Dear Editor,
Female genital cosmetic surgery (FGCS) is a non-medical procedure altering the appearance of both internal and external healthy genitalia. Women consider these surgeries for what is now regarded as acceptable and desirable in nowadays culture (1). Women believe these surgeries provide psychological and functional improvement in sexual activity for themselves and their partners (2, 3).
Similar to the rest of the world, we are witnessing an increase in the demand for these procedures in Iran. Due to the growing demand for these surgeries among women, in 2007, the American College of Obstetricians and Gynecologists stated that: “these procedures are not medically indicated, and the safety and effectiveness of these procedures have not been documented.” (4).
Internet advertisements and pornographic access have increased the attraction to these procedures (3). Skimpy bikinis, thong underwear, Brazilian waxing, laser hair removal, oral sex, provocative fashion advertising, and internet pornography have made women believe that genital appearance matters (5).
Internet advertisements claim that these procedures can affect physical, psychological, social, and sexual aspects of women’s lives; so, they can lead to anxiety and lack of sexual confidence in women. Alongside advertisements, pornography, blogs, and forums cause psychological distress over genital appearance (4).
Also, social media has a significant impact on advertising. In 2002 makeover shows streaming on television made a trend in cosmetic surgery, encouraging people to undergo multiple procedures to have “transformational makeovers” (5).
There is a conflict of interest between the public and doctors. In 1970, against all debates, physicians' advertisement became possible, which led to promotions and discounts, medical franchising, and hiring experts to plant stories in women's magazines. Many surgeons offered these procedures to women, advertising cosmetic surgeries. Physicians' advertisements led to under-informed consent, causing dissatisfaction among patients saying that the outcome was not what they had expected. Misinformation and misconception play a considerable role in this matter (5). There is not enough evidence regarding these surgeries' consequences and long-term outcomes, and patients should be warned about the dangers (4).
We believe that these enhancement procedures are made to make people feel deficient about their appearances and turn a restricted cultural concept into a norm. The cultural change causes people to undergo procedures to obtain society’s idea of normal (5). Giving complete information about the complications and dangers of these procedures, besides medical and psychological consults, might be a proper way to inform patients seeking FGCS (3-5).
References
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1.
Royal Australian College of General Practitioners. Female genital cosmetic surgery: A resource for general practitioners and other health professionals. Author Melbourne, Australia; 2015.
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2.
Dobbeleir JM, Landuyt KV, Monstrey SJ. Aesthetic surgery of the female genitalia. Semin Plast Surg. 2011;25(2):130-41. [PubMed ID: 22547970]. [PubMed Central ID: PMC3312147]. https://doi.org/10.1055/s-0031-1281482.
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3.
Ekrami F, Mirghafourvand M, Farzipour S. Comparison of Mental Health and Self-Esteem in Applicants and Non-Applicants for Female Genital Cosmetic Surgery (FGCS): A Case-Control. Shiraz E-Med J. 2018;In Press(In Press). https://doi.org/10.5812/semj.68751.
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4.
Liao LM, Taghinejadi N, Creighton SM. An analysis of the content and clinical implications of online advertisements for female genital cosmetic surgery. BMJ Open. 2012;2(6). [PubMed ID: 23171607]. [PubMed Central ID: PMC3533050]. https://doi.org/10.1136/bmjopen-2012-001908.
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5.
Tiefer L. Female Genital Cosmetic Surgery: Freakish or Inevitable? Analysis from Medical Marketing, Bioethics, and Feminist Theory. Femin Psychol. 2008;18(4):466-79. https://doi.org/10.1177/0959353508095529.