"Let's face it, 30 years ago, women didn't think about their labias as much." This is Dr. Sam Gershenbaum, board-certified plastic and reconstructive surgeon, whose state-of-the-art Aventura facility gleams brilliantly, like a day in Fiesole, Italy, or the engine housing of a new Maserati. Dr. Gershenbaum, in fact, is easily imaginable behind the wheel of a luxe sports car, blowing through the Kennedy part of Palm Beach, his coiffed dark hair barely registering wind vectors, his gorgeously tanned and handsome face planed hermetically, bearing the finest specimen of an aquiline nose I've ever seen, more perfect even than Donatello's David's schnozz -- and when I compliment him about it, he doesn't miss a beat: "Well," he chuckles. "They didn't have the technology then."
Dr. Gershenbaum and his partner, Dr. Bernie Stern, make women all over South Florida ever more beautiful ("We do eyes, tummy tucks -- the whole gynecological shooting match"). Their offices are centrally located, right across from the Aventura Mall, so that if some well-off lunch ladies have finished their oeufs gratinée avec salades vertes at, say, P.F. Chang's, have plundered their way through the cunning new Fendi collection at Studio Italia, and fortified themselves with a couple of mimosas, they might be inclined to say to each other: 'Hell, Sylvia, let's go see Sam!' And teeter their gym-toned ways across Aventura Boulevard to the doctors' rounded, fashionable operating rooms, there to be cosseted, interviewed, shown films, given phone numbers of satisfied customers who'd been afraid to wear their Anna Sui catsuits, or their Brazilian string bikinis on Golden Beach or to pool parties, too, for fear their oversized labia minoras might ride up like a big camel toe and ruin the crotch line -- which is, after all, the whole point . . .
"Thirty years ago, no problem. Women just suffered in silence and their doctors were complicit, telling them: 'It's nothing. Ignore it.' Because they had no means of dealing with these very real situations," Gershenbaum says sympathetically. But as time passed and near-nudity became a fashion statement in itself if not a way of life in climates that permitted it, teens and adult women began to measure themselves against the growing spates of hot babes on, say, Baywatch, or HBO's Real Sex, or Showtime's Red Shoe Diaries, or MTV's endless Spring Break segments, not to mention all the images in the pages of Vogue, Mademoiselle, Cosmo, VF, Playboy, Penthouse, Maxim, In Shape, and in all the hardcore product you could punch up on the Internet, or find on every hotel-room TV set worth its salt . . . Well, the truth was, the teens and adult ladies had to admit their labia minoras, the inner lips of their vaginas, were just not like all those tight, neat lips on the models and movie actresses and porn stars. Compared with women like Pamela Anderson, or Christina Aguilera, or Asia Carrera (XXX star of Chinatown and Ladies' Room), let's be honest, their pudendas were wrinkled and flapping like elephant ears . . . You couldn't show up like that in tights or a fingernail-paring-sized monokini on, say, the Savarona, the world's largest yacht, when Turkish tycoon Kahraman Sadikoglu steamed her into the Port of Miami for his annual on-board party! Elizabeth Hurley and Kate Moss showed up at those things, plus über-chic designers like Miami's Bianca. So that was no time to be getting it together! Events like those can do your husband or boyfriend (or girlfriend) a world of good if you can do justice, for example, to a nude criss-cross Narciso Rodriguez dress. It's like you're auditioning . . . Plus, besides the business/social stuff, when your lover pushed in, really, he'd be dragging a couple of inches of extra sail with him -- which was no fun for anybody.
Anyway, about 20 years ago, cosmetic surgeons began to respond to the pressure, but what they did was just cut off excess tissue in crude labioplasties like Oregon timberjacks stripping bark off white pine, without regard to the aesthetics of what women wanted. "They'd just start from the outer part of the inner lip -- you know the darker, rose-colored edge with all the nerve endings and blood collection? -- and cut it off! The extraneous tissue was reduced, sure, but the scar tissue that formed during healing dulled some of the feeling, too." Also, when the healing was complete, the exquisite earlike curl of the outer edge of the labia minora was gone too, Gershenbaum lamented, an "artistic" loss for connoisseurs. Another thing -- the operation hurt like a bitch.
What he and Stern have been doing for the last few years is tracing an imaginary line somewhere inside the problem "territory" and removing some inner portion of the sometimes doubled or even tripled "wrinkles," leaving the "rosy" edge intact. Then they rejoin the outer labial curl to the uncut tissue and close it "seamlessly," so that the appearance of a pre-op inner vagina is what civilians see. "Best of all, the darker pigmented contour is there, so that looks natural and beautiful, too," Gershenbaum enthuses. Because the nerve-ending centers haven't been "invaded," the pain is less: "I've seen surgery patients out lunching on Lincoln Road on a Sunday after a Friday operation," but usually recovery is four or five days. "Sex can resume in six weeks," the doctor advises. Then he smiles. "That's what I advise, anyway."
Labia minora enlargement can be genetic, or due to hormone manipulation during infancy; it can also be caused by stretching of various kinds -- from childbirth to overzealous manual and "toy" stimulation, to repeated, Olympic intercourse, to various kinds of piercings with weighty B&D rings and "friction enhancers" (21st-century foreplay). Other designer vagina modifiers include the beautification of the labia majora outer vaginal lips by fat transplant or injections. This is called augmentation labioplasty, and keeps the majora lips from puckering and drooping with age. Liposuction can also be used to remove fat from a too-large mons pubis (the mound of Venus) -- this sometimes happens in middle age -- the opposite of men, whose penises and gonad sacs tend to shrivel under heavy duty as they get older. Gershenbaum will even perform a hymenoplasty -- the artificial restoration of the "virginal" hymen tissue for young women who want their future husbands to feel they're absolutely brand-new . . .
The doctor can't help laughing a little at this last one: "Look, I talk patients out of unnecessary operations as often as not. I don't encourage 'Michael Jackson' stuff. But our ways of looking at plastic enhancement are different from our grandparents . . . I mean, it isn't a moral issue.
"How much do I charge? Four thousand for the labia minora reduction." The other procedures vary according to difficulty ("from $1000 to $5000").
"So erotic retooling isn't for the Chevy Cavalier set then, right Doc?" I ask.
Gershenbaum peers across his desk as though it were snowing, then refers me to some of his successful clients.
"Tony," the first one, keeps saying she'll call back, and finally does: "I love Dr. Gershenbaum. He understands the psychological weight he's taking off. This is a common problem with older women."
"Sarah," the client of a rival surgeon, Dr. Richard Levin, also of Aventura, insists on "absolute anonymity," then cancels at the last minute.
"Jackie," an alumna of a third physician, whom she won't identify (but who is herself vouched a true post-op by an industry source), answers rather truculently:
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"Men can't possibly understand what it's like to be distended at that point . . ."
Me: "Well, isn't it the opposite of guys who are too small? Or who have erectile trouble, or early ejaculation, uh, issues . . ."
"See. You have no idea. It's not a plumbing problem for us. It's more who you are, your identity . . ."
Gershenbaum, emerging from a long afternoon of vaginal surgery, wearily assents: "Yeah," he says, "for some patients, labias rule."