Christopher J Salgado, Lydia A Fein MPH, Renee Gasgarth, Priscila Sanchez, Dalila Lo Bue, Brian A Crosland, Ashley Taggart BS, Madison Rumbaut and Ajani Nugent
Objective: In recent years, women have become more dissatisfied with the appearance of their labia minora, in particular their width, shape, and symmetry, prompting increased requests for labiaplasty. This has been attributed to the popular depiction of female genitalia in media outlets as homogenously hairless, symmetrical, and without protruding labia minora. Over-reduction of labia minora, although requested by patients, should not be performed due to their physiologic importance.
Methods: We designed a survey to better understand preferences for the aesthetic appearance of female external genitalia. Survey Monkey was used to distribute an online questionnaire to a convenience sample of authors’ contacts. Respondents were asked to refer to three images of female external genitalia-varying in labia minora width but all still physiologically normal-and select the image that they felt to be most normal and most attractive, respectively. Pearson’s chi square test with significance level of 5% was used for statistical analysis.
Results: Overall 95.8% (767/800) selected non-visible or slightly visible labia as the most “normal” variants, and 96.6% (773/800) selected either A or B for the most “attractive” variants of labia minora. Respondents selected images most consistent with popular culture depictions of genitalia, which seem to be driving genital plastic surgery requests.
Conclusion: Given these findings, we recommend a discussion with patients about preferences and a belief regarding what is truly normal and encourages more wide spread media visibility and education about normal physiologic variability in female external genitalia.