Vulvar Cosmetics
Over the past decade, there has been an increase in cosmetic vulvovaginal surgery. It was augmented by publicity and media coverage. This chapter discusses vulvar cosmetics: the need for standardization of the indications. It also raises the question of w
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Claudia Marchitelli
10.1 Introduction Over the past decade, there has been a great surge in aesthetic vulvovaginal surgery [1]. Publicity and media coverage [2] have placed these procedures in the public eye. This massive influx of information has led to several developments; on one hand, women have begun to observe their genitals in detail and compare them to those of other women, either through online searches or magazines, raising consciousness. On the other hand, this awareness has also given way to a misleading belief, which is that there is such thing as an “adequate vaginal design” or the “perfect vulva or vagina” [3]. This erroneous concept has encouraged many women to consult their gynecologist in search of a solution for a technically inexistent problem. One controversial issue regarding these practices is the standardization of their names and indications. This is important, because many physicians around the world use different names for these procedures, frequently based more on marketing than science, which makes them C. Marchitelli (*) Unit of Vulvar Diseases, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina School of Medicine, Instituto Universitario, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina ISSVD (International Society for the Study of Vulvovaginal Diseases), Waxhaw, NC, USA
appear novel, when in fact they are traditional gynecologic procedures which should not be labeled as new cosmetic practices. The creation of registered trademarks and a business model based on this area of gynecologic practice not only interferes with medical knowledge but is also ethically quite questionable and leads to a generalized understatement of the techniques, which following the correct indication and with adequate patient information are a very useful tool in the gynecologist or plastic surgeon’s practice. Another issue that leads to great discussion is whether or not these practices increase sexual pleasure. This erroneous belief arises from the way that some practitioners publicize vulvar and vaginal aesthetic surgery, which lead women to associating the procedures with better orgasms or greater sexual pleasure. However, there is no scientific, evidence-based proof to support the use of these surgeries to that end. These surgeries are strictly anatomical and are not oriented toward vulvar physiology and therefore do not guarantee sexual improvement. However, it must be taken into consideration that for some women, a change in the vulvar or vaginal anatomy may lead to improvement of self-confidence, increasing comfort and self-acceptance. This may impact psychologically on the patient, allowing her to enjoy sexual intercourse from a different viewpoint, free from embarrassment, inhibitions, and self-consciousness.
© Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_10
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It is because of all of these reasons, it is highly recommended that all patients have a thoro
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