The new frontier in cosmetic surgery heads down under, with more Perth women seeking an intimate makeover than ever before.
In the waiting room at Academy Laser Clinics I hear fragments of conversation between two women. Listening in on their note-swap about a newfangled laser treatment that has "brightened and tightened" their vaginas, I hear one woman say she has noticed better lubrication, so she's enjoying sex and bike-riding way more. The other says it has positively affected her state of mind, and boosted her libido (which, if my eavesdropping is correct, her hubby is pretty stoked about, too).
When I quiz facial plastic surgeon and laser specialist Dr Jayson Oates about the so-called MonaLisa Touch laser treatment he is offering, he paints a pretty fabulous picture of what it's achieving for his patients. This laser is the most recent advancement in what has become a hot topic in cosmetic enhancement – yes, the vajay-jay is gaining notoriety.
Statistics from the American Society for Aesthetic Plastic Surgery (ASAPS) say vaginal rejuvenation – for both cosmetic and functional reasons – grew 64 per cent between 2011 and 2012. We could blame the prevalence of Brazilian waxing, whereby we have achieved a much clearer idea of what things look like down below. Or perhaps the mainstreaming of porn, which has normalised an industry standard on what bits 'should' look like.
Or, if you believe New York City plastic surgeon Dr Norman Rowe, Lycra has a lot
to do with it. "Lululemon has played a huge role in the increase in labiaplasty in the US," he told The Daily Beast. "I can't tell you how many women come to me worried about how they look at the gym."
Whatever the case, where once these procedures were kept under wraps, they are now discussed openly over coffee, at school drop-off, and all over the media.
"TV makeover and medical programs have removed some of the stigma previously associated with surgical procedures like these," says Dr Mark Hanikeri, specialist plastic surgeon at Assure Cosmetic Centre. "The internet has exposed a lot of younger people to visual images of female genitalia, and some see themselves as being 'abnormal' when compared to the soft-porn images they see online."
After her second child, reality television star Brandi Glanville of The Real Housewives of Beverly Hills knew her lower love land wouldn't be the same. She devoted a whole chapter to vaginal rejuvenation surgery in her book Drinking & Tweeting and Other Brandi Blunders. "I had two children vaginally, and I chose [surgery] for functionality, not to make anything pretty. But I was also going out into the world a forty-year-old single mother, and I wanted to be secure in everything I had going on."
There is a delicate interplay between form and function in female genital surgery, which encompasses a wide range of procedures, some of which are done in the name of vanity and others for health and wellbeing.
Today's options go beyond the well-known 'yummy mummy makeover' vaginoplasty procedure, which aims to tighten the vaginal muscles via suturing and reconstructing what has become slack or loose from childbirth or ageing. This procedure may also be required due to side effects of serious medical situations such vulvar cancer. While some surgeons claim it can improve sensitivity, it is a claim the American College of Obstetricians and Gynecologists (ACOG) has challenged.
More recently, down-under rejuvenation has ventured into the realms of 'designer vaginas'. Yes, perhaps it is just another element of our bodies we have become hung-up about, but then our lady parts are so often caught up in perceptions of beauty, self-esteem and confidence that fixing bits we're unhappy with may just be a natural progression (especially now we have become so free and easy with nose jobs, boobs lifts, and liposuction of love handles).
Labiaplasty, currently the most common aesthetic gynecological surgical procedure, involves reducing and/or reshaping of the labia minora (inner lips) until – as Goldilocks would say – they're just right. Perhaps they're too large, too asymmetrical, too long for comfortable sex or tight clothing, or too changed by the birth process.
"It can cause embarrassment with peers at school or the gym, but it is also an issue when bicycle riding or in certain occupations, such as manual workers requiring to sit or crouch," Dr Hanikeri says. "For some, it is also a source of embarrassment with sexual partners, while some people perceive large labia minora as being associated with sexual promiscuity."
Dr Hanikeri says he has never had a patient unhappy with this procedure. "I have not yet had anyone say they weren't pleased with the result," he says. "Patients have ranged from teenagers still in school who come in with their mothers, to women in their 30s who have issues in the gym or in their occupation."
Women are also having the labia majora (outer lips) trimmed (majoraplasty) or fattened up with injectables for a more exuberant look. "The labia majora is a bit like the face, it needs skin removal and tightening (like a face lift), or plumping with fillers, or shrinking with laser resurfacing," says Dr Oates. "With ageing, there is frequently loss of fat from the labia majora and the quality of the skin also alters. They also vary in colour from one woman to another, and these changes and variations over time, and from person to person, are normal."
Dr Oates offers two main options for volume replacement – fat transfer or cosmetic fillers. "Fat is great because it is natural and may be permanent, but it can be variable, and much can disappear in some women," he says. "Hyaluronic acid fillers are the main fillers used, which are temporary but they are readily available and make it a quick and simple procedure."
G-spot amplification is a more divisive topic. Much like the Loch Ness Monster, the G-spot has been the subject of various scientific papers, which have claimed to conclusively prove or disprove its existence.
"For some women it is a definite sensitive spot, for others it is a mystery," says Dr Oates. The G-spot amplification procedure involves injecting hyaluronic acid into the front wall of the vagina, to make it protrude in order to receive more stimulation.
"You will be positioned on your back, like when you are having your Pap smear
then, using a speculum, a fine needle is used to inject a hyaluronic acid filler, which usually lasts six months," says Dr Oates. "The whole G-spot augmentation procedure takes fifteen minutes."
More downright controversial procedures include 'revirgination' by hymenoplasty,
which repairs the hymen to mimic its original state. Clitoral unhooding, not dissimilar to male circumcision, removes the tissue that normally covers the clitoris, for heightened sensitivity. Dr Red Alinsod, who runs the South Coast Urogynecology Center in California, calls the look where no labia are present at all 'the Full Barbie'.
