PART ONE:GENITAL LANDSCAPING, LABIA REMODELLING AND VESTAL VAGINA: FEMALE GENITAL MUTILATION OR FEMALE GENITAL COSMETIC SURGERY?


Dr. Tight
Hey, girls! A Beverly Hills gynecologist says he can juice up your sex life with some quick, below-the-belt surgery.But some medical experts have reservations.
Lisa Derrick
New Times Los Angeles Online \Dr. Tight".
04/30/1998
First it was hair color, with women being told that blondes have more fun. Then came breast implants, liposuction, collagen, and Gortex. But now women are informed that they should make some internal modi cations as well. And though they may not be what kind of changes Deepak Chopra has in mind, a Beverly Hills gynecologist says his one- hour laser procedure to resculpt and tighten the vagina will result in better sex. Dr. David Matlock is selling an operation normally used to relieve stress urinary incontinence{leakage of urine from the bladder during coughing, exercise, or sexual intercourse. But he's marketing the surgery as a way to enhance sexual gratification, a claim that has yet to be proven in clinical studies.
According to Matlock, ''sexual grati cation" doesn't necessarily equal orgasm.''Sexual grati cation is sexual pleasure," he says. Orgasm is just a part of that; it's the pinnacle of that." To the doctor, who cites Masters and Johnson repeatedly, sexual grati cation means an increase in ''frictional forces." That is achieved, he explains smoothly, by decreasing the diameter of the rst third of the vagina. To accomplish this, he makes incisions in the top and bottom of the vaginal canal using a laser, overlaps the muscle, stitches it in place with absorbable sutures, and removes excess surface tissue. ''I get patients that say they are not satis ed sexually, that they desire to have a more aesthetic appearance. They want to be tighter," he explains. Some patients, the husband and wife, come in together and say, We're not sexually satis ed."The woman has to come in here initially without anorgasmia (the inability to achieve orgasm)," Matlock continues. ''We don't want to deal with that; that's in the realm of dysfunction." Instead, he wants to enhance the sex lives of ''normal functioning women" who have no serious problems sexually. Traditionally, gynecology{even gynecological plastic surgery{has concerned itself with issues of physical function such as incontinence rather than sexual pleasure. But Matlock feels this needs to change.''You're not here to make an ethical judgment; you're here to help people," he says. ''And if [women] feel this will help their sex life, okay, we can go ahead and enhance these things." Among the enhancements Matlock is betting women want is ''designer laser vaginoplasty," a cosmetic remodeling of the labia. ''It's called `designer' vaginoplasty because the woman is the designer," says Matlock. ''The doctor is just the instrument." He cites the airbrushed women of Playboy as examples of what is aesthetically pleasing in labia. ''Honestly, if you look at Playboy, those women, on the outer vagina area, the vulva is very aesthetically appealing, the vulva is rounded," he says. ''It's full, it's not at...Women are coming in saying, `I want something dierent, I want to change things.' Then look at Playboy, the ideal woman per se, for the body and the shape and so on. You don't see women in there with excessively long labia minora." The glossy brochures that share space with Vogue, Cosmopolitan, Allure, and a bouquet of arti cial owers in Matlock's beige-marble offices on Sunset Boulevard contend that 30 million American women ''suer" from symptoms of vaginal relaxation, primarily stress urinary incontinence, a gure other gynecologists interviewed for this article supported. But Matlock claims that, after surgically treating women for this problem, his
patients reported an astounding side eect. ''They would call me and say, `my sex life is greatly enhanced.' I had husbands calling. Patients would tell their friends who may not have had functional problems, saying, `well, Suzy had this done.' I thought, if the patient wants this and we can oer it, let's do it. I changed my concepts and oered it to patients who wanted it. Laser vaginal rejuvenation for the enhancement of sexual grati cation is a laser surgical procedure designed to enhance sexual grati cation."
Another Beverly Hills gynecologist who declined to be named says that he has performed this surgery on women with stress urinary incontinence and they, too, said it improved their sex lives. But would he recommend the operation to a woman purely for sexual enhancement? \Not at this stage, no," the physician says. ''What Dr. Matlock is doing is very avant garde and on the cutting edge. I prefer to be in the middle of the pack."