Sex and self-confidence: Do genital enhancements help?

Within the field of plastic surgery, genital cosmetic surgery has been picking up steam for both women and men. In this article, we look at some of the options, whether they can bring added general or sexual satisfaction, and what to keep in mind when considering genital cosmetic surgery.

Recently, one news outlet reported a shocking new trend among some men in Thailand: penis bleaching. This has brought the attention back to the often controversial procedures of "enhancing" one's private parts.

Nowadays, there are plenty of genital cosmetic interventions and other genital "improvements" that have become available to both men and women who, for one reason or another, may feel dissatisfied with their nether regions.

According to the American Society of Plastic Surgeons (ASPS) 2016 statistics for plastic surgery, the demand for labiaplasties, or interventions that alter the size and shape of the inner or outer labia, went up by 39 percent in 2016 compared with 2015.

Men are also fans of aesthetic interventions, making up 8 percent of all those who seek cosmetic procedures in the United States, say the ASPS. Worldwide, more than 8,000 penis enlargement procedures take place annually, state the International Society of Aesthetic Plastic Surgery.

What kinds of genital "update" are available, and why do we choose them? Also, are they likely to improve our sense of self-satisfaction and well-being?

Below, we tackle these questions and give you an overview of genital cosmetic surgery, and what you should keep in mind before you go under the knife.

Female genital cosmetic surgery

Women have a choice of genital enhancement or rejuvenation procedures, some of which focus on making their private parts look aesthetically pleasing or feel more comfortable, while others aim to help women achieve improved satisfaction under the sheets.

Labiaplasties

Labiaplasty is probably the best-known genital cosmetic intervention for women. In it, the size of one or both of the inner labia — the "lips" flanking the vaginal opening — is reduced.

This is usually done when one labium is visibly longer than the other one and is aesthetically unpleasing, or when the size of one or both of the labia makes sex or other physical activities uncomfortable or painful due to excessive tugging and twisting of the skin. 

According to plastic surgeons most women who come to see them about a genital cosmetic procedure "present because of functional issues such as discomfort with exercise, horse riding, cycling, and yoga."

"Certain types of clothes, underwear, and swimwear may also be uncomfortable [to them]. A proportion of these patients may also mention aesthetic concerns in concert with their physical symptoms."

According to the ASPS, a labiaplasty costs approximately $2,730, on average, in the U.S.

Sometimes, labiaplasties are accompanied by a clitoral hood reduction procedure — though this type of intervention can also be carried out separately — which involves reducing the folds of skin that "sheathe" the clitoris.

This is can be done purely to improve appearance following a labiaplasty or to improve clitoral sensitivity, though the BAAPS note that "there is little information on outcome, other than anecdotal."

Women may also opt for an intervention to reduce their labia majora (labia majoraplasty), which are the outer "flaps" of skin that cover the labia minora.

As with the labia minora, some women may feel discomfort from the tugging and twisting of the labia major experienced during various physical activities, or they may simply be uncomfortable with their physical aspect.

Monsplasty and vaginal tightening

Another type of cosmetic intervention offered in some clinics is the monsplasty, or the reduction in size of the mons pubis, which is the area just under the belly and above the labia majora. This part of the female body forms a natural protuberance, but some women may feel uncomfortable about its size.

In these cases, liposuction is often performed to remove excess fat from that area, and sometimes the removal of some skin is also necessary.

Vaginal tightening, or vaginoplasty, is a "rejuvenation" procedure in which a woman's vagina is tightened, often required by women after having gone through natural childbirth, which can cause the vagina to become more stretched.

Vaginoplasty can involve "going under the knife," though sometimes noninvasive procedures such as laser surgery are also available. 

This type of intervention has also been shown to help with stress urinary incontinence.

More controversial procedures

Some "restorative" or "enhancing" genital procedures for women have been the target of much more controversy than others. One such example is that of hymen reconstruction surgery, an intervention that aims to "repair" a ruptured hymen, the thin membrane that lines the vaginal opening.

The hymen can occasionally rupture during sexual intercourse or even due to strenuous physical exercise, which does not usually affect gynecological health. However, its traditional association with virginity has led to many debates about the legitimacy of hymen repair procedures.

And more recently, injections that claim to boost female sexual satisfaction, called "O-shots" and "G-shots," have also attracted much attention.

O-shots — short for "orgasm shots" — are interventions wherein platelet-rich plasma, derived from a person's own blood, is injected into the clitoris and neighboring vaginal area. This is supposed to boost clitoral sensitivity, allegedly making women more likely to experience "mind-blowing" orgasms.

Similarly, G-shots — short for "G-spot shots" — aim to enlarge the surface area of the controversial and elusive G-spot with the same goal of enhancing sexual gratification.

But in speaking to experts, we have learned that the effectiveness of these procedures relies on anecdotal evidence, and no conclusive studies have yet been conducted to confirm success rate.

"These particular procedures are considered somewhat controversial at the present time and many doctors feel their claims do not have merit. [...] whilst there are anecdotal reports of some benefits, it is agreed that well-designed scientific studies are required to confirm the efficacy of these concepts."