Increasing numbers of women are having cosmetic surgery to achieve a “designer vagina” but doctors warn that the operation may be unsafe.

No studies have looked at the long-term safety of labiaplasty, an operation to make the labia smaller, experts said. The irreversible operation, which can cost £3,000 privately, is often carried out for cosmetic reasons.

Once considered the special domain of glamour models, female genital cosmetic surgery is becoming more common in wealthy nations and is being advertised to healthy women, according to researchers from University College London (UCL).

Writing in BJOG: An International Journal of Obstetrics and Gynaecology, they say that surgery can damage the nerve supply to a woman’s genitals and called for more research on the effects of surgery on long-term sexual function.

The team searched electronic databases for relevant articles and studies carried out between 1950 and April 2009. They found 40 articles, 18 of which included patient data. Details of how the study was designed were unavailable for 15 of the 18 papers and the remaining three related to past surgery. No properly designed studies were found among the literature.

The authors said “all reports claimed high levels of patient satisfaction and contained anecdotes pertaining to success”. However, they said more research was needed on whether women were actually suffering physical symptoms — such as discomfort or lack of sensation — or if their desire for surgery was purely cosmetic.

The number of NHS operations for labia surgery has also risen in recent years, to 1,118 procedures in 2008-09, compared with 669 in 2007-08 and 404 in 2006-07.

Lih-Mei Liao, a consultant psychologist at UCL, said that healthy women were being commercially targeted for “invasive and irrevocable surgery”.

“Advertisements promote labial surgery as easy answers to women’s insecurities about their genital appearances — insecurities that are fuelled by the very advertisements that prescribe a homogenised, prepubescent genital appearance standard for all women,” she said.

Sarah Creighton, consultant gynaecologist at University College Hospital and one of the report’s authors, added that there was a “shocking lack of solid evidence” about the procedure.

“Labial surgery needs to be rigorously evaluated in future,” she said.

Professor Philip Steer, editor-in-chief of BJOG, said: “Commercial images and social pressures often serve to distort public perceptions about what is physically normal. Healthy messaging about the normal variation in female genitalia, as well as body shape and size more generally, is needed and important.”

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