Laser technology, replacing the traditional scalpel for vaginal rejuvenation and other vaginal surgeries, is putting an infinitely more appealing offer on the operating table.
"The key benefits of the MonaLisa Touch are that it's suitable for almost all women," Dr Oates says. "In addition, it is painless, low risk, with little or no side effects, and achieves long-lasting improvements with no downtime."
For women wanting some change in appearance, but not surgery, Dr Oates uses the laser to shrink the labia. "Using lots of tiny dots of laser energy causes tightening of the skin, and also lightening of the skin colour of the vulva," he says.
Like all other organs in our bodies, Dr Oates says the female genitals are not immune to the effects of time. "Especially during menopause, the genital tract is particularly affected by declining oestrogen production," he says. "Almost 50 per cent of postmenopausal women complain about the typical symptoms of genital atrophy interfering heavily with their sexual experience and quality of life."
He says relatively young and socially active women are also turning to specialists
because prolonged use of progesterone-dominant oral contraceptive pills, or breast feeding can create an issue. MonaLisa Touch has also been found to be particularly helpful for women who have had cancer, and those who are unable to take hormone-replacement therapies.
"We have a wide range of patients who come in for treatment, from women in their mid-thirties who are experiencing some laxity after childbirth, to women in their fifties and sixties who are wanting to treat dryness caused by hormonal changes post-menopause," says Dr Glenn Murray, cosmetic doctor at Absolute Cosmetic Medicine. "Our patients have reported an increase in tissue tightness, better lubrication, and an overall rejuvenation of the area. A number of patients have reported that they are now able to enjoy intercourse with their partners again after many years of pain and discomfort."
Within the vagina, the MonaLisa Touch treatment uses hundreds of tiny pillars of laser energy to stimulate the natural regeneration of the tissue. "In as little as thirty days after treatment, the regeneration of new tissue in the vaginal walls builds a naturally stronger structure, and the protective mucosa recovers volume, hydration and elasticity," says Dr Oates. "MonaLisa Touch is the most frequent vaginal rejuvenation procedure we're doing, at about ten treatments a week, but we expect that to become much more."
Dr Murray says the MonaLisa Touch is a quick treatment, taking only about five minutes. "For best results, it is suggested that patients have a series of three treatments spaced four to six weeks apart, with costs starting from around $1000 for one treatment, or $2500 for a package of three," he says. "Most patients will notice a difference after their first treatment, once the area has had time to heal and rejuvenate."
Dr Gina Messiha of Perth Skin & Laser Clinic says, in addition to prolapse, many women have issues with incontinence due to weak vaginal wall support, which she treats with Erbium YAG laser modalities – IncontiLase and IntimaLase.
"Both conditions have extreme social and emotional impact on women – from avoiding enjoyable activities and continuous fear of public embarrassment, to more intimate implications like lack of sexual satisfaction and its consequences on relationships," says Dr Messiha.
"In the past, treatment was limited to conservative options like physiotherapy and topical oestrogen replacement therapy, to more invasive surgical options like bladder lift and vaginal-wall repair," she says. "Now we have effective non-invasive laser therapy, and clinical studies show very promising results in treating vaginal relaxation with noticeable improvement in sexual gratification and vaginal tightness, and excellent results in both mild to moderate-stress urinary incontinence."
While you may ponder the level of commitment it would take to have the 'Full Barbie' for vanity alone, cosmetic surgery is a deeply personal decision that
can improve quality of life.
"All cosmetic surgery is about feeling comfortable and confident in your appearance," says Dr Oates. "It is not about beauty or how other people view
you – this is the great mistake in negative comments about cosmetic surgery,
and the cause for dissatisfaction with cosmetic surgery."
BITS & PIECES
When it comes to the hoo-hoo, there's any number of treatments to make things feel dainty.
Vagacial
What a facial does for your face, a vagacial will do for your ladybits. It includes
a refreshing line up of exfoliation, an antibacterial wash, mask, and a lightening cream to even out skin tone.
Vajazzling
Having a beautician glue-gun Swarovski crystals to your labia to make it look pretty. Bare Beauty in North Perth will bling your beaver with more baubles than a Christmas tree for an extra $15 on top of your Brazillian wax. Boys can get a penazzling, too. Yup.
Vagina dye
Apparently there is such a thing as a washed out vajay. My New Pink Button
is a temporary dye to "restore the youthful pink colour back to your labia", as the website (mynewpinkbutton.com) says. Consider it blush for your pink bits.
Vagisteam
Big in Korea – steam is used to gently infuse specialised herbs and treat a variety of health concerns while nourishing the skin. Clients (including Gwyneth Paltrow, according to her blogs on Goop.com) sit over steam machines for around 30 minutes to get their fix.
DID YOU KNOW?
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The clitoris contains 8000 nerve endings, compared to the penis, which only has 4000.
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The average vagina expands three to four inches when aroused.
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What do sharks and vaginas have in common? Both have natural lubrication containing squalene.
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The word vagina roughly translates to 'sword holder' in Latin.
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The vagina has a self-cleaning mechanism
CONTACTS
Absolute Cosmetic Medicine Nedlands (08) 9389 9099, Applecross (08) 9364 1884, absolutemakeover.com.au
Academy Laser Clinics Subiaco (08) 9382 3238, academylaserclinics.com.au;
monalisatouchclinics.com.au
Assure Cosmetic Centre (08) 9380 0380, assurecosmeticcentre.com.au
Perth Skin & Laser Clinic (08) 9245 4377, looksbylaser.com.