Any woman who feels she is structurally ‘not right’ is eligible for cosmetic vaginal surgery. This is no different from someone desirous of a breast augmentation or reduction, nose job, face lift, or tummy tuck. It is just another part of the body that an individual would like to resculpt for their personal satisfaction.
No one has the right, nor can any medical body rule whether it should or should not be done, so long as there is no harm in doing the procedure. Standard discussions of the benefits, medical risks, and complications that can occur can help an individual decide if this procedure is right for them. To determine if you may be eligible for CVS, consult with an experienced surgeon as soon as possible.
There are circumstances that would preclude a physician from determining that an individual is not eligible for cosmetic vaginal surgery. First, the doctor will determine if the patient has an abnormal body self-image. This is the patient who may have an anatomically normal to small labia who desires further reduction, i.e., labial amputation. This could also include a woman with an already exposed clitoris who requests complete removal of the overlying skin. Occasionally, a patient presents with a normal diameter vagina with excellent muscular tone requesting further tightening.
On the opposite end, a patient who has a wide vagina but poor muscular tone, who cannot contract her pelvic floor muscles, may not be eligible for CVS. Surgery on these patients can result in a very poor outcome, and leave the individual dissatisfied. The former due to no apparent change since she was tight to begin with, and the latter’s failure to have any strength or tone results in a persistent lack of feeling. It is a surgeon’s responsibility to screen patients for psychiatric problems, unrealistic expectations, and functional deficiencies that would guarantee a poor outcome.
Women who desire vaginoplasty and who decline an elective cesarean section for future pregnancies need to be dissuaded from surgery. A subsequent natural birth with ruin any repair.
Patients with a known psychiatric history should have a psychiatrist’s note clearing them for surgery, and patients who have clearly unreasonable expectations should be declined. Someone who says she wants to be perfect or look like someone in a pornographic magazine needs to be referred out. There is no way any surgeon will meet her needs, and she will not be deemed as eligible for cosmetic vaginal surgery.
The strongest candidates for eligibility for cosmetic vaginal surgery are those whose result will have the greatest impact on their lives. Lack of sexual feeling or pain with intercourse can have a very deleterious effect on a marital relationship. Sometimes, a woman may put up with the lack of feeling for years. If that marriage comes to an end, she may not be willing to deal with the loss of intimacy with a new partner. Similarly, if she has reluctantly accepted large or irregular labia this may be the time to correct them.
Women who are active in the gym, in competitive sports, and swimming really have an issue with enlarged labia that interfere with their activities. The most extreme example is the equestrian. Large labia get compressed for hours at a time, day after day, resulting in a process called keratinization or thickening of the skin which can be both cosmetically and functionally unacceptable.
These are the most prominent examples of candidates for pelvic cosmetic surgery. However, dissatisfaction with one’s appearance which is anatomically at a significant variation from the norm, along with the loss of sexual function, are the usual reasons women seek help.