The craze for designer vaginas, already frowned upon by the medical establishment, has come in for further criticism.
The American College of Obstetricians and Gynecologists has come out strongly against such procedures like as "vaginal rejuvenation," "designer vaginoplasty" or even "revirgination," saying they are not medically necessary and are not guaranteed to be safe.
The procedures include changing the shape or size of the labia, "restoring" the hymen, and tightening the vagina
In guidance published in the September issue of its journal, Obstetrics & Gynecology, the group, known as ACOG, said the procedures can cause complications such as infection, altered sensation, pain and scarring.
Dr. Abbey Berenson, who helped write the guidelines, said some women may be fooled by deceptive marketing practices into thinking they need the surgery because they are somehow abnormal.
"Many women don't realize that the appearance of external genitals varies significantly from woman to woman," Berenson said in a statement.
Doctors who perform the procedures say the opinion from the American College of Obstetricians and Gynecologists is overly cautious. They say the procedures are safe and that more women are requesting such surgeries, having seen TV shows and magazines featuring them. The E! entertainment cable network's "Dr. 90210" reality-television program has spotlighted doctors performing genital surgery.
Dr. John Miklos, director of the Atlanta Urogynecology Associates, Laser Vaginal Rejuvenation Institute of Atlanta Medical Research Institute, is one of those who offer such procedures.
He defends himself saying that while some may seek the procedure to restore a tighter feel during sex, such surgery is often intended to prevent and treat legitimate conditions such as vaginal prolapse that can follow childbirth or some other trauma.
For many women the operations can relieve them of both physical and emotional anguish, he claims and stresses, "These are medical diagnoses and not some made-up stuff."
Still procedures such as revirginization, which seeks to create the effect of a restored hymen, and G-spot amplification, in which a filling agent is injected into the front inner wall of the vagina, have no clear medical indication and therefore little justification, according to ACOG.
"To undergo such procedures for cosmetic reasons, and to say it will improve sexual fulfillment is totally absurd," says Thomas Stovall, past president of the Society of Gynecologic Surgeons and a clinical professor at the University of Tennessee at Memphis.
The American College of Obstetricians and Gynecologists doesn't gather statistics on the procedures. The American Society of Plastic Surgeons began collecting data on "vaginal rejuvenation" in 2005 and reported 793 surgeries in that year. In 2006, the number jumped to 1,030.
A number of doctors mentioned David Matlock, a Los Angeles gynecologist who has appeared on "Dr. 90210," as a catalyst for the procedures' growing popularity. They say Dr. Matlock tightly controls his techniques by trademarking their names and training other doctors through proprietary courses.
One New Jersey gynecologist, Marco Pelosi II, who took Dr. Matlock's training course says it cost more than $50,000, and included laser equipment used to perform the surgeries, which cost from $3,500 to as much as $20,000 for a package of procedures.
Dr. Matlock declined to be interviewed. In a statement, he said, "Many surgeons come to me to receive training on how I perform these procedures. Since I have developed a good amount of expertise over the past 12 years, I feel my techniques are the gold standard of care."
He has been quoted in other publications as saying he has treated more than 3,000 women and trained 140 doctors. In 1998, the Medical Board of California tried to revoke his license, alleging insurance fraud, dishonesty and negligent care to two patients, according to state records. In 2000, Dr. Matlock settled with the board and was placed on probation for four years.