USED TO BE, a woman who wanted to spice up her love life would buy a sex toy, learn a new lovemaking technique or invite more than one partner into her bed.
But in this age of extremes, some women are taking a more radical route to please their paramour: They're having their vaginas sliced and diced.
"Vaginal rejuvenation" surgeries give women a chance to tighten private parts pulverized by childbirth, or to just correct those that Mother Nature made assymetrical or imperfect, supporters of the surgeries say.
"Because of the recession, most cosmetic surgeons are doing far less [business] than they have in previous years, but I'm busier than ever," said Sherman Leis, a Bala Cynwyd-based plastic surgeon who partially credits vaginoplasties and labiaplasties with his practice's success. "Women want to look good all over and feel better, too."
While some women cringe at the idea of someone carving up their most sensitive spots, "designer vaginas" and "Mommy makeovers" - a fraction of the 12 million cosmetic procedures done nationally each year - are growing in popularity, statistics show.
The American Society of Plastic Surgeons reported fewer than 800 vaginal rejuvenations in 2005. By 2009, the American Society of Aesthetic Plastic Surgery tallied more than 2,500.
The cost of vaginal rejuvenation averages just under $4,000, according to the American Academy of Cosmetic Surgery.
One local vaginoplasty patient says it was worth the money.
"Things were not right down there," said a 36-year-old Lansdowne mother of three who said that she also suffered post-childbirth urinary incontinence. "Sexually, I was blank-feeling. Now, my vaginal area feels like I'm a teenager, really. It's like back to its original state. I'm so glad I did it."
The woman had her surgery eight months ago at the RenewMedSpa Anti-Aging and Aesthetic Medicine, in Center City, where gynecologist Pamela Dyer-Goode said that she averages one vaginal-rejuvenation procedure a day. Older patients typically want a sexual or functional problem fixed, but younger patients often seek a pornographically perfect aesthetic, Dyer-Goode said.
Popularized by Los Angeles gynecologist David Matlock, of the reality-TV show "Dr. 90210," vaginal rejuvenation started more than 10 years ago as a response to functional problems, such as pelvic-floor laxity, said Mark Berman, an L.A. plastic surgeon and president of the American Academy of Cosmetic Surgery.
But as smirking patients told doctors of its side effect of improved sexual gratification, some surgeons began offering the procedures as elective, Berman added.
Vaginal rejuvenation actually refers chiefly to two types of surgery: Vaginoplasty, which tightens the vaginal canal and muscles stretched out by childbirth; and labiaplasty, which involves cutting "uneven, asymmetric, droopy, bulky [or] discolored" labia that a woman might find unsightly or uncomfortable, Leis said.
Besides addressing concerns about aesthetics, genital function and sexual satisfaction, both procedures also are part of sexual-reassignment surgery for transgender males-to-females, Leis added.
Dyer-Goode also offers hymenoplasty, or "revirginization," in which a surgeon "restores" a woman's hymen. And the Lansdale-based Laser Vaginal Rejuvenation Institute of Philadelphia offers "the G-Shot," in which a doctor injects collagen into a woman's G-spot to enlarge it.
Critics charge that such procedures are genital mutilation. Doctors who offer the surgeries are nothing short of scalpers in white lab coats, they argue.
"It's a pretty misogynistic procedure on some very obvious levels," said Beth Jordan, medical director of the Feminist Majority Foundation and a women's-health and internal-medicine physician in Washington, D.C. "A cultural overemphasis on pornography has created an unrealistic expectation of what a woman's body should look like."
Further, there's little proof of practitioners' claims that the procedures enhance sexual sensitivity, critics say.
"Sexual pleasure has to do largely with clitoral stimulation, which has nothing to do with [labiaplasty and vaginoplasty]," said Susan Bennett, associate physician at the Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School.
Bennett said that "a lot" of her patients inquire about it. She advises them against it.
The American College of Obstetricians and Gynecologists also has warned against such procedures. In September 2007, The ACOG urged physicians to advise patients that procedures such as "vaginal rejuvenation, designer vaginoplasty, revirginization and G-spot amplification" have not been scientifically proven as safe or effective. Doctors should inform women about potential complications such as infection, altered sensation and scarring, the ACOG said.