title: Why Women Request Labiaplasty.
abstract: BACKGROUND
  In recent years, labiaplasty has jumped in popularity, despite opposition to the procedure. In 2007, the American College of Obstetricians and Gynecologists declared the recommendation of cosmetic vaginal procedures to be "untenable," although in 2016 they allowed consideration of labiaplasty in adolescents if symptoms persist. The reasons for labiaplasty requests are not yet fully understood, and physician opposition limits patient access to surgical relief.
  
  
  METHODS
  In this prospective study, 50 consecutive patients consulting about labiaplasty were given a questionnaire assessing 11 physical and appearance-related symptoms associated with elongated labia.
  
  
  RESULTS
  The mean patient age was 33.5 years (range, 17 to 51 years). Fifty-eight percent of women had given birth, 52 percent noticed that their labia had become elongated as they got older, and 93 percent had bilateral elongation. When asked about physical symptoms, over half of patients experienced tugging during intercourse, found tight pants uncomfortable, experienced twisting of the labia, and noted labia visibility in yoga pants. Nearly half experienced pain during intercourse, and 40 percent said their labia could become exposed in bathing suits. Regarding appearance, almost all patients were self-conscious and over half felt less attractive to their partner, experienced restricted clothing choice, and noted a negative impact on self-esteem and intimacy. Nearly all patients experienced at least four symptoms.
  
  
  CONCLUSIONS
  Most patients requesting labiaplasty experience both physical and appearance-related symptoms. Understanding this patient perspective is crucial in assessing surgical outcomes. Furthermore, the better all physicians understand labia symptomatology, the better supported patients will be in seeking surgical relief.
authors.affiliation: Stanford and Santa Rosa, Calif.|From the Division of Plastic Surgery, Department of Surgery, Stanford University; and Plastic Surgery Associates of Santa Rosa.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Sorice
authors.affiliation: Stanford and Santa Rosa, Calif.|From the Division of Plastic Surgery, Department of Surgery, Stanford University; and Plastic Surgery Associates of Santa Rosa.
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Li
authors.affiliation: Stanford and Santa Rosa, Calif.|From the Division of Plastic Surgery, Department of Surgery, Stanford University; and Plastic Surgery Associates of Santa Rosa.
authors.forename: Francisco L
authors.initials: FL
authors.lastname: Canales
authors.affiliation: Stanford and Santa Rosa, Calif.|From the Division of Plastic Surgery, Department of Surgery, Stanford University; and Plastic Surgery Associates of Santa Rosa.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Furnas
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods / Q000523:psychology*; D014844:Vulva / Q000601:surgery*; D055815:Young Adult