Female Cosmetic Genital Surgery: Patient Characteristics, Motivation, and Satisfaction

Background: Female cosmetic genital surgery is rapidly growing. However, controversy reports raised around these procedures question their indications, motives, and safety. Warning against performing this surgery might unjustly restrict surgical alleviation of symptoms. Objectives: Through anonymous research, the authors explored patient characteristics and motivation, when women started to think about surgery, and effects of surgery on psychosocial and cosmetic aspects. Methods: Of 125 patients who underwent female cosmetic genital surgery at Oslo Plastic Surgery Clinic between 2010 and 2016, 69 patients were reachable by email. A questionnaire with 40 questions was completed anonymously. Answers were processed by a third, independent party via QuestBack return mail system. Results: The response rate was 77%. Mean follow-up time was 31.4 months. Mean patient age was 30.8 years. Motivations for surgery were cosmetic (69.8%), physical/practical (62.3%), emotional (54.7%), and intimate (49.1%). When emotional reasons were involved, media (39.7%), pornography (31.5%), and negative comments (28.8%) influenced the decision to undergo surgery. Genital concerns had negative effects on self-esteem (63.2%) and sexual attractiveness (57.9%) among others; 90.5% thought about surgery for more than 1 year. The overall cosmetic result was satisfactory for 69.8%, and the operation as a whole was satisfactory for 75.5%. Conclusions: Age, level of education, and gross income of patients who underwent this surgery seem high compared with those of breast implant patients. Genital dissatisfaction arose early in life and affected various psychosexual aspects. Most patients are satisfied with the outcome of surgery and would recommend this surgery to others. Additional anonymous multicenter studies are recommended.