Why More Women Than Ever Are Getting Their Vaginas Done

"No one wants to advertise that they have had anything done," says Giese over the phone. With other procedures, she says, her clean work has come back to bite her; her clients are not walking advertisements for her practice. However, with labiaplasty—or "vaginal rejuvenation," or "a facelift for the vagina"—women aren't exactly flaunting their refreshed vulva as though it were a nose job anyway.

Today, labiaplasty and vaginal rejuvenation are in high demand, and not just for women who are post-menopausal or post-childbirth. According to a UK study, interest in vaginal rejuvenation increased by 109 percent in 2012. In 2013 more than 5,000 labiaplasties were performed in the United States alone, demonstrating a 44 percent increase in actual procedures performed in just one year.

The hottest trend in this realm is non-invasive vaginal rejuvenation through a technique pioneered in Europe called Protégé Intima. The 12-minute procedure requires four weekly treatments that are about $300 each and has earned the nickname "vontouring," after the makeup contouring ritual championed by drag queens and the Kardashians. Contouring allows people to completely reshape their facial structure with makeup alone, but Giese—who says she is waiting for success rates to increase before bringing the procedure to her own practice—explains that Protégé Intima is a bit more involved.

Using a fractional laser gentle enough for the face, Protégé Intima uses a beam that cuts through and stimulates natural collagen and elastic tissues in the lips of the vagina. While Giese has not tried it herself, it's said to be a painless procedure. (She sounds skeptical as she notes this.) Nevertheless, the lasers have been approved by the FDA (though not specifically for cosmetic use) and are making their way into the American cosmetology market for women.

But while the trend may sound ridiculous to some, it isn't all about the aesthetic. Not only does the process promise to improve the outward appearance of the vagina, making the labia look plumper and firmer, but it also improves sexual satisfaction.

"I have a lot of patients who, while doing liposuction surgery or breast surgery, want to also do some labial surgery after seeing I also do that," Giese says. "It only adds half an hour or an hour onto the surgery time."

Women's reasons for wanting labiaplasty range as much as vaginas do themselves. The labia is meant to protect the vaginal opening, which is constructed of highly sensitive nerve endings, from bacteria, and women with larger labia have thought this to be the cause of pain during sex or even yeast infections. People most commonly go under the knife to mend post-menopausal or post-childbirth changes that can make looser inner labia uncomfortable in clothing or during sex.

However, aesthetic justifications for labiaplasty or the new, non-surgical vaginal rejuvenation procedure are becoming more popular. Giese comes from a long line of surgeons, but she's the first in her family to focus on aesthetic cosmetic surgery. During medial school, she was mentored by Dr. Donald Laub, a pioneer of transgender medicine in the US. Training with professionals nearly two decades her senior, Giese apprenticed in aesthetic genital surgery, and even though today her focus is mostly on the breasts, body, and face, she says patients prefer her to do their labiaplastic procedures.

"These are relatively simple surgeries, but they make women a lot more comfortable," Giese explains. "What is most common is that the inner lips of the vagina can get bigger as people age or after childbirth, and the [labiaplasty] fix takes a simple operation. Sometimes it's the outer lips—they can get bigger or even deflated, and with that, we can cut some of the skin out or do fat grafting. It's aesthetic, but also about physical comfort." Some OB/GYNs blame pornography for showcasing small labia as the norm, while other doctors claim their patients have noticed irritation when wearing tight yoga pants.

Porn star Sydney Leathers had a labiaplasty (along with multiple other plastic surgeries) and laughed off recovery. "This is going to sound nuts, but it was the easiest plastic surgery to recover from," the Indiana-based adult star says. "I was in absolutely no pain. I actually went for a walk on the beach afterwards. I had stitches for about four weeks, so I had one period where I could only use pads, and I couldn't have sex or masturbate during that time. Those were the only downsides." Leathers also attempted to sell the parts of her labia that were removed on eBay in a publicity stunt, but bids were quickly halted because the website has a strict policy about purchasing human body parts or remains.

"I have been doing plastic surgery for 15 years, and I think there is a lot more focus on the vagina, how it looks, because of the overwhelming popularity of Brazilian waxing," says Giese. "There has been a real change in the aesthetic of the vagina, more focus, and women are taking a lot more of the hair off. I see naked women all the time during liposuction, tummy tucks, so I see the change in grooming. It's not just a change in the younger population—it's in the mature population as well."

Female pubic hair is a topic that has become popular outside of quiet, women-only circles. In 2014, Men's Health published an article about the bush making a comeback (the author also stated that, based on her own research, 90 percent of men surveyed were strictly against their partners being completely bald), while Cameron Diaz famously declared in her book that, "The idea that vaginas are preferable in a hairless state is a pretty recent phenomenon, and all fads change." Maybe vajazzling and laser hair removal are trendy now, but what happens if the full bush comes back? Will Gucci start marketing the pubic wigs once used for syphilitic prostitutes in the 1450s? Are the trend-starved and totally hairless going to sport designer merkins?

Giese thinks about trends when her patients request permanently removing all their pubic hair. "One of my personal hesitations, because we have laser hair removal treatments available [at my practice], is [not] leaving a certain amount of hair. Losing everything…that is really pre-pubescent looking," she says. And as far as aesthetics go, the look of your labia matters less if they're covered in hair.

Giese is positive about plastic surgery, and realistic about her career-oriented clientele who desire effective surgeries and quick recovery time. After all, she works in Manhattan, a city where, she says, upper-class women take very good care of themselves and age well, all over their bodies. Innovative, non-invasive aesthetic procedures that are fast but long-lasting meet the needs of today's female market.

While many plastic surgeons are seen as capitalizing on women's insecurities, however, for her part Giese seems very wary of innovations in vaginal rejuvenation. "There are so many variations of normal," she continues. "I don't want to make women feel bad about themselves; from a marketing perspective, it can be easy to exploit any insecurity. Women have a hard enough time being held up to airbrushed Hollywood standards. Women are taken advantage of at the makeup counter, with packaging, marketing, and [vaginal aesthetic] is another area where women can be taken advantage of—there is plenty of subjectivity to the scale."