Advocating for women’s choice: Cosmetic gynecological surgery

Thirteen years ago, when I started working in cosmetic gynecological surgery, many people thought I was a bit of a visionary. I had finished additional training with Dr. David Matlock at the Laser Vaginal Rejuvenation Institute of Los Angeles in 2000 and was one of the first people in Canada to be offering this type of medical service at the time. (Read a 2005 article in The Tyee in which I was featured.)

Since then, cosmetic surgery has become much more mainstream in Canada and in the world. Words like ‘Botox’ and phrases like ‘tummy tuck’ are commonly understood, with many people having either considered cosmetic surgery, undergone a procedure themselves, or known someone who has.

The change in attitude – particularly towards cosmetic gynecological surgery –  ties into the increased understanding that women should have the right to take ownership of their bodies. I’m proud to have been one of the first medical practitioners in Canada to pave this path towards offering women the services and safe care that supports their wellbeing and advocates for choice.

The freedom to choose in a safe space

I am not blind to the held criticisms against cosmetic surgery. Some say psychological counselling is the only answer to people’s dissatisfaction with themselves. However, I am a strong supporter of helping women achieve fulfilment and satisfaction in their bodies so they can live fuller lives and experience satisfying sex and intimacy with their partners – in whatever way they choose and that I know is safe. And when I evaluate these women and take a detailed history from them during our consultations, if at any stage I feel they need psychological help, I refer them. However I do not hold the view that only women who are psychologically or emotionally unstable make the choice to have this type of surgery.

Two of the primary procedures I focus on in cosmetic gynecological surgery are labial contouring and vaginal rejuvenation. While for many, such topics can leave them flustered and embarrassed, as a medical professional, I am dedicated to holding space for safe and open discussions with my patients to determine what is best for them.

Recently, one patient, an athlete who plays professional sport, came to my office. For many years, she was reluctant to shower with the rest of her team, too scared about what “it looks like” and what other women would think. This case exemplifies that women’s body image is not solely influenced by the opposite sex.  

Another patient came for a consultation sharing with me that every time she got intimate with her partner, she would turn off the light – the reason being that she was self-conscious in how she looked in “that area” and didn’t want her partner to see it. Another came to me with a similar issue, except was holding off intimacy with a newly serious partner altogether because she was self-conscious about her labia. She now worried it would ruin their relationship.

The patients I see range from their early twenties into their late sixties; many are women who take care of themselves and lead healthy lifestyles. For all of them, the appearance of their labia has been something that has affected their confidence for a number of years leading them to consider and undergo labial contouring.

A better sex life for women

Some of the dissatisfaction that women face about their bodies is a result of the changes we’ve observed in sexual habits and preferences over the last decade; the effects of the pornography industry, as well as changes in fashion and sexual trends (like removal of pubic hair and more women now enjoying oral sex) has made women become more aware of their own bodies – and particularly sensitive to standards of beauty related to their labia majora and minora. And society has not necessarily prepared all women equally to embrace body diversity. The women I see feel that they are being negatively perceived, whether because of protruding labias in spandex clothing or bathing suits, or because of abnormally-shaped or -sized vaginal lips under the sheets. And for many, nothing by surgical change will make them change their outlook within their own lifetime.

Another reason many women come to be dissatisfied in the appearance of their vaginal area is due to natural childbirth. Many women who have had a natural childbirth typically undergo decreased laxity and tone to the vaginal tissues. This results in decreased sensitivity during intimacy and intercourse. Another procedure that is available to them is vaginal rejuvenation, which helps to increase the strength of these tissues and muscles so that they can have a more fulfilling experience with their partner and so that they can feel more.

For many women, accepting their bodies is an upward battle that needn’t be fought. I believe it is the woman’s right to decide and be offered options – with support from medical professionals like myself to help them make safe choices.