Why Few Women Are Pleased with the Results of Labiaplasty

Few people of any gender consider the inner vaginal lips (labia minora) attractive, especially if they’re at all asymmetrical, fluted, wrinkly, folded, protruding, or different in color from surrounding skin. That’s why every year some 10,000 U.S. women undergo labiaplasty, a cosmetic surgery that minimizes or hides the inner lips to make them appear more “normal” or “ideal.” But according to a recent study by Canadian researchers, after labiaplasty, people of all genders say the inner lips look only slightly better—and are still unattractive. Which raises the question: Is labiaplasty worth it?

“Overall Perceptions Were Quite Negative”

Psychologists at Kwantlen Polytechnic University in British Columbia used Facebook, Reddit, and other websites to recruit 4,513 people, age 16 to 85. Somewhat more than half (56 percent) were women. Four of 10 (42 percent) were men. And 3 percent were other/nonbinary/queer. Participants viewed close-up photographs of eight white women’s shaved vulvas before and after labiaplasty, 16 images total. The researchers asked three questions:

• How normal does this vulva look?
• How well does this vulva represent the societal ideal?
• How well does this vulva represent your personal ideal?

After labiaplasty, viewers of all genders rated the vulvas slightly more attractive, and slightly closer to cultural and personal ideals. However, the researchers observed, “Overall perceptions of the labia—regardless of participant gender or labiaplasty—were quite negative.”

Why So Many Consider Vulvas Unattractive

• History. In many cultures going back centuries, slang terms for the vulva call the area dirty, ugly, and shameful. Historically, protruding inner lips have been deemed deviant, deformed, a marker of promiscuity, and, in non-whites, a sign of racial inferiority.
• Symmetry. A robust research literature shows that people of all races, genders, and cultures consider faces most attractive when they appear left-right symmetrical. Evidently, the same is true for vulvas: When the inner lips are asymmetrical or when one side is larger or looks different, people judge those vulvas less attractive.
• Pubic grooming. Before 1990, few women altered their pubic hair. But since then, pubic hair removal (“grooming”) has become increasingly popular. Today, 85 percent of women trim their pubic hair or shave away some or all of it. Pubic grooming makes the vulva more visible—and highlights perceived imperfections such as large, asymmetrical, and/or protruding inner lips.
• The medical profession. Some women visit plastic surgeons bearing screenshots of internet porn pages, saying, “I want to look like that.” Others whose inner lips protrude or look asymmetrical tell plastic surgeons they feel abnormal or deformed. Unfortunately, many plastic surgeons are quick to agree, diagnosing “enlarged” inner labia. They’ve even coined a term for it, “labial hypertrophy.” When women hear that, many become convinced their labia look abnormal. These days, plastic surgeons perform 10,000 labiaplasties annually. That’s far fewer than nose jobs (215,000) or breast augmentations (300,000). However, labiaplasty ranks among the fastest-growing cosmetic surgical procedures.

Feminists have railed against the many ways our culture bashes women’s bodies, and the activism has had an impact. Since 2014, for example, Barbie doll sales have plummeted. In addition, several photographers and artists have created works celebrating the natural diversity of vulvas. Works include the photo books Femalia by Joni Blank and Petals by Nick Karras. Illustrator Hilde Atalanta has collected hundreds of drawings in her work, “The Vulva Gallery.” And “The Great Wall of Vaginas” by artist Jamie McCartney has displayed plaster casts of 400 vulvas at many galleries and museums.

But despite the efforts to normalize natural genital diversity, many women continue to contact plastic surgeons, complaining that their “abnormal” inner lips have contributed to low self-esteem, reluctance to visit gynecologists appropriately, and loss of sexual desire, pleasure, and satisfaction.

Labia and Labiaplasty: What You Need to Know

Many women are in the dark about the appearance of the inner labia. The truth is that there is no “normal” or “ideal” look. Every woman’s labia are uniquely her own. Some tuck under the outer vaginal lips and are hardly visible, while others protrude slightly or a good deal—up to several inches. And almost all inner-lip presentations are normal.

• Inner lips vary considerably in color from lighter than surrounding tissue to much darker. That’s normal.
• Some inner lips appear smooth like babies' skin. Others appear folded, fluted, or wrinkly. All normal.
• Labiaplasty typically costs $4,000 to $6,000. Unless it’s prescribed for reconstruction after cancer surgery, health insurers don’t cover it.
• As the new study shows, after labiaplasty, you—and others—are unlikely to see much benefit.
• After labiaplasty, it takes around two weeks to return to preoperative levels of energy and activities, and six-to-eight weeks to return to comfortable sexual play involving the vulva or vagina.
• Labiaplasty's most common side effect is increased vaginal dryness, which may become chronic. Lubricants usually resolve this, but not always. Loss of vulvar erotic sensitivity is rare but possible.

We need a new labial esthetic. Think long and hard before opting for labiaplasty.