Professional concerns about female genital cosmetic surgery (FGCS) are evident in a number of recent publications. Critiques have come from diverse positions including:
the provision of medically unrecognisable procedures;1
professional laissez-faire relating to audits of adverse events and clinical outcomes;2
absence of scientific evidence;1,2
extension of medicalisation of sex and sexuality;3
commercial exploitation of women and girls;1,3
operations being offered to children;4 and
rebound of the cosmetic surgery industry in the private sector on NHS resources.4
In the UK, women and girls are most likely to first present concerns about their genitalia to their GP. Their complaints are likely to fall into two broad categories: physical and psychological. Physical complaints may include discomfort, pain, rubbing, and chaffing during activities such as cycling and horse riding. Psychological complaints may include embarrassment as a result of the labia minora protruding beyond the labia majora, and attendant restrictions on lifestyle choices (for example, concerns about not being able to wear tight clothes or take public showers or engage in certain sexual activities). Reduction of the labia minora is the most likely first line FGCS procedure.
TYPES OF PROCEDURES
Labia reduction procedures fall broadly into two categories. The labial ‘trim’, where a strip of the labia is cut off, is usually performed by gynaecologists. The ‘wedge resection’, which is a more complex procedure involving cutting away a section of each labia minora, is usually carried out by plastic surgeons. The procedures have not been evaluated comparatively, but it is generally assumed that the latter is more likely to result in superior cosmesis, though it may also …