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2012-07-24 05:47:38
By Melissa Hogenboom BBC News
The film called Centrefold, funded by the Wellcome Trust, features three women
discussing how labiaplasty - the surgical reduction of the inner labia - has
affected them.
Last year more than 2000 labiaplasties were carried out on the NHS, and in the
last five years there has been a fivefold increase.
Experts believe the total number is likely to be much higher when considering
the unregulated private sector, where the surgery costs upwards of 3,000.
Despite the increase in labiaplasty there are no universal NHS guidelines on
the size and shape of normal female genitalia.
Start Quote
I thought it was going to be the end of all my problems - I thought it was
going to look lovely, like a little designer vagina
Emma
Researchers say there is little known about the long term effects and are
concerned women are not receiving enough psychological support before opting
for surgery.
Anxiety dreams
Jessie said she used to spend hours flicking through magazines looking for
women with a similar labia to hers. She did not find any.
She said it was "another piece of evidence that there was something wrong with
me" and made her feel like a "complete freak".
She experienced recurring dreams where she would imagine her labia as a scarf
that would wrap itself around her neck. "There would be people standing around
laughing and pointing."
"Shortly after the operation I would dream that they would grow back and I'd
wake up in a bit of a panic."
A year on, her dreams no longer occur. She said she feels "really silly talking
about it", but it was significant enough to cause her daily anxiety.
Labiaplasty on the NHS
Many NHS trusts consider the surgery a low clinical priority procedure and will
not routinely fund it.
Bristol, North Somerset and South Gloucestershire PCTs say requests will only
be considered:
Where the labia are directly contributing to recurrent infection
Where repair of the labia is required after trauma
NHS Plymouth makes special consideration to patients who demonstrate that they
are "significantly different to the general population of patients with the
condition in question".
Source: NHS
BBC Health: Cosmetic surgery on the NHS
Emma also thought her genital area was abnormal. She said before her surgery
her labia was "very long, dark, stretchy. It looked disgusting - shrivelled
up".
"It was the only thing in my life that made me feel depressed. I was very
excited about having labiaplasty. I thought it was going to be the end of all
my problems. I thought it was going to look lovely, like a little designer
vagina."
Though it is now smaller, Emma is still unhappy with her labia's appearance.
Women seeking labiaplasty need more opportunity to discuss their concerns, said
Dr Lih-Mei Liao, a consultant clinical psychologist at University College
London Hospitals.
"Worries about the labia are quintessentially psychological. When a woman says
she is worried about her labia, surgeons may hear the word 'labia' and operate,
I hear the word 'worry'.
"It's difficult when surgery is being advertised as a straight forward
solution. It makes it hard for these women to engage psychologically with
what's going on."
She added that psychologists "simply aren't being accessed as surgery is being
presented as the obvious solution".
Still from the film Centrefold Jessie imagined her labia as a scarf around her
neck - pictured here in a still from the film Centrefold
Grooming trends
The British Association of Aesthetic Plastic Surgeons is calling for mandatory
psychological screening before cosmetic surgery. It said a recent report found
that routine psychological checks were carried out in less than 35% of clinics.
Dr Liao believes that a woman's anxiety or dissatisfaction with certain areas
of her life may manifest itself as body image concerns.
"Surgery may have its place, but it needs to be seen as an extreme solution,"
she added.
Consultant gynaecologist Dr Sarah Creighton said her clinic sees girls as young
as 11 years old seeking surgery.
She found that although a small percentage of women do have abnormal labia, in
the majority of cases those with concerns had what she would consider a normal
sized labia.
The trend for more extreme pubic grooming leaves the labia more exposed -
something which has contributed to more women seeking surgery, said Dr
Creighton.
"What we should be doing... is looking at alternatives to surgery so that women
have other options, rather than resorting to an operation about which we know
very little," she said.
The names of the women featured have been changed as they wish to remain
anonymous.