Secret Surgery.(genital enhancement)(Interview)

Secret Surgery

With porn going mainstream and plastic surgery more common than ever, perhaps it's no surprise that vaginal enhancement is popular. By Joan Kron

Much of cosmetic surgery is still discussed in whispers and layered with a veneer of suspicion. (Did she do something to her nose? Do her breasts look bigger? Have you noticed that her abs are ridiculously flat?) But the most secretive and controversial surgery today is performed on a part of the body that is rarely seen and often unconsidered. Euphemistically, it's called genital enhancement; in cold, scientific terms, it is labioplasty, a reduction of the inner and/or outer lips of the vagina. There are no statistics available on the number of women who have surgery on this most intimate region of the body, but if the experience of Christine Hamori, a plastic surgeon in Massachusetts, is any indication, such alterations are quietly on the rise -- not only in high-traffic plastic-surgery locations such as Southern California, Texas, Florida, and New York, but even in staid New England. Hamori, a board-certified doctor who gave a presentation about genital cosmetic surgery at a recent meeting of the American Society of Plastic Surgeons, believes the credit (or blame) is owed to a collision of cultural phenomena: the Brazilian wax and how it exposes an area that was once hidden, thong underwear, tight jeans, the mainstreaming of porn, and discussions about surgery on the Internet. Because women are embarrassed about being discontent with their genital anatomy, many patients seek out female surgeons, such as Hamori. Her website displays explicit before and after photos as well as computer-animated demonstrations of the three vaginal procedures she performs -- two types of labioplasty and one operation on the clitoral hood. "Almost all the people who come in for a consultation have seen the website," she says. "It helps them conceptualize which of the surgeries they want to do. And I'll explain to them the theory behind the shape of the result." Hamori began performing vaginal surgery about six years ago, when she was an assistant professor of plastic surgery at Boston University, and her sister-in-law, urologist Jennifer Berman, referred a patient. (Berman specializes in female sexual medicine in Los Angeles, and her sister, Laura Berman, is a sex therapist and the director of the Berman Center in Chicago.) But these operations date back at least to the 1980s, when gynecologists were performing them to remove excess tissue. In the '90s, modifications introduced by Gary Alter, an assistant clinical professor of plastic surgery at UCLA, made scars less prominent. And bizarre though it was, a 2004 episode of the TV series Nip/Tuck -- in which the surgeons plan to use tissue from a woman's labia to reconstruct her mouth -- raised awareness when blogs and chat rooms fervently discussed the show (not always politely). Hamori, who has performed more than 100 of these procedures, believes there's more to the subject than vulgar jokes and embarrassed titters. JK: Why do patients want genital cosmetic surgery? CH: Some women have a perception that they are enlarged visibly in this area. They feel bulky in thong underwear or bathing suits and very self-conscious sexually. They feel it gets in the way with intercourse or even with tight pants. Then there's the mechanical: They can feel it while they're on a bicycle, for example. The area gets irritated. And some people have asymmetries, where one side is larger than the other. We can make things more even. JK: You believe this is driven in some part by waxing? CH: I think people are more conscious of how trim they are there. Probably more than half of the woman who come in have, if not a complete Brazilian, just a tiny little tuft of hair. Now that it's in to wear sheer underwear and small bathing suits, people are becoming more cognizant of how much labial protrusion they have, especially women under 30. They say, "When I stand up, I don't want ...