Female genital cosmetic surgery

Introduction

Female Genital Cosmetic Surgery (FGCS) refers to non-medically indicated cosmetic surgical procedures that change the structure and appearance of the healthy external genitalia of women, or internally in the case of vaginal tightening. This definition includes the most common procedure, labiaplasty, as well as others, such as hymenoplasty and vaginoplasty, also known as vaginal reconstruction and vaginal rejuvenation.1,2

According to figures from Medicare, the number of women undergoing medicare-billed vulvoplasty or labiaplasty in Australia has increased from 640 in 2001 to more than 1500 in 2013, an increase of 140%.3 The highest number of claims was equally distributed between three age groups: 15–24, 25–34 and 35–44. However, these numbers do not reflect the whole picture as many may seek FGCS through the private health system without necessarily claiming a rebate or may not meet the criteria for this item number.4

There has been no concomitant rise in the incidence of congenital or acquired disease conditions that warrant this surgery.4 Rather, it appears that in response to changing cultural norms, this surgery is increasingly being sought by women who want to either feel ‘normal’ or look ‘desirable’.2 As a result, general practitioners (GPs) are increasingly managing patients who present seeking surgery due to concerns about the appearance of their genitalia.5

Labiaplasty is the most common form of FGCS requested and performed, accounting for around 50% of the procedures performed.4,5 The terms labiaplasty and FGCS will be used interchangeably throughout this document unless otherwise specified.

This guide aims to help inform GPs and health professionals about FGCS, including the factors influencing demand, and provide a set of recommendations on how to manage women requesting referral for FGCS or expressing concern regarding their genitalia.

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