Last week, several articles surfaced about "vontouring" (short for vaginal contouring), which is a non-invasive plastic surgery procedure that claims to use a special tool to make your vag gorgeous. The procedure uses a device called the Protégé Intima to heat the skin of the vulva to remodel the underlying collagen. The affect produces tighter, plumper, supposedly more youthful labia. The manufacturers claim the tightening procedure makes for an — ahem — snugger fit, improving blood flow to the labia and making sex feel awesome.
While the procedure is already available in Europe, with a press release stating that demand for the surgery has grown up to 109% since 2012, it appears to now be gaining traction in the United States: The Protégé Intima has been approved by the FDA for other, non-cosmetic purposes, and the procedure is offered by a handful of spas and dermatological practices in the United States. Vontouring is being marketed as a cheaper, non-surgical alternative to increasingly popular procedures like labiaplasty.
For women who are uncomfortable with the appearance of their genitalia but feel squeamish about going under the knife, the Protégé Intima might seem like a safe and easy alternative. But not only is the procedure not definitively proven to be safe, but it also exploits women's insecurities about their own vaginas.
There's precedent for this type of procedure. Labiaplasty is a costly (and controversial) procedure that also reduces the length of the labia, ostensibly making the vulva appear tighter and more compact. While a full course of vaginal contouring treatment costs roughly $300, a full-on labiaplasty can run up to $5,000.
Manufacturer BTL Aesthetic's website says the device (called Exilis Protégé in the U.S.) produces radio waves that heat the layer of collagen within the skin, breaking it down and triggering cells to produce new collagen fibers. Essentially, the device destroys old, tired, saggy collagen, causing the body to replace it with new, springy, youthful-looking collagen.
Research shows that this type of procedure reduces wrinkles and cellulite by tightening and plumping the skin. One study published in May tried the product out on pigs and looked at collagen structures under a microscope. The researchers found that skin tightness improved by about 16% three months after a month of weekly treatments. A scientific review of human studies also showed that devices like the Protégé Intima perform consistently well in reducing the appearance of wrinkles, cellulite and for tightening saggy skin. But no studies specifically mention its use in altering the appearance of the vulva.
However, it's unclear that vaginal contouring can improve sexual function. On its European website, BTL Aesthetics claims that all 10 of the women they surveyed who had the procedure reported an improvement in their sex lives, with two saying the improvement was "excellent." But due to the small sample size of the survey, we can't really use it to glean any information about the safety or efficacy of the procedure. And while an article on Mashable suggests the tightening of the labia increases sensitivity, leading to enhanced sexual pleasure, there's no evidence to suggest that having a tight, plump, "perfect" vulva makes sex any better.
Furthermore, there is no evidence that a "perfect" vulva will make women feel more confident about their sexual performance. Rebecca Covey, esthetician and founder of EsthetixMD in Bend, Oregon, is skeptical of such claims. "I do not believe that changing the appearance of the labia improves sexual satisfaction," Covey, whose spa is one of only a handful in the U.S. that offer the vaginal contouring procedure, told Mic.
Covey said that while about 70% of her patients report some improvement in sexual function after having the procedure, she believes that's due to enhanced blood flow helping to "wake up" the genital area. She also posits that the tightening of the labia might allow for more friction during sex, thereby improving sensation. BTL Aesthetics did not respond to a request for comment.
Although there haven't been any long-term follow-up studies on the effects of vontouring, a 2014 study compared women who got more invasive surgical labiaplasty with women who didn't. They found that while the surgery group initially reported a bump in sexual function after the procedure, by 11 months or more after the surgery their sexual function had fallen back to where it was before going under the knife.
While other, larger studies show that surgery to tighten the vagina and labia does lead to greater sexual satisfaction in the long term, without long-term follow-up studies on the Protégé Intima, it's unclear how non-surgical vaginal contouring will hold up against its slice-and-dice cousin.
Regardless of the efficacy of vontouring, it's part of a disturbing new trend. Even if you do feel you're in dire need of this procedure, you may have a hard time getting it in the United States, where the necessary device is approved for the reduction of pain, wrinkles and cellulite, but not for vaginal cosmetic surgery. And while it's been suggested that the Food and Drug Administration is on track to approve labiaplasty for the list of uses for the device, the FDA declined to comment about the status of approval for the procedure.
"Products defined by federal law as medical devices for the treatment of diseases or medical conditions are under FDA regulatory authority, and doctors are not allowed to use unapproved medical devices to perform procedures on patients," FDA press officer Deborah Kotz told Mic in an email. But Kotz also added that the FDA does not prohibit doctors from using approved medical devices "off-label within the context of a legitimate health care practitioner-patient relationship," so long as it is safe and effective.
There's some evidence to suggest that it will be. According to a report from the American Society for Aesthetic Plastic Surgery, more and more American women are seeking out extreme vaginal surgeries like labiaplasty, with the number of surgeries jumping 44% between 2013 and 2014.
That same 2014 study also reported that women primarily get labiaplasty for three reasons: to reduce self-consciousness in public situations like a locker room; to reduce self-consciousness and judgement in sexual situations; and to improve comfort. Researchers also found that nearly a third of women seeking labiaplasty "have been teased or had negative comments made about their genital appearance," usually by a partner or friend. And the worst part is, gynecologists say the surgery is totally unnecessary: Of the women who seek labiaplasty, the vast majority have totally normal labia.
While some blame the porn industry for promoting this vaginal beauty ideal, others suggest that mainstream pop cultural images, such as Miley Cyrus's Terry Richardson shoot, are contributing to the increased demand for compact, Barbie-like labia. But the truth is, vulvas come in all shapes and sizes, as the website the Labia Library aims to prove. The site showcases the full spectrum of vulva appearances, reassuring women that their labia are normal, regardless of their size.
Ultimately, the decision to get any sort of medical procedure is an agreement between a patient and their doctor. But if you're a woman who's self-conscious about her vagina and thinks it looks gross and weird, just keep in mind that it almost certainly doesn't. And either way, even if you do want to "fix" your (perfectly normal) vagina, a collagen shot to the vulva probably isn't your best bet.