Very young women are going under the knife to sculpt parts that are still growing and changing.

By Kali Holloway / AlterNet

Never underestimate the power of beauty myths to manufacture inadequacies where before there were none. A little over a decade ago, labiaplasty—the partial or wholesale removal of parts of the labia minora, aka the inner vaginal lips—was a relatively obscure plastic surgery, compared with nips, tucks and lifts to various other parts. In more recent years, the number of women opting for the surgery has grown exponentially. Now very young women—girls still in their teens—are requesting the procedure in numbers growing so quickly that even some practitioners are concerned.

The American College of Obstetricians and Gynecologists has met increased labiaplasty demand among adolescents with a set of recommendations for doctors, most of which are aimed at forestalling the surgery. The organization’s Committee on Adolescent Health Care suggests clinicians treating teen patients “should have good working knowledge of nonsurgical alternatives”; provide “education and reassurance regarding normal variation in anatomy, growth, and development”; offer “patient counseling and assessment of the adolescent’s physical maturity and emotional readiness” before any surgical intervention is undertaken; and respond to any indications of “body dysmorphic disorder,” with a referral to a mental health provider.

That ACOG—which unequivocally stated its disapproval regarding cosmetic vaginal procedures back in 2007—felt the need to issue another opinion focused on teens requesting the surgery is a testament to how many girls are looking to get the operation. The American Society for Aesthetic Plastic Surgery reportsthat across age groups, the number of labiaplasties increased 49 percent from 2013 to 2014. (From 2012 to 2013, there was a 44 percent increase, another impressive year of growth.) A recent New York Times piece notes that 400 girls 18 and younger underwent labiaplasties in 2015, an 80 percent increase over the year prior. That figure likely only provides half the story, considering that it omits surgeries performed by gynecologists, who perform the lion’s share of labiaplasties. The Times also notes that while adolescent girls comprise just 2 percent of those who go under the knife for cosmetic purposes in general, they make up 5 percent of labiaplasty patients.

Vaginas, most reputable doctors (and parents, ahem) will tell you, come in all sorts of varieties. With the exception of congenital deformities, which are fairly rare, labia majora and minora differ wildly, a condition that used to be perfectly acceptable. As the Times notes, vaginal rejuvenation—an umbrella term for surgeries that can include “vaginal tightening, perineoplasty (focused on the skin between the vagina and the anus), reduction of the clitoral hood, laser vaginal bleaching, and injections to increase the size and sensitivity of the g-spot”—were mostly favored by women who felt that age and children called for a vulva tuneup of sorts. For teens, labiaplasty seems to come down to aesthetics.

“One theory is that girls these days are seeing images of ‘idealized’ bodies,” Julie Strickland, chair of ACOG’s Adolescent Health Care Committee tells WebMD. “There have also been cultural changes, with more girls grooming their pubic hair. That may make them more self-conscious about the appearance of their genitals.”

In other words, for a generation raised with unobstructed, fully waxed views of Photoshopped vaginas easily accessed via any laptop, there may now be the idea of a standardized, societally approved, one-size-fits-all vagina.

As you might guess, the increase in teen requests for labiaplasty is troubling for lots of reasons. Few accrediting bodies, such as ACOG and the American Board of Obstetrics and Gynecology, recognize cosmetic gynecology as a legitimate area of practice, which means that there are few required training programs. Not every doctor is a surgeon, and with the large number of gynecologists who undertake vaginal rejuvenation, mishaps are not all that uncommon. (In fact, there is a thriving subspecialty of labiaplasty correction and revision, which,yikes.) While an idealized designer vagina might be a best-case outcome, it hardly seems worth risking future sexual gratification, which can be affected by the surgery.

“The big thing I tell patients about labiaplasty is that there are a lot of unknowns,” Strickland told the Times. “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.”

Unlike fully adult women who choose to have their bits sculpted, teen girls, as ACOG notes, are “under the influence of pubertal hormones” and their parts are still changing all the time. That’s why, as Dr. Strickland noted to the Times, labiaplasty “should not be entertained until growth and development is complete.”

It’s inevitable that our increasingly plastic—or silicone—culture will trickle down to kids. The American Society of Plastic Surgeons estimates that since 2000, the number of cosmetic surgeries overall has increased an astounding 115 percent. The Washington Post cites statistics indicating there were “15.9 million surgical and minimally invasive cosmetic procedures” (think Botox and the like) performed in 2015. That means one in 16 people had something done to get a little closer to their idea of perfection. (Here, I feel the need to quote ASPS, which dubbed 2015 “the year of the rear” and states that “there was a buttock procedure every 30 minutes of every day, on average.” Just FYI.)

Teenagers receive the messages they’re sent via glossy, frothy media loud and clear. Imperfection is a choice; your best self is just one or two, or three invasive surgeries away.

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