90 percent of women who underwent vaginal tightening surgery said their sex life was either greatly or significantly improved. (He noted that the study had "several shortcomings." There was no control group; the results were based on subjective experiences; and the follow-up period was only six months.) Dr. Matlock says that his patient surveys for the G-Shot show an 87 percent satisfaction rate, but that he could not share details of his unpublished research with SELF.

"Surgeons insist most of their patients are very happy with the results," Herbenick says. But she wants to know who these women are and to follow up over time to learn what, if any, impact these procedures have on arousal, desire and orgasm. "Some women will say that it's easier for them to have an orgasm now or that they feel more aroused, more easily," she says. "But is that 5 percent of patients or 70 percent?"

Until there is medical proof, some doctors remain skeptical — and worried that cosmetic surgeons are profiting from women's insecurities by promising a physical cure for what may not be a physical problem. "There are women who think that if they have a tighter vagina, their husbands will come back," says Stephen B. Young, M.D., president of the Society of Gynecologic Surgeons in Germantown, Tennessee. Dr. Young has operated on women whose long labia interfere with daily life, but he draws the line at performing such surgeries for purely aesthetic reasons or tightening relaxed vaginas solely for sexual enhancement. "Very commonly men and women have issues that don't allow them to have a good sex life," Dr. Young says. "Rarely do these problems have anything to do with the size or shape of the woman's vagina."

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