The Barbie Labiaplasty. Yikes!

Trying to imitate Barbie in real life is nothing new. A few women who, I fear, are a few cards short of a full deck, have undergone multiple, major surgeries to bring Barbie to life. Do a Google search under “real life Barbie” and you will find 93 million sites. The poster girl is arguably Valeria Lukyanova, a Ukranian model often referred to as the “Human Barbie Doll”. I did a quick perusal of a gallery of images of women who have attempted to duplicate the look of a Barbie doll. To say that all look bizarre, would be an understatement. In addition to her other cosmetic surgical alterations, which are considerable, I cannot but wonder if Valeria has undergone the Barbie labiaplasty.

Since when did a plastic doll become the model for what a woman should look like? I thought it was the other way around; dolls model real life people, at least superficially, not vice versa. To think that adolescent girls and young women feel imperfect or, worse, deformed, because they don’t match some company’s doll is scary, and very sad. To see surgeons promoting this is, in my humble opinion, appalling.

I have performed labiaplasties, however, in every case the issue was something practical, rather than an attempt to produce some fantastical ideal. A few women with prominent labia minora experience discomfort, pinching in certain clothes or when sitting on something like a motorcycle or bicycle seat, or interference with intercourse. For those, a conservative labia reduction can work wonders. Appearance is rarely an issue. Ironically porn starlets, who might be expected to be particular about that area reportedly do not obsess about the look of their booty.

Labiaplasty isn’t rocket science or highly technical surgery; it just takes care to avoid problems from overdoing things. I don’t want a scar at the introitus that could cause pain or discomfort. I scrupulously avoid surgery on or near the clitoris. As with many faddish procedures, e.g. the Brazilian butt lift, promoters of these surgeries typically gloss over potential complications, which can be severe and not correctable- scarring, pain, dryness, discomfort with intercourse, etc.

Cosmetic surgery is defined as surgery to make a normal feature more attractive. This raises the obvious question: what is the ideal, beautiful normal when it comes to external female genitalia? The answer is: there is no single beautiful ideal normal. As with all human features there is a wide range of normal. This goes for facial features, breasts, hands, feet, essentially any anatomical feature. What makes something or someone beautiful is as much in the mind’s eye as in reality. If there is one thing I have learned in 33 years as a plastic surgeon, it is that women are their own worst critics. This appears to be especially true of impressionable adolescent girls and young women who often seek an ideal as exemplified in the media, especially in today’s social media, that is often unrealistic, not to mention unattainable. It is our responsibility as the adult professionals in the room, not to feed the insecurities of our patients.

What’s next? Young men asking to look like Ken down there? Now, there’s a scary thought!

R. T. Bosshardt, MD, FACS

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