title: Selecting aesthetic gynecologic procedures for plastic surgeons: a review of target methodology.
abstract: BACKGROUND
  The objective of this article was to assist cosmetic-plastic surgeons in selecting aesthetic cosmetic gynecologic-plastic surgical interventions.
  
  
  METHODS
  Target methodological analyses of pertinent evidence-based scientific papers and anecdotal information linked to surgical techniques for cosmetic-plastic female external genitalia were examined. A search of the existing literature from 1900 through June 2011 was performed by utilizing electronic and manual databases.
  
  
  RESULTS
  A total of 87 articles related to cosmetic-plastic gynecologic surgeries were identified in peer-review journals. Anecdotal information was identified in three sources (Barwijuk, Obstet Gynecol J 9(3):2178-2179, 2011; Benson, 5th annual congress on aesthetic vaginal surgery, Tucson, AZ, USA, November 14-15, 2010; Scheinberg, Obstet Gynecol J 9(3):2191, 2011). Among those articles on cosmetic-plastic gynecologic surgical technique that were reviewed, three articles met the criteria for evidence-based medicine level II, one article was level II-1 and two papers were level II-2. The remaining papers were classified as level III. The pertinent 25 papers met the inclusion criteria and were analyzed. There was no documentation on the safety and effectiveness of cosmetic-plastic gynecologic procedures in the scientific literature.
  
  
  CONCLUSIONS
  All published surgical interventions are not suitable for a cosmetic-plastic practice. The absence of documentation on safety and effectiveness related to cosmetic-plastic gynecologic procedures prevents the establishment of a standard of practice. Traditional gynecologic surgical procedures cannot be labeled and used as cosmetic-plastic procedures, it is a deceptive practice. Obtaining legal trademarks on traditional gynecologic procedures and creating a business model that tries to control clinical-scientific knowledge dissemination is unethical.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors: Institute of Gynecology, Inc, 7001 Central Ave., St. Petersburg, FL 33710, USA. ao@baymedical.com
authors: Adam
authors: A
authors: Ostrzenski
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D013518:Surgery, Plastic / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery; D014844:Vulva / Q000601:surgery