Understanding its popularity and potential risks

In the opening episode of the second season of the Netflix show Fabulous Lives of Bollywood Wives, Maheep Kapoor, Seema Khan, Neelam Kothari Soni and Bhavana Pandey visit a gynaecolog to understand the many facets of menopause. During the course of the conversation, Bhavana asks the expert about women losing interest in sex as they age, to which the doctor responds talking about the growing interest in ‘designer vagina’.
“So many of my patients come for vaginal tightening when they feel their vaginas have become too loose. I don’t agree with designer vaginas, at all,” says Dr Kiran Coelho, gynaecolog and laparoscopic surgeon.
But, what exactly is a designer vagina? It is a fancy term for ‘labiaplasty’, which is “a surgical procedure that reduces the size of the labia minora, which are the flaps of skin that are located on either side of the vaginal opening,” Dr Swati Chitnis, Obstetrician and Gynaecolog, Shal Hospitals, Ahmedabad said. “The operation is performed to enhance the appearance of your labia and to alleviate physical discomfort removing the labial tissue to reduce its size.”
Elucidating, Dr Mayur Shetty, Consultant Plastic Surgery, Narayana Health City, explained that due to factors such as childbirth and ageing, the labia becomes patulous and lax. “In labiaplasty, the size of the labia is reduced and along with this, we may also rejuvenate the surrounding area with fat grafting.”
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According to a 2017 study released the International Society of Aesthetic Plastic Surgery (ISAPS), there’s a significant growth in the number of labiaplasty surgery worldwide. “Worldwide, the number of labiaplasties performed in 2019 reached 164,667, which corresponded to a 24.1 per cent increase compared to 2018 and a 73.3 per cent rise compared to 2015. Labiaplasty was the 15th most popular plastic surgery procedure among female patients for 2019,” another study, published in the International Journal of Impotence Research, stated.
Why is it done?
With this ever-increasing trend of labiaplasty or ‘designer vagina’ worldwide, it’s crucial to delve into a rather complicated question — why do women get labiaplasty done? From pornography and increasing sexual pleasure to certain medical conditions, several factors contribute to its popularity, with cosmetic reasons being at the heart of it, experts pointed out.
“People get it done so that their vaginas to look aesthetic, and it also gives more sexual intimacy,” Dr Vanaja Shivkumar, Consultant – Obstetrician and Gynecolog, Reproductive Medicine, Milann Hospitals said. Dr Shetty added that it is “usually done in women who desire to undergo genital rejuvenation to reverse the changes in labia as a result of multiple pregnancies or because of the process of ageing”.
The risks associated with labiaplasty vary from patient to patient, experts say (Source: Getty Images/Thinkstock)
In her book titled Body, Migration, Re/constructive Surgeries: Making the Gendered Body in a Globalized World, professor Ruth Holliday put forward Virginia Braun’s argument that pornography presents only one kind of vagina: a small, hairless vagina that is neatly tucked within the labia majora. This, according to her, results in “an incredibly high proportion of women [who] dislike their genitalia enough to have considered surgery as an option”.
However, for many others, the growing trend can be attributed to increasing awareness of women’s body parts. “For many generations, vaginal health has been considered taboo, and procedures and options for care for female genitalia weren’t available,” Dr Juliana Hansen, MD, professor of surgery and division chief of plastic and reconstructive surgery at Oregon Health and Science University School of Medicine, had earlier told Women’s Health magazine.
Dr Chitnis added that “the procedure is becoming increasingly popular among women as a means of improving their sexual well-being, their appearance, and in some cases, their health”. Talking about health — is labiaplasty or ‘designer vagina’ medically necessary?
“It is often done for persons with labia hypertrophy (an overgrowth of the skin due to high testosterone), some congenital problems, and chronic urinary infections,” she explained, adding that many women with excess skin opt for it as that skin, which is prone to chafing and twing, “can be a source of discomfort during activities such as sports, athletic activities, and intimate encounters”.

“It is medically indicated in women who struggle with dryness and poor sexual gratification because of the patulous labia,” Dr Shetty added.
The peaking popularity of ‘designer vagina’ in 2022, however, is pinned on another reason. Wondering what is it? The sharp increase in designer vaginal procedures is due to tight leggings and activewear, according to renowned plastic surgeon Dr John Skevofilax.
“Exercise clothing is a little bit tighter and it’s form-fitting so it does put pressure on the area,” he told MailOnline. “They experience pain, discomfort in general, chafing, a lot of women actually will feel so uncomfortable that they avoid trying to wear this type of clothing. It’s all really interlinked, choosing a pair of leggings which causes discomfort and which in turn draws attention to the labia and the need for surgery.”
Earlier, in 2015, plastic surgeon Dr Richard Swift had told The Post that “the ubiquitous yoga pants that everyone is wearing are playing a big part in this trend”.
Potential risks
The risks associated with labiaplasty vary from patient to patient, experts say. “Infection and anaesthesia-related complications” are possible side effects, according to Dr Shivkumar. Some other risks include vaginal sensitivity and excessive scarring, Dr Chitnis added.
For a period of 6-12 weeks after the surgery, use sanitary towels in place of tampons and refrain from sexual activity (Source: Getty Images/Thinkstock)
Additionally, the experts advised certain people to avoid opting for a ‘designer vagina’. “Due to the fact that the labia continues to develop well into early adulthood, it is not recommended for girls under the age of 18 to undergo the procedure,” Dr Chitnis said. Dr Shivkumar added that patients with implants in the body, suffering from cardiac issues or having uncontrolled diabetes should avoid getting it done.
It is also not favourable for habitual smokers. “Even if they do, complete cessation of smoking 4 weeks before and after the procedure is a must,” Dr Shetty said.
With respect to psychological well-being, it is found a small study, published in PubMed.gov, that while ‘designer vagina’ seems to have a positive effect on women’s genital appearance satisfaction, the same can’t be said about their mental well-being or intimate relationship quality. “Medical professionals should be mindful of patients with greater psychological dress, as this may compromise satisfaction with surgical outcomes,” it noted.

What you should know before opting for labiaplasty
If you are someone who has made up her mind to get a ‘designer vagina’, here are some things that you must know, according to Dr Chitnis.
*The entire process usually takes between two and three hours.*If you’re considering having labiaplasty done, make sure to inquire about the surgeon’s experience and training.*Wound dehiscence and hematoma are common postoperative complications which need evaluation but re-surgery is rarely needed.*Being a cosmetic procedure, it may take several weeks for the final result and revision surgery may be needed
It “is a safe, daycare procedure and takes about 15 to 20 days to recover. The return to normal activities is immediate and the effects are seen over a period of 4- 6 weeks,” Dr Shetty added.
Before and aftercare tips
Before the surgery, it is important to tell your doctor about any pre-exing condition or if you are on any medications. After the procedure,” abstinence from intercourse for a period of 15 days is an absolute must. Aftercare only involves keeping the area clean and dry,” according to Dr Shetty.
Dr Chitnis concluded saying that after the surgery, it is important to avoid getting an infection keeping the area clean and comfortable. “For a period of 6-12 weeks, use sanitary towels in place of tampons and refrain from sexual activity. Pain, bruises, and swelling are all common reactions to labiaplasty. It could hurt to urinate or sit down. The surgeon may recommend pain medication to help with the discomfort.”
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