Mamamia Team Tuesday 22 January 2013 11:02am

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What do you think of ‘the Barbie’?

A ‘Barbie’ is no longer just the name of the beloved childhood doll whose hair you cut and whose bizarre shaped feet you squeezed into painful looking plastic shoes. If only.

Now the term ‘Barbie’ is being used to describe a popular – and extreme – variety of labiaplasty.

Stop the world, we want to get off.

‘The Barbie’ is so nicknamed because the procedure involves removing the inner lips of the vulva entirely so that only the outer lips are visible. In other words, it makes the genitalia of real life women look like Barbie’s.

Labiaplasty – the surgical trimming of the inner lips of the vulva and reconstruction of the appearance of the vagina – is on the rise. But the invasive procedure is only rarely carried out for medical reasons.

The real reason labiaplasty is going gangbusters is that women and girls have become more concerned about the asthetic appeal of their baby making parts. This has been prompted, at least in part, by the fact that our society’s view of what ‘normal’ even looks like has been vastly distorted by what photoshopped vaginas look like in porn.

This leaves many women feeling insecure about what their vaginas look like. Commonly cited insecurities include being worried that their vulva in uneven or unsymmetrical, or thinking the inner labia is ‘too long’.

Kristen O’Regan, a writer for art and politics magazine Guernica, went undercover to find out more about the surgery. Kristen made an appointment with a plastic surgeon and told her that she was interested in labiaplasty. Kirsten was told, “Oh yes, you’re not alone.”

Dr. Red Alinsod, who invented the ‘Barbie’ surgery explains the reasoning behind it, to Kristen.

This results in a “clamshell” aesthetic: a smooth genital area, the outer labia appearing “sealed” together with no labia minora protrusion. Dr Alinsod tells me he invented the Barbie in 2005. “I had been doing more conservative labiaplasties before then,” he says. “But I kept getting patients who wanted almost all of it off. They would come in and say, I want a ‘Barbie.’ So I developed a procedure that would give them this comfortable, athletic, petite look, safely.”

And how many people are getting surgeries like these?

The American College of Aesthetic Plastic Surgeons recorded 2,140 vaginal rejuvenation surgeries in 2010. The International Society of Aesthetic Plastic Surgeons estimates that 5,200 procedures are performed annually…

This is despite the fact that the American Congress of Obstetricians and Gynecologists have issued statements advising against vaginal cosmetic procedures, because the safety of the surgery is questionable.

In Australia requests for labiaplasty that have more than doubled over the past 10 years. More. Than. Doubled.

Labiaplasty, like any surgery, has risks such as infection, scarring and of course the ever present danger that something could go wrong. This is surgery after all.

So we’ve got patients who don’t really need to be patients and doctors agreeing to operate anyway. Why would that be?

The Atlanic reported on the growing trend of labiaplasty, which was a hot topic of discussion at the fifth annual Congress on Aesthetic Vaginal Surgery in America last year.

Many of the conference’s OB-GYNs groused that even after they’ve amassed hundreds of thousands of dollars in medical-training debt, their insurance reimbursements are lousy.

One doctor said he receives just $1,700 in fees for prenatal care and delivery, and a mere $800 for a hysterectomy. By contrast, a labiaplasty can be done in just a few hours, in-office, for a fee upwards of $5,000 and no “income socialism” to spread the proceeds among hospitals, insurers, and group-practice partners.

Although obviously labiaplasty operations are only ever performed with the consent of the patient, the procedure does draw some uncomfortable comparisons with Female Genital Mutilation – which is illegal in Australia.

Dr Rebecca Deans discussed this issue with the ABC last year, saying:

In its extreme form it’s complete removal of the clitoris as well as the labia however there are more moderate forms if you like of female genital mutilation that are only described as cutting or nicking of the genitalia and in fact, it is not that dissimilar and I really wonder about that grey area that exists between the two because obviously FGM is illegal in Australia.

Female Genital Mutilation, in its most extreme form, involves removing the clitoris as well as the labia. Cosmetic gynecology by contrast – or perhaps in comparison – can include reducing the size of the clitoral hood, and reconstructing the hymen, as well as reducing the labia minora (inner lips), labia majora (outer lips), and tightening the vagina.

Labiaplasty and Female Genital Mutilation are definitely not the same thing.  But both involve – to put it bluntly – cutting parts of the vulva clean off.

The comparison raises questions about  what it is exactly about female genitals, that make women want to – if not mutilate – then change the way their vaginas look.

What do you think about ‘the Barbie’? Would you ever consider labiaplasty?