The Short of It
When I was growing up, the go-to plastic surgery for teens was a nose job. Today it's ... labiaplasty.
So many teenagers are seeking cosmetic surgery to trim or shape their labia that the American College of Obstetricians and Gynecologists issued guidelines to doctors last week, urging them to educate prospective patients, suggest alternatives to surgery, and screen for body dysmorphic disorder.
According to the American Society for Aesthetic Plastic Surgery, 400 girls ages 18 and younger had labiaplasty last year, which is an 80 percent increase from 2014.
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The procedure, sometimes coined "vaginal rejuvenation," is usually geared toward older women and women who have given birth, so what's behind the teenage trend?
"Adolescents, under the influence of pubertal hormones, undergo rapid transformation and growth of their breasts and genital tissues," the ACOG committee ventured in the guidelines. "At the time of puberty, the labia minora enlarge and grow to adult size. The normal labia minora can have marked variation in size, shape, and appearance."
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Some girls actually feel physical discomfort from the rapid changes, but most of the requests for surgery are for cosmetic reasons. ACOG says while asymmetry is common, it can lead a teen girl to question whether her body is normal and to express occasional dissatisfaction with her body's appearance, shape and size. Add to that the fact that many young girls now shave and wax their pubic hair, leaving the genital area bare, and then go online and compare themselves to the symmetrical—and often airbrushed—images they see online, it's not hard to understand how they can come away thinking their own body is somehow "flawed."
Because the guidelines did not rule out labiplasty for teens, the committee says it's important for OB-GYNs to know how to counsel and assess their patient's physical maturity and emotional readiness before surgical referral. They also suggest offering nonsurgical alternatives to alleviate discomfort, including supportive garments, arrangement of the labia minora during exercise, and use of form-fitting clothing. If emotional discomfort or symptoms still persist, then surgical correction can be considered.
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"It should not be entertained until growth and development is complete," Dr. Julie Strickland, the chairwoman of ACOG's committee on adolescent health care, told The New York Times, adding that even then, there are a lot of unknowns. "The labia have a lot of nerve endings in them, so there could be diminishment of sexual sensation after surgery, or numbness, or pain, or scarring."
Would you let your teen trim her labia minora for cosmetic reasons or to relieve discomfort? It's certainly a lot to think about.