Do Genital Cosmetic Procedures Improve Women’s Self-Esteem? A Systematic Review and Meta-Analysis

Abstract

Background The popularity of genital cosmetic procedures in women is increasing. These procedures are often assumed and promoted as having a positive effect on women’s psychological well-being, particularly their self-esteem. Empirical support for these claims is lacking. Objectives The aim of this study was to conduct a systematic review and meta-analysis of the impact of genital cosmetic procedures on self-esteem in women. Methods The authors performed a systematic literature review of MEDLINE, PreMEDLINE, Ebase, EMBASE, OVID, CINAHL, Cochrane, PsycINFO, and PubMed to identify articles that measured self-esteem in women after a genital cosmetic procedure. A meta-analysis was conducted to assess the pooled effect of these procedures on self-esteem. Results The authors identified 5 eligible studies for the meta-analysis, comprising 2 prospective and 3 retrospective studies. Labia minora reduction was the most commonly studied procedure. All 5 studies used different measures of self-esteem, with only 1 study employing a validated psychometric measure at both preoperative and postoperative time points. The meta-analysis results showed a pooled logit rate estimate of 1.230, indicating a positive effect of surgery on self-esteem. However, there was substantial heterogeneity across studies. Conclusions Female genital cosmetic procedures, particularly labiaplasty, appear to have a positive effect on women’s self-esteem. However, inconsistencies in study measures and methods limit our conclusions. Future research should involve the development of standardized outcome measures to more accurately assess the impact of these procedures on self-esteem, and on psychological well-being more generally. Level of Evidence: 3

Invited Discussion on: Clinical and Patient Reported Outcomes of 19 Patients Undergoing Clitoral and Labial Reconstruction After Female Genital Mutilation/Cutting

“…Authors state that ''discomfort in sexual encounters was due to the external appearance of their genitalia'' and this is in accordance with other authors who have noted a direct relation between sexual satisfaction and the appearance of the vulvar zone [13,14]. Regarding this matter, we believe it is of extreme importance to provide accurate information including pre and postop images in order to set realistic expectations.…”

Australian women’s lived experiences of stigmatization after cosmetic surgery: A qualitative investigation.

“…Extensive literature to date has investigated how cosmetic surgery impacts the lives of its recipients. Broadly, outcomes are often positive—recipients demonstrate improved body image (Adams, 2010; Bolton et al, 2003; Sarwer et al, 2002; Schwitzer et al, 2015; Sinno et al, 2015; Sobanko et al, 2018; von Soest et al, 2009, 2011), sexual satisfaction (Adams, 2010; Bolton et al, 2003; Stofman et al, 2006), and psychological well-being (Schwitzer et al, 2015; Sharp et al, 2020; Sinno et al, 2015). Conversely, women with pre-existing mental health conditions (namely, body dysmorphic disorder—a mental illness characterized by constant worrying over a perceived or slight defect in appearance) may experience poor psychosocial outcomes after undergoing surgery (Higgins & Wysong, 2018; Honigman et al, 2004; von Soest et al, 2011).…”

The Safe Practice of Female Genital Plastic Surgery

“…Less common procedures, which are beyond the scope of this article, include hymenoplasty, anterior and posterior commissuroplaty, and labia minora reconstruction after iatrogenic amputation and female genital mutilation. 3 , 41 Nonsurgical procedure modalities, such as energy-based devices, PRP injection, the O-shot, and G-spot augmentation, are also beyond the scope of this article.…”