Designer Parts: Inside the Strange, Fascinating World of Vaginoplasty

By Melanie Berliet

Why are some women spending upwards of $10,000 for complete "vaginal rejuvenation"? A visit to one plastic surgeon for a evaluation and sizing

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Dr. Ronald Blatt squats on the stool between the fuzzy pink stirrups propping up my legs. As I brace for the gynecologist to start poking around with his lubricated, latex encased paws, my eyes dart from a garage sale castaway of a seascape painting to an anatomy chart then back to the sole odd aspect of this setup: a mirror positioned so I can see my lady parts alongside Blatt's pink necktie-adorned head. Thank goodness I remembered to trim.

But the doctor I'm straddling isn't about to inspect my ovaries or administer a routine pap smear test. Blatt runs the Manhattan Center for Vaginal Surgery, and he's preparing to assess my vaginal tightness and to demonstrate how he might alter my labia.

I scheduled this complimentary consultation under the guise of wanting "to understand my options." Secretly, I want to explore why a growing number of women are modifying a body part so few can see by undergoing the elective surgeries in which Blatt specializes: vaginoplasty (removal of excess lining and tightening of surrounding tissue and muscles) and labiaplasty (reshaping of the labia minora, and sometimes the labia majora and/or clitoral hood). The former is often pursued by women who believe their capacity to enjoy sex is compromised by a loose vagina, which can be the result of a congenital condition -- as it was for Lucy Mancini in a Godfather plot point neglected by Francis Ford Coppola for the screen -- or childbirth. I'm especially interested in the latter, which is typically endured for purely cosmetic reasons. Although statistics on these operations are difficult to come by since most are performed by OB/GYN's rather than plastic surgeons, it is believed that the number of women having them is increasing rapidly -- some estimate by fivefold over the last decade. Perhaps most interestingly, an August 2011 study in the British Journal of Medicine showed that 40 percent of women who inquired about genital reconstruction reported the desire to go through with it even after being informed that their labia were normal.

"That looks like a porn star," I say, as it occurs to me how strange it is that our medical diagrams don't depict variations in human anatomy.

Many point to the prevalence and accessibility of pornography as the fuel behind this "designer vagina" craze. Although relationship expert Rachel Sussman hasn't encountered the matter discussed openly in her practice, she asserts that "pornography has made women a lot more uncomfortable with their bodies" and "too much porn will affect a sex life."

Are we children of the Internet so bewitched by the taut nether regions of the Playboy bunnies and porn stars we masturbate to that we can't accept anything else in reality? Is the emphasis on cultivating genital Shangri-Las a predictable extension of our body-obsessed culture, in which breast and lip augmentations are embraced as wholeheartedly as fad diets, Spanx, and skincare regimens? Either way, is it cause for concern that more and more women are pursuing aesthetic perfection from head to hooha?

Like a lot of girls, for a long time my vagina was the only one I knew. Inspired by the "straddle your mirrors" method of embracing femininity portrayed in Fried Green Tomatoes, I first checked myself out with mom's compact around age 10. But unlike boys, whose external genitalia make for brazen locker room comparisons, young girls are left to wonder whether our privates look like others'. By now, of course, I've seen my share of porn, so I know I'm not a carbon copy of Jenna Jameson or Sasha Grey down there. Maybe because I've been blessed with a series of kind boyfriends and a shortfall of "camel toe" exposing clothes, my vagina has never caused me much insecurity. Until today.

"One. Two," Blatt says. So far, his right pointer and middle fingers are inside me. "I'm going to press down now," he warns. And when my vaginal wall succumbs to the resistance, he adds his left index finger to the mix.

Medical degree or not, it's unnerving to expose oneself to a stranger -- especially one charged with evaluating your eligibility for vaginal plastic surgery. Mental math doesn't help. Within 26 years of practicing, I calculate that Blatt has amassed an index of thousands of vaginas against which he can measure mine. Why didn't I cram for this with daily Kegel exercises? How big or small are my labia and clitoral hood compared with my best friends'? Where do I fall on The Vaginal Spectrum? And does it matter?

"So not real loose, but there's room for tightening," Blatt concludes.

Relieved to know I don't have one of the five- or six-finger vaginas the doctor earlier mentioned, I ask: "Could you get it down so just two fingers fit comfortably?"

"That's what we do," he assures.

"And that's better for me and my boyfriend, right?"

"Generally," he says, though hesitant to guarantee enhanced sexual pleasure.

"Fifty-nine hundred bucks for a tighter vagina," I muse. Internally, I consider what else I might buy with that kind of disposable income if I actually had it. Fifty hour-long hot stone massages! A dozen tickets to The Book of Mormon! A lifetime supply of Bazooka gum!

