Demand for female genital cosmetic surgery – so-called "designer vaginas" – has risen five-fold in a decade on the NHS yet most women do not need it, researchers have found.
Surgeons who treat women when there is no clinical need practise a type of female genital mutilation outlawed in the UK, the researchers say.
The rise in women seeking the operation, which involves reducing the size of the labia at the entrance to the vagina, is being driven by pornographic images of women on the internet and TV programmes about cosmetic surgery, which have increased awareness of the genital area among women.
The first study of 33 women seeking the operation, whose average age was 23, found they all had normal-sized labia. Only three had a significant assymetry for which surgery would be appropriate. But 40 per cent of them still wanted the operation, mostly because they wanted to make their labia smaller "to improve appearance". More than 2,000 operations were performed on women on the NHS last year. Thousands more are thought to have been performed privately.
Sarah Creighton, of the Elizabeth Garret Anderson Hospital, London, led the study published in the British Journal of Obstetrics and Gynaecology. She said that without evidence of clinical need, there was nothing to distinguish the practice from the genital cutting practised in other cultures, which is outlawed in Britain. She said: "It has not been tested [legally] and no one has been taken to court. But the question is whether it is being done for non-medical purposes. I think it is.
"In that case, it is difficult to see how it is anything other than cultural. Surgeons will say the woman was upset, couldn't wear jeans, or ride a bike, or have sex because she complained of being uncomfortable. But no one has said surgery will change that."
Women were "bombarded with images suggesting they were not normal", including websites advertising female genital cosmetic surgery which presented idealised images of the perfect vagina, she said. Children as young as 11 had been referred by their GPs. Yet genitalia continue to develop through adolescence and any initial asymmetry may become more symmetrical over time.
Some studies have suggested that surgery may reduce sensitivity, which could affect sexual function. Oestrogen receptors have recently been discovered at the edge of the labia which would be removed by surgery.
The researchers criticised professional bodies, including the Royal College of Obstetricians and Gynaecologists, for failing to issue guidance on when it is appropriate to offer treatment to women.
... while men opt for fake 'six-packs'
The latest cosmetic surgery to get public attention (or at least that of Celebrity Big Brother watchers) is a fake "six-pack".
Displayed with questionable pride by contestant Darryn Lyons – who invests in the firm that does the treatment, the effect is created by producing grooves in overlying chest fat using liposuction, to replicate the tendons inside muscle.
Consultant plastic surgeon Kevin Hancock told The Independent: "It's not going to be firm like a normal six-pack, it's just going to be soft like normal fat. It is an illusion and one wonders what will happen to it as time goes by. It may last his celebrity, assuming that it won't be terribly long."