We know women and girls are concerned with the appearance of their vulva (the external part of the vagina), despite there being no such thing as a "normal" one. They worry about its size, shape and colour, and now, too, its plumpness. The fetishisation of youth and beauty knows no bounds.
The popularity of non-surgical lip fillers has grown exponentially in the last few year, according to the British Association of Aesthetic Plastic Surgeons (BAAPS) – at the same time as more expensive surgical procedures are on the decline. And now, women are "plumping up" their labias in the same way as they are doing their lips.
Labia filler treatments – also marketed as the "labial puff" and "intimate area fillers" – are available at dozens of private clinics in London (and throughout the UK) and involve injecting hyaluronic acid, or a woman's own fat into the labia majora (the outer folds of the vulva).
It's marketed as a quick procedure (clinics say it takes half an hour and requires little to no down time), costs from about £150 per treatment, and the potential risks are often glossed over.
A quick Google search renders results for several clinics making bold claims about their labial filler treatments. First Clinical Aesthetic, a clinic with branches in London and Essex, offers "labial puff" injections from £150, which it promises will "'plump up' the outer area of the vagina" for "a fuller", "more voluminous" and "more youthful look". "You don’t need to resort to the Surgeons [sic] knife to get a better looking vagina," it proclaims. While Dr Jacqueline Lewis says her "intimate area fillers" will give "flaccid or deflated" outer labia "a rejuvenated appearance, conceal the labia minora and give a better appearance in proportions between the labia."
But gynaecologists are warning such treatments may be dangerous and result in infection, scarring, disfigurement and altered sensation of the labia. Others have warned about the risks of having injections administered by untrained practitioners. (Because the treatment is non-surgical, there is virtually no regulation over how it is conducted in most of the UK. By law, practitioners who administer fillers, and carry out other non-surgical procedures like Botox, do not need to have any qualifications. Hence the abundance of stories about botched Botox and dodgy fillers that we've become accustomed to reading.)
Clinics that provide only non-surgical cosmetic procedures need to do so in a "safe and suitable environment", according to patient information provided by the General Medical Council. There are regulatory bodies overseeing surgical procedures in England, Wales and Northern Ireland, but not non-surgical treatments. In Scotland, fillers are regulated by Healthcare Improvement Scotland.
Professor Janice Rymer, consultant gynaecologist and vice president of the Royal College of Obstetricians and Gynaecologists (RCOG), told Refinery29 the association was "very concerned by reports of genital cosmetic procedures," including labia fillers and vaginal rejuvenation. "Complications may include infection, scarring, disfigurement and altered sensation of the labia, which may interfere with normal sexual function."
Like all cosmetic procedures, there are risks associated with labia fillers, and because of the "significant lack of peer-reviewed medical research on the safety and efficacy of these procedures," doctors are unable to advise patients on the risks or long-term consequences, Professor Rymer added.
Many clinics claim the procedure gives the labia a "rejuvenated appearance" , and "a fuller more youthful look" (and even "a better looking vagina!"), which the RCOG also takes issue with. Professor Rymer said she was "alarmed by the marketing tactics used by some providers to advertise genital cosmetic procedures," including language that's "emotional, negative and plays on [women's] insecurities and vulnerabilities."
As with other cosmetic procedures on the female genitals, like vaginal lightening and rejuvenation, there's also concern that labia fillers are medically unnecessary. Women should explore their reasons for seeking these treatments with a doctor, who may be able to offer safe alternatives to address any underlying concerns, such as psychosexual counselling.
“Women who are unhappy with the appearance of their genitalia should be informed about the significant variations in normal genitalia and how the appearance of the vulva can change throughout life," she added. But with intimate waxing now the norm and "perfect pussies" the most commonly spotted porn, it's easy to see why women these days pay more attention to the appearances of their genitals than they once did.
As regards the advertising of these procedures, the Advertising Standards Authority had this to say about the promotion of labia fillers. "Our stance will always be that advertisers should hold robust documentary evidence to back up their claims (so they do not mislead) and they should prepare their ads in a responsible way," a spokesperson explained. Given the aforementioned lack of peer-reviewed medical research on the safety and efficacy of labia fillers, this requirement is important.
"If the procedure is legally available, our role is to step in where ad claims are potentially misleading or harmful," the spokesperson added. Anyone advertising labial fillers "should be taking great care to avoid any claims that might encourage women to be dissatisfied with their bodies or that trivialise the serious nature of cosmetic surgery," the ASA added. The organisation urged people with concerns about advertising they spot to contact them and make a complaint.
Professionals have warned about the risks of genital fillers for years and yet clinics are still providing them to women with few questions asked. In 2015, Harley Street skin specialist Dr Neetu Nirdosh warned of potential nerve paralysis, bleeding, swelling and loss of sensation during sex. "While [fillers] can make your hands and face look up to a decade younger, there are more risks associated when you apply to genitals," she said. "The extra risk is because of the vast amount of nerves and blood vessels around the clitoris, labia and urethral opening."