Singapore - Nip and tuck for extra spark

About 10 years ago, she caught sight of her nether regions in a mirror and began obsessing about how "dark" it was.

It bothered the management consultant so much that she began losing interest in sex.

She eventually decided to go for labiaplasty to reduce the size and lighten the colour of her labia.

"It got so bad that sex with my boyfriend became unenjoyable," the consultant, who gave her name only as Ms Ho, 42, told The New Paper in a telephone interview.

"I would wonder if he hated the sight of it and I would lose the mood just like that. But now, I feel confident and right with the world again."

Ms Ho, who got the procedures done some time last year, is part of a growing number of women here who are spending big bucks to get a nip-and-tuck "down there" to enhance sexual gratification, self-esteem and the general beauty of their genitalia.

The surgical procedures, which include reducing the size and appearance of the labia, can help women with gynaecological problems after childbirth, sexual difficulties or congenital defects.

But increasingly, women are also going under the knife for non-medical reasons.

A class of relatively new procedures surfaced in the last 15 years, and in countries such as Australia, Britain and the US, the numbers of women undergoing such procedures have also been steadily rising.

In Australia, Medicare figures showed that almost 1,400 women made claims for labiaplasty operations in 2009, a jump from 454 in 2000.

Although there are no official statistics here, several Singapore plastic surgeons, obstetricians and gynaecologists said they have seen a jump in numbers.

Plastic surgeon J.J. Chua attributed this not just to the rise in women's financial independence but also an increase in their knowledge of the trend "through sharing among friends, the Internet and the media".

But these procedures don't come cheap: Each typically costs between $4,000 and $25,000 - depending on what the patient wants.

Doctors doing such procedures see mostly professional women - both married and single -"who simply know what they want".

According to the Singapore Medical Council, female genital operations are traditionally done by obstetricians and gynaecologists, and mainly for medical reasons.

These include repairs to the vagina and surrounding area due to birth defects and childbirth-related injuries.

Trimming

Dr Christopher Chong, a consultant gynaecologist in private practice, said: "The labia may get thicker or longer because of hormone levels, genetics or from a difficult pregnancy.

They tend to hold extra moisture and bacteria, resulting in infections.

"Large labia can get scraped or chafed during horseriding or bike riding, and in some cases, simply sitting can cause pain and irritation. Under such circumstances, trimming the excess tissue is beneficial."

But in the past decade, women began turning to plastic surgeons believing that a surgical "trim" would help them look more "normal".

Dr Chong has seen his fair share of women asking for labia reduction "for cosmetic reasons", but he said his clients here are mainly women from other countries in the region.

"Just as these women travel here to have labiaplasty done, I believe Singapore women are seeking similar work in Thailand and Korea," he said.

Dr Michael P. Goodman, who has about 40 years of medical experience in Obstetrics and Gynaecology in the US, told TNP in a telephone interview: "Women should be made aware that they are not developmentally or structurally abnormal."

Agreeing, obstetrician and gynaecologist Quek Swee Chong said: "The onus falls on the surgeon to ensure that he is sufficiently trained in both plastic and sexual health."

Plastic surgeon Ivor Lim said that while he performs reduction labiaplasty and liposuctions of the pubic mound, he draws a line at other procedures.

"Should they require tightening procedures, I refer them to the OBGYNs, who are, of course, perfectly capable of doing the other operations as well," he said.

In the US, some doctors who are not fully qualified are offering these procedures, said Dr Goodman.

"Having gone through a one-day workshop on laser techniques doesn't qualify these doctors to perform the surgery," he said.

"These doctors don't know how to tell who is suitable for the procedure and who isn't.

"In my experience, patients who come for genital cosmetic surgery look on it as relatively risk-free and do not expect much discomfort.

"But these are serious surgical procedures and recovery can be rather long-drawn. Doctors carrying out such operations should share such information."

Risks include protracted healing, over- or under-tightening, injury to bladder or bowel, infection and abcess.

A spokesman for the Health Sciences Authority said all doctors here are required to comply with its Ethical Code and Ethical Guidelines.

"Doctors in health-care institutions licensed under the Private Hospitalsand Medical Clinics Act should not provide services that are not evidence based," she added.

Different types of procedures

There are different types of genital surgery for women involving the labia, vagina and vulva. These procedures include:

Vaginoplasty

A reconstructive and corrective vaginal surgery for defects and deformities of the vaginal canal and its mucous membrane.

Parts of the mucous membrane are cut out surgically from the deepest portions of the vagina, reducing the size of vaginal muscles, resulting in more friction during sex.

Labiaplasty

Labiaplasty reduces the size of the labia and the inner and outer folds of the vulva. Sometimes, it also involves reconstruction.

Clitoral hood reduction

This surgical procedure separates the hood that sheaths the clitoral node, theoretically to improve sexual stimulation.

Perineoplasty

The vaginal opening is surgically reconstructed to either tighten or loosen the muscles.

Hymenoplasty

The surgical reconstruction of the hymen - a piece of tissue that blocks some or all of the entrance to the vagina.

The restoration of the hymen is to cause bleeding during sex, which in some cultures is considered proof of virginity.

Vaginal Rejuvenation/Laser Vaginal Rejuvenation (LVR)

Vaginal rejuvenation tightens the vaginal barrel and restores the muscle tone. LVR uses a laser procedure to modify existing vaginal surgery to treat vaginal relaxation and its associated symptoms, such as stress urinary incontinence.

A patented technology by Los Angeles-based American doctor David Matlock, it promises several things: Less blood, faster healing time and better sex. Source: Dr Michael P. Goodman

Judith Tan

The New Paper

AsiaOne