Female Genital Surgery
July 10th, 2009
New York City now boasts of an art exhibit featuring before and after plastic surgery pictures. According to Allure Magazine, all aspects of plastic surgery are featured in the exhibit, including cleft lip and palate correction, nose surgery, and face lift surgery. The surgical photos which drew the greatest attention were the before and after pictures of genital surgery for women. It was not clear if the fascination was because this type of surgery was so novel to the viewers or because there was a genuine interest in the procedure.
It was pointed out that this seems to be inconsistent in a world where female mutilation still occurs. Yet it is embraced in some circles as an acceptable alternative for women. In fact, women who have undergone genital mutilation often turn to reconstructive surgery once they have emigrated to western cultures. Female genital mutilation is an involuntary lay practice carried on outside the purview of medial care. Genital aesthetic surgery is an elective surgery performed by physicians in appropriate hospitals and clinics. In addition, mutilation is designed to minimize sexual desirability while cosmetic genital surgery is designed to maximize sexuality. They are completely different and unrelated.
An interesting study is now underway by the World Health Organization. The title, “Female genital mutilation and other harmful practices, a multi-country study on gender, sexuality and vaginal practices” seems to be inconsistent with its own findings. It was supposed to be, “A study on harmful sexual practice that is being conducted in: Indonesia, Mozambique, South Africa and Thailand.” The study seems to be confusing and perhaps attempts to avoid any politically incorrect findings. Their findings seem to minimize harmful aspects and focus on some of what genital aesthetic surgery is trying to accomplish:
- “Vaginal practices to tighten the vagina during sex are more common than acknowledged”
- “Practices are not always aimed at “drying” the vagina; women focused more on “closing, warming and tightening”
- “Motives for the practices are linked to anxiety and competition among women to gain or hold on to sexual partners”
- “Many practices are linked to a desire to improve sexual relations and necessitate ‘skin to skin’ contact and thus eliminate the possible use of condoms”
- “There are similar practices in different countries.”
The Allure article goes on to quote 2008 statistics from the American Society for Aesthetic Plastic Surgery which report a sharp decline in female genital aesthetic surgery among plastic surgeon members. I suspect this number is inaccurate overall, since much of this surgery is being done by gynecologists, not plastic surgeons. In fact, recently a med-spa dedicated solely to vaginal and female genital surgery, called Phit, has been established in New York City. You have to give them credit on the name!
Nippin’ Out
July 9th, 2009
I just do not know how else to describe the recent article in Allure Magazine. Quoting a London Daily Mail article about Victoria Beckham, they show a photo of her is a fitted top. The photo prominently displays the shape of her nipples and areola. The article claims surgical enhancement to create this appearance is becoming more popular.
The breast can be separated into three profile components. First is the breast mound, which accounts for the majority of the breast size. Traditional breast enlargement surgery enhances this through placement of an implant beneath the breast and/or muscle. The center portion of the breast is highlighted by the nipple and areola. This is the eye point or where a person looks when they look at another person’s (man or woman) chest. The nipple is the central portion of this area. It projects out from the breast normally. The nipple represents the termination of the breast milk ducts allowing breast feeding. The darker skin around the nipple is known as the areola. Its color varies widely with genetic background and past pregnancy history. The areola is usually flat in relation to the surrounding breast mound. Sometimes this projects above the breast mound to add another contour to the breast. This is apparent in the Allure photo.
There are a variety of cosmetic nipple surgeries. The most common procedure in the past has been correction of inverted nipples. In this condition, the normal milk ducts are too short and cause the central part of the nipple to be drawn inward thus reducing the nipple projection. Correction of inverted nipples eliminates the ability to breast feed and can interfere with nipple sensation. It is important to understand nipple inversion can be a sign of breast cancer. The internal mass can cause scarring of the milk ducts which draw in the nipple. If a patient experiences this inward movement after having normally projecting nipples, they must be evaluated for a possible breast tumor.
Some women are self conscious of nipple prominence. It embarrasses them when they wear clothing. For those women I suggest the use of clear plastic adhesive dressings which flatten the nipples. The dressings are imperceptible beneath clothing.
Other women are requesting increased nipple and sometimes areola projection. There are implants available but these are generally reserved for nipple reconstruction after breast cancer surgery. In addition, there are many reconstructive nipple procedures which use the remaining skin and fat after the cancer surgery to make a new nipple. The potential scarring resulting from these procedures require that they generally keep those surgeries in the realm of reconstruction surgery.
Women considering increased nipple and areola projection might consider temporary fillers like Restylane ® or Juvederm ®. These will be reabsorbed after six to nine months. If there are any reservations regarding the appearance, nothing need be done. A more permanent solution is fat graft injections. Fat taken from another area of the body is transferred with injections to the areola and/or nipple. The result can be permanent but some of the initial improvement will be lost as the body absorbs some of the transferred fat.
Just like clothing and hair styles, this fashionable trend may only be popular only for a season or two. I think temporary solutions to increase nipple and areola projection are the best choices. Any surgery is serious business and it should not be considered frivolously.
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