By DR ALFRED MURAGE

There has been a rising trend in surgical requests for ‘designer vaginas’ more akin to cosmetic breast surgery. This is rampant in the West, but such requests are becoming common in Kenya. Vaginoplasty refers to cosmetic vaginal surgery, usually aiming to tighten up a loose vagina. Vaginoplasty is commonly combined with Labiaplasty, which aims to change the appearance of the vaginal lips (labia) to a cosmetically appealing look.

Requests for vaginal surgical rejuvenation arise from various reasons. Some women are looking for heightened sexual sensitivity, arousal and enjoyment. Others are unhappy about their genital appearances, often desiring a particular designer look likely gleaned from glossy modelling magazines or videos. Rarely, is there a genuine reason for cosmetic genital surgery.

Women must be very cautious before subjecting themselves to vaginoplasty purely for erotic reasons. While it’s true the vagina changes with childbirth and age, surgically tightening it cannot guarantee a heightened sexual response. Sexual desire, arousal, and orgasm are an interplay of complex mechanisms that include emotional, spiritual, and interpersonal factors; and not just aesthetics. In addition, heightened sexual sensitivity doesn’t automatically lead to more pleasure. Equally, surgery for the sake of changing vaginal appearance should not be casual. Women’s genitals have a wide range of natural appearances, and no single look can be labelled as superior or more alluring.

Many dangers

Many gynaecological societies advise extreme caution with cosmetic genital surgery. None of such cosmetic procedures are considered accepted or routine; even though proponents claim benefits such as beauty, self-esteem, confidence and sexual performance. Scientific data on safety and effectiveness of cosmetic vaginal surgery is lacking. Risks include infection, permanent changes in sensation, pain and scarring. Women’s long-term satisfaction and complication rates have hardly been tracked, and are presently unclear.

So what should the approach be if one is considering undergoing vaginal cosmetic surgery? You have to be very clear about what it is you want to achieve. Talk openly to your gynaecologist about feelings and concerns you have regarding your genitals. Be wary of unachievable surgical expectations, and potential long-term risks that can interfere with future sexual function, pregnancy and childbirth. Cost is another matter; such cosmetic procedures are rarely covered by medical insurance. You are likely to end up with a bill amounting to thousands of shillings, rather than the latest fad in designer vaginas.

Consider non-surgical options. Targeted and supervised pelvic exercises can tone weak vaginal muscles and improve sexual enjoyment. And psychosexual counselling can address issues of sexual self-esteem and confidence. The well marketed revirgination and G-spot amplification may well turn out to be a pipe dream, and you may be better off just the way you are now.