Scientists writing in the journal Reproductive Health Matters are taking a close look at cosmetic surgery, especially female cosmetic genital surgery. Cosmetic surgery no longer includes just facelifts, breast implants, breast reduction and nose reconstruction. An editorial appearing in Reproductive Health Matters targets the increasing number of surgeries being performed on women, suggesting that surgery performed on women’s genitals are akin to mutilation procedures; highly profitable, and yet little information exists about outcomes, complications, and satisfaction following the procedures.
Marge Berer, writing the editorial, says the following about female genitalia surgery:”Too big, too small, too narrow, too wide, too high, too low, too flabby, and too wrinkled. The permutations are endless. What a great way of making money!” Berer adds, “Surgery – for the most part emanating from the private, profit-making health care sector, including in plastic surgery and obstetrics and gynecology – has entered the beauty industry, and has become a high-earner with a powerful and growing influence.” She also suggests performing surgery on women’s genitals may be a waste of resources that could be utilized to deliver needed healthcare to the public. According to Berer, …”we should be asking from a public health perspective why any health system would tolerate available resources, including skilled surgeons, being consumed by tens of thousands or even millions of people every year for such procedures, let alone to deal with any complications that arise.”
Berer says women are the prime targets of cosmetic surgery. A series of articles published in the journal look at “The relationship between what is labeled female genital mutilation and female cosmetic genital surgery.” Also, a number of the papers address how cosmetic surgery should be regulated. Laws exist in Europe and Africa against female genital mutilation surgery, yet Berer says “there are but none against female cosmetic genital surgery that I know of.”
The cosmetic surgery industry is self-regulating. As an example of the need for regulation of aesthetic surgeries, Diana Zuckerman points out in a review that few women really understand the risks, complications and outcomes of breast implant surgery, despite FDA regulations that women be fully informed before undergoing surgery. Women should understand that breast implants wear out after 10 years, can leak, reduce the ability to breastfeed, decrease sensation in the nipples, and obscure mammogram findings. Furthermore, few cosmetic surgeons know how to deal with those complications. There is also little research that addresses the long-term complications of breast implants.
According to the author, I” find it cause for despair that women are pursuing genital surgery because pornographic videos have made them believe their labia are “abnormal” or “uneven” or “showing” or that their vaginas aren’t “tight enough”. Berer, who has had surgery for minor and major health problems states, “I find it hard to imagine anyone who doesn’t really need surgery happily running after it, finding it a salutary experience and then going back for more. Shall I conclude, like some of the Brazilian surgeons interviewed by Daniela Dorneles de Andrade, and as the British psychologists did, who did one of the first studies of young women who had had labia reduction surgery, that at least some of the women may have underlying psychological problems that they hope surgery will resolve? I don’t know, but I think it is important to find out. I do know what I think about the surgeons who have made that judgment and who are profiting from it, and the clinics offering loans to women who are too poor to afford this surgery.”
Perhaps some cosmetic surgeries performed on women are “more dubious than others says Berer who admits she has many questions, saying she feels “sorry” for women who are “taken in” by the need for cosmetic surgery. The numbers of complications that result from cosmetic surgery are unknown and require more investigation. She adds, “I still think we should take pride in our bodies as they are, as hard as that may be on the bad days, and promote some serious consciousness-raising among our children and grandchildren on these matters.” Berer says if cosmetic surgery is really necessary, “then we all need it.” Given the lack of information about the health effects of cosmetic surgery, both psychological and physical, Berer wonders if “all cosmetic genital surgery – on both women and men, as well as infant girls – be considered condemnable and banned?”
One of the biggest questions explored in the journal is why women think their genitals need to be altered. One article review looks at a TV documentary from the UK in 2008 discussing pornographic films that shows women with no labia – something that may be boosting the numbers of female genital surgeries. The review also suggests that women think their genitals look “awful” in skimpy clothes. Berer believes the need for cosmetic surgery, and especially female genital cosmetic surgery deserves a close look, better regulation, and that the whole notion is profit driven and manufactured. The series of reviews in Reproductive Health Matters explores the cosmetic surgery industry and raises many questions that should be answered. Cosmetic surgery in Sweden, UK, USA, Brazil, Burkina Faso, Iran, and South Africa, and in the Round Up on Cosmetic Surgery also Senegal and Lebanon are explored in the journal. The main topic is female cosmetic genital surgery that is under scrutiny by the authors.