ACOG cautions against cosmetic vaginal procedures

The American College of Obstetricians and Gynecologists recently issued a statement cautioning its members about performing such procedures as vaginal rejuvenation, designer vaginoplasty, revirgination, and G-spot amplification. They stated that an increasing number of such procedures are being performed without medical indication and without documentation as to their safety or effectiveness.

If patients request such procedures, ACOG advises practitioners to explore through history and physical evaluation why patients are seeking these solutions and inform them of the lack of data surrounding the procedures and the inherent risks, including infection, altered sensation, dyspareunia, adhesions, and scarring. ACOG Committee on Gynecologic Practice. ACOG Committee Opinion No. 378: Vaginal "rejuvenation" and cosmetic vaginal procedures. Obstet Gynecol. 2007;110:737-738.

Commentary by Paula J. Adams Hillard, MD, Professor, Department of Ob/Gyn, Chief, Division of Gynecologic Specialties, Stanford University Medical Center, Stanford, Calif.

The ACOG Committee on Gynecologic Practice is to be applauded for its principled statement on vaginal rejuvenation. Many physicians are unaware of the presence of Web sites that promote surgeries to alter vaginal appearance; these Web sites provide "before" and "after" pictures, suggesting to women (especially teens) that the "before" view is abnormal, while the "after" view represents normal. In viewing these sites (which I viewed in response to a patient's questions), I was struck by how normal and wide-ranging the "before" pictures are, while the "after" pictures all look the same-clones, or someone's view of what women's vulvas should look like. I talk with my patients about how wonderful it is that we don't all look the same. In particular, adolescents are vulnerable to the feeling that a certain body part is abnormal-in the extreme, patients requesting these surgeries may meet the criteria for the psychiatric diagnosis of body-dysmorphic disorder. This ACOG Committee opinion makes it clear that there is a lack of data supporting the efficacy of these cosmetic procedures and they have potential risks.