"Well if you do the vaginoplasty and labiaplasty simultaneously, we charge $9,900 for what we call vaginal rejuvenation."

Just then, a mix of fear, curiosity, and a need to know if I should start saving prompts me to blurt, "Are my labia larger than average?"

The doctor refocuses on my vulva. He pinches each labial wing and spreads them apart. I cock my head at the reflection of what resembles a miniature stingray. When he tugs downward, the sensation is awkward, but not painful. Blatt tells me he would slice off two small pie-shaped pieces of flesh, leaving me with a smooth edge forming a narrow, upside-down U.

"If you look online, some people are a lot bigger. You're kind of average," he says.

"How big are they supposed to be?"

"Wow. That's a good question. It depends how you want it." Pointing to his anatomy chart, "This is an idealized version of the labia minora. So you can use that as a guide."

"That looks like a porn star," I say, as it occurs to me how strange it is that our medical diagrams don't depict variations in human anatomy.

A shrug. "It all depends on what you feel comfortable with."

Blatt stands to dispose of his gloves while running through protocol. I sit up, attentive, happy that my private parts are just that again. Recovery takes six to eight weeks, I learn, during which time you're not allowed to have sex and cannot take baths. In addition to bleeding and infection, dangers associated with any surgery, the main risks are the creation of a hole between the vagina and rectum and popped stitches, both of which can be mended relatively easily.

"Do you have any questions?" Blatt asks in closing.

"Yes. Why do most women come to you?"

"Vaginal tightenings are generally -- not always, but usually -- done for women who've had kids and feel loose. Others say they've always felt loose and don't feel friction during sex. As far as the labia ... some do it for purely cosmetic reasons, while others say their labia are irritated by clothing or exercise. I'm going to send someone in with some literature now that might help."

Moments later, a middle-aged lady with a black bob in a white lab coat bounces toward me wielding pamphlets. She hugs me then steps back.

"You like my doctor? I love this man," she begins, eyes hypnotizingly wide.

"Have you had it done?"

She confesses that she hasn't, but not before reassuring, "I don't have one dissatisfied lady." Continuing, "This is a life changing surgery. You're saying boyfriend now? After this he's going to marry you. I'm telling you, my love. I'm telling you."

Blatt's hype woman escorts me on a tour of the facilities before wishing me well.

On the way home I think about my vagina. Sure, tighter and trimmer is appealing. But I laugh aloud at the prospect of literally squeezing a ring out of my boyfriend. And I can't justify spending ten grand on an operation that wouldn't even grant me more attention on a daily basis, as a boob job or Botox injections might.

Later, a Google search leads me to several message board threads about vaginal surgery. Sarah B was 22 when she worried that hormonal changes had warped her vagina, but only decided to get a labiaplasty after a lover declared, "your vagina is screaming at me." One wise commentor replied that a person who doesn't appreciate the way you look, smell, and taste simply isn't right for you. Another points to the fact that the women choosing these surgeries are adults capable of rational decision making as opposed to all the male infants out there who were circumcised without eliciting much controversy. Some believe surgery renders women too childlike, while others proclaim that women should do whatever it takes to attract men since "that's the natural way." As outlandish as this last point seems, sex is, arguably, about pleasing one's partner.

What is most striking, however, in the dialogue on this topic is the obvious confusion among women about what they should or should not look like. The pronouncements of self-loathing and embarrassment over genital appearance are widespread, reinforcing my growing sense that we're failing to educate. If we feel more vulnerable to our insecurities after viewing pornography, it's probably because no one has filled our vaginal diversity knowledge gap.

Luckily, the very World Wide Web that hosts all that porn also bestows us with Show Your Vagina, a Tumblr I chance upon while researching. Launched in September 2010, the site encourages women to post anonymous photos of their vaginas. Though shocking at first, the disparities are fixating, and I feel a whiff of empowerment for every female participant while browsing. It seems wrong not to upload my own spread eagle portrait.

Show Your Vagina is an overwhelmingly simple concept that highlights the importance of sharing and openness in combating body-related shame. Unfortunately, we can't rely upon our frighteningly remedial sex-ed programs. Nor can we rely upon popular women's magazines. When I naively pitched this piece to one such glossy, I was told: "Our EIC probably wouldn't take well to an idea that so prominently involves the word 'vagina.'" Exactly.


This article available online at:

http://www.theatlantic.com/health/archive/2012/04/designer-parts-inside-the-strange-fascinating-world-of-vaginoplasty/255188/