When we picture a self-conscious 16-year old worrying about her appearance, we might expect to hear complaints about acne outbreaks or perhaps a wish for a conspicuous feature to be larger or smaller. What likely doesn’t come to mind is a desire to look different “down there.”
But it is on the mind of more and more young women: a spike in the number of teenage patients requesting labiaplasty and other cosmetic surgeries prompted the American College of Obstetrics and Gynecology to release a statement of guidelines for physicians on how to approach this issue in their practice.
Why are labiaplasty rates among teenagers increasing?
It’s common for teenagers to feel self-conscious about their appearance, given the rapid state of change they are experiencing in their bodies. It can be difficult for them to understand what is “normal” and what is not. A desire to fit in, combined with a powerful media presence that saturates their day-to-day lives with messages about what constitutes the “ideal” female body, can easily exacerbate a young woman’s feelings of dissatisfaction.
The issue has extended to the vaginal area for a number of reasons. First off, trending options for rejuvenating vaginal tissues have made the appearance of the genital area a more prominent issue in women’s beauty media. While this is helpful for adult women who simply want to correct common post-childbirth issues or other uncomfortable abnormalities, the suggestion that one’s genital tissues may benefit from a cosmetic procedure may be confusing for adolescents. In addition, young women can more easily access images of idealized female genitalia online, creating anxiety about how one’s individual anatomy compares, even though these images may be retouched or, like other models, represent the real appearance of very few women.
Such conflicting information can lead a teen to feel confused and wonder if she needs surgery.
Vaginal rejuvenation during the teen years is rarely a good idea. Here’s why.
The labia majora and labia minora change throughout a woman’s life cycle, and puberty is no exception. Variations in size, shape, and symmetry are perfectly normal and rarely indicate a potential problem in the teen years.
Undergoing cosmetic surgery on a body that is in a state of transition is also discouraged, as the risk for unsatisfactory results, including a need for a secondary, corrective surgery, is sharply increased. This is why reputable cosmetic surgeons require patients to wait 6 to 12 months after significant weight loss before having body contouring surgery.
The same principle applies to teenagers and labiaplasty. Adolescent patients are still developing physically and emotionally; many women do not reach full maturity until their early 20s. At best, undergoing cosmetic surgery could be jumping the gun, “improving” the shape of normal tissues that a patient will not find bothersome in just another couple of years.
At worst, surgery on the labia while a young woman is still undergoing puberty could alter the natural growth of these tissues. This not only risks leaving her dissatisfied with the appearance of the area once she reaches adulthood, but also opens the door for other unintended negative consequences, such as scarring, a loss of sensation in the vaginal tissues, discomfort wearing form-fitting clothing, or painful intercourse.
Is labiaplasty ever appropriate for teenager?
Regardless of a patient’s age, the decision about whether or not cosmetic surgery is an appropriate solution is entirely personal. While in general labiaplasty should be postponed until adulthood, in rare cases labiaplasty may be appropriate for a teenaged patient:
- A physical deformity of the genital tissues is causing discomfort during day-to-day activities or preventing a patient from comfortably wearing certain types of clothing.
- Injury or previous surgery to the area has created ongoing issues or pain.
In such cases, it is also important to verify that a teenaged patient is emotionally ready for surgery, demonstrating that she understands what results are realistic for her, and that she is ready to take a responsible approach to recovery.
What to do if your teenager asks about labiaplasty.
Try not to be immediately dismissive of her concerns; you want to avoid creating the feeling that it is you against her, which may cause her to argue for the procedure out of defiance. Instead, let her share with you her reasons for wanting this kind of surgery, what she knows about labiaplasty, and how she thinks having it would help her. Allow her to research the procedure beyond what her friends or celebrity social media blurbs are saying. Being heard and learning more about the process may quell her concerns and lessen interest in the procedure if it isn’t truly necessary.
If your teen is persistent in her desire for surgery, it may be time to consult with a board certified cosmetic surgeon or gynecologist. Talking to an experienced physician will help both you and your daughter understand what is normal physiology for her age and consider whether surgery is appropriate. You might find it helpful to review our guide for preparing for a cosmetic surgery consultation prior to the appointment to help you vet a potential provider’s qualifications and ensure your key questions are thoroughly addressed.
A qualified physician can also screen your daughter for signs of body dysmorphic disorder, a mental health condition characterized by an individual’s fixation on a perceived (yet often non-existent) body flaw. Body dysmorphic disorder often presents during the teenage years, and treatment includes counseling and psychological therapies—not cosmetic surgery.
Concerns over appearance of the genitals is understandably a very sensitive, personal topic that merits serious conversations between the teen, her parents, and trusted healthcare providers. If you are facing questions about labiaplasty or any other cosmetic surgery as a teen or a parent of a teenager, we encourage you to contact a board certified cosmetic surgeon in your area.