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Female genital cosmetic surgery

Key sources
The following summarized guidelines for the evaluation and management of female genital cosmetic surgery are prepared by our editorial team based on guidelines from the Austrian Society of Gynecology and Obstetrics (OEGGG/DGPRÄC/DGGG/SGGG 2023), the Society of Obstetricians and Gynaecologists of Canada (SOGC 2022), the Japanese Society for Neonatal Screening (JSNS/JSPU/JES/JSPE 2022), and the American College of Obstetricians and Gynecologists (ACOG 2020; 2017).
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Guidelines

1.Diagnostic investigations

Clinical assessment: as per SOGC 2022 guidelines, elicit a complete medical, sexual, and gynecological history, and confirm the absence of any major sexual or psychological dysfunction, including body dysmorphic disorder, in females requesting vaginal cosmetic procedures. Rule out any possibility of coercion or exploitation.
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2.Therapeutic procedures

Vaginal laser therapy: as per DGGG 2023 guidelines, insufficient evidence to recommend vaginal lifting with CO2 lasers, non-ablative Er:YAG, or radiofrequency therapy for purely cosmetic reasons.
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3.Surgical interventions

Indications for surgery: as per DGGG 2023 guidelines, consider performing esthetic and functional surgery to improve sexual self-image and sexual satisfaction in patients with body dissatisfaction relating to their genitalia.
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More topics in this section

  • Technical considerations for surgery

4.Specific circumstances

Adolescent patients: as per SOGC 2022 guidelines, ensure that physicians seeing adolescents requesting female genital cosmetic surgery have additional expertise in counseling adolescents.
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  • Patients with body dysmorphic disorder

  • Patients with congenital adrenal hyperplasia

  • Patients with female genital mutilation

5.Patient education

General counseling: as per SOGC 2022 guidelines, educate females about their anatomy and help them appreciate individual variations, including transitions through the reproductive life cycle.
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6.Quality improvement

Advertising: as per SOGC 2022 guidelines, be cautious in advertising female genital cosmetic surgeries, to ensure such advertising is factual and not misleading.
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