Women from around the world flock to David Matlock's marble waiting room carrying purses stuffed with porn. The magazines are revealed only in the privacy of his office, where doctor and patient debate the finer points of each glossy photo.
The enterprising gynecologist sees countless images of naked women, but none are more popular than Playboy's fresh-faced playmates. They represent, he says with a knowing smile, the perceived ideal.
“Some women will say, ‘Hey, you take this picture and hang it up in the operating room and refer back to it when you're sculpturing me,'” he said in an interview in his clinic overlooking hazy Los Angeles. “I say, ‘Okay, all right, fine.'”
Dr. Matlock is a colourful pioneer in a controversial — and growing — frontier of plastic surgery: nipping and tucking vaginas. Patients from the United States and more than 30 other countries pay thousands of dollars for his “designer vagina,” a purely esthetic procedure that includes shortening or plumping up the labia, or vaginal lips. He attracts even more women for an operation he claims improves sex by tightening, or “rejuvenating,” the vagina.
“There's a need for this,” he said. “Women are driving this. I didn't create this market, the market was there.”
While doctors have long known how to enhance women's genitals, demand for vaginal surgery has mushroomed in recent years because physicians — led by Dr. Matlock — market it as enhancing sexual satisfaction.
Doctors working in the field, including those in Canada, report higher caseloads and longer waiting lists. And the American Society of Plastic Surgeons says the increase is so great that it expects to soon start tracking volumes.
The trend has even reached girls as young as 15. In the past 18 months, the number of teens — and in one case an adolescent and her mother — who come to Dr. Matlock for designer vaginas has doubled.
“They're mature. Breasts, body, everything. I mean the clothing that they're wearing, the whole thing. These are not little girls. They're mature young ladies.”
Plastic surgery's spread to women's nether regions alarms those who see it as a manifestation of society's air-brushed standards of the female form that exploits women's deep-seated insecurities.
“I think it's appalling and frightening and one more way in which perfectly normal, beautiful women are terrorized by the possibility of being less than a perfect 10,” said Joy Davidson, a certified sex therapist and author in Seattle.
Michael Atkinson, a sociology professor at McMaster University in Hamilton, says the increasing popularity of cosmetic vaginal reconstruction is partly the outcome of the West's obsession with plastic surgery.
“This is essentially a cultural problem that we fix medically,” said Prof. Atkinson, who studies cosmetic surgery. “We have this notion the body's a problem to be worked and if you slightly deviate from a supposed norm you should do something about it, which is really a market logic. That's how we make a lot of money in our culture, to plant these cultural ideals in people's heads and then try to enforce them.”
However, women who have had their genitals surgically enhanced say it has transformed their lives. While some patients have genuine health problems, such as incontinence, many also ask their doctors to perform additional procedures while they are on the operating table. Others are solely driven by cosmetic or sexual reasons.
For the past 14 years, Julie Gause was troubled by the after-effects of an “extremely awful episiotomy,” which is an incision to facilitate childbirth, that she had while delivering her son. But “the No. 1” reason she sought the surgery was to “enhance” her sex life.
“It's definitely going to be worth it for the rest of my life,” the bubbly, tanned, 35-year-old Los Angeles resident said in an interview. “It takes you back to before children, for sure. It's an amazing difference. It's unbelievable.”
