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The last time I went for a facial, my aesthetician told me that I wasn’t exfoliating enough. She recommended I use a sugar-and-salt scrub two to three times a week and follow it with a deep moisturizing lotion. She also said I would benefit from a clarifying mask. When she was done, she told me to avoid taking a hot shower and exercising for the rest of the day. I emerged from the treatment room feeling a bit sore, tender to the touch and walking a little funny. Did I mention the facial was performed on my vagina?

Dubbed the vajacial and inspired by its popularity in cities like New York and San Francisco, the treatment is now available at Fuzz Wax Bar's three locations in Toronto. In a nutshell, it's a revitalization treatment performed 10 or more days after a bikini wax and is intended to beautify the area. With the deftness normally reserved for dental surgery, an aesthetician tackles the delicate skin with a cleanser, exfoliant, tweezers and a needle (to poke out the ingrowns) before applying the mask. And for the finale, a high-frequency electrical wand is smoothed over the area to treat deep-rooted ingrown hairs and to prevent breakouts. It's hard to say which tool is less welcome near my lady-cave: a glass conductor that emits electrical currents or a medical-grade needle. Believe it or not, the former felt like a happy ending compared to the latter.

It wasn't an unpleasant treatment; in fact, I was pleased to see smoother and clearer skin afterwards. But it did make me rethink my responsibilities to my vagina and ponder whether I've been falsely confident in it all this time. Suddenly, my semi-regular bikini wax seems like a joke. Even the Brazilian is no longer top seed in the vaginal beautification ranks. In addition to the vajacial, women are now being offered an increasingly invasive array of treatments for their nether regions that includes steaming, bleaching, dyeing and surgical trimming. What's more, the number of women signing up for these services is on the rise.

According to the International Society of Aesthetic Plastic Surgeons, more than 114,000 labiaplasty procedures, a surgery that reduces the size of the outer labia, were performed worldwide in 2013. The highest concentration of procedures (13,683) occurred in Brazil, followed by the U.S. at a reported 6,072. According to American statistics from the same year, labiaplasties saw a 44 percent increase nationwide. Over in Australia, a recent national Medicare-system report claimed that labiaplasty procedures in that country doubled in 2012; and a 2014 U.K. National Health Service report reveals a fivefold increase in the procedure over the past 10 years. There are no statistics for the Canadian market, but the plastic surgeons interviewed for this article reported that in their practices, requests for vaginal rejuvenation procedures over the past five years have doubled on the low end and quadrupled on the high.

Although the beauty industry has long been accused of brainwashing women into believing they aren't taut enough, smooth enough, young enough, and – let's say it – white enough, the birth of the vaginal beautification industry owes its ascendance to another pervasive influence: porn.

"Because of technological advances, we have greater access to pornographic images that explicitly and implicitly convey aesthetic and erotic ideals," says Eileen Anderson-Fye, associate professor of anthropology at Case Western Reserve University in Cleveland. "These images hold women to increasingly singular standards about beauty and desirability."

One of those aesthetics is the bleached look, and at Allure Body Bar, a Toronto skincare and waxing salon, requests for vaginal "pinkening" have increased by more than 20 percent in the past 12 months, says co-founder Alaa Abbassi. Darkened pigmentation of the bikini line, inner thigh area and outer labia, which can be caused by hormonal fluctuations in childbirth or menopause and with extreme weight gain or loss, is, according to Abbassi, a common concern.

"These are women who feel insecure about wearing a bathing suit in public and even letting their partner see them naked," Abbassi says of the clients who make appointments for vaginal bleaching. "The service isn't just for women in the sex industry but average stay-at-home moms and professionals."

The treatment is something of a misnomer. There aren't any bleaching agents involved; the product used is actually a natural skin-lightening cream with barberry and licorice-root extract. Abbassi says that clients can see results up to four shades lighter after the first in-salon treatment, and they'll have their normal colour back within two to six weeks with home care. Allure also offers a version of the vajacial called the Bikini Peel, which cleanses and exfoliates the region and uses a vegetable-based peel to help calm inflammation and curb ingrowns.

Other spas across the country that offer bleaching include Beaming Beauty Skin Care Clinic in Edmonton, which opened in February, and Beautiful Canadian Laser & Skincare Clinic in Surrey, B.C. Dr. Sachit Shah says there has been a marked increase in inquiries about the clinic’s bleaching procedure and estimates that he now performs up to two per week, versus approximately one per month in 2013.

For anyone too ashamed to expose her darkened vulva to a defenseless doctor or aesthetician, the long arm of the Internet offers an alternative. Bleaching creams like My New Pink Button, Pink Privates and My Pink Wink can be purchased and shipped directly to one's front door.

Of course, on the far end, there is labiaplasty. Dr. Martin Jugenburg, a plastic and reconstructive surgeon at the Toronto Cosmetic Surgery Institute, estimates the demand for the elective procedure at his clinic has increased 30 per cent in the past three years. He's been performing the surgery since 2001, a year after the famous Sex and the City episode in which Carrie gets a surprise Brazilian wax sent requests for the service into overdrive.

Like Anderson-Fye, he credits porn as a driver of the trend: "Because of the increased exposure to [pictures of] labia on the Internet, people are more aware of what the labia looks like in other women," he says. "This makes them feel very self-conscious and it can have a significant negative impact on body image."

Dr. Richard Bendor-Samuel, a plastic surgeon at The Landings Surgical Centre in Halifax, echoes Jugenburg's sentiments. "In pornographic media, they have a term called 'cleaning up,' where images are digitally altered to depict a clipped and reshaped vagina," he says. "It creates unrealistic expectations."

Despite doing his utmost to dissuade most of the women who come to him for labiaplasty surgery, he says demand for the procedure has quadrupled over the past five years. He estimates that between himself and his partner, Dr. Louis Boileau, their clinic performs at least one labiaplasty per week.

Dr. Anthony Lockwood at the First Glance Aesthetic Clinic and Surgery Centre in Winnipeg has seen a doubling of labiaplasty surgeries in the past four years at his clinic, and he says he's performed just over 100 in the past 12 months alone.

"Women across the board, from 17 to over 60, are much more discriminating about what they want to see when they look in the mirror," he says. "Plastic surgeons have had a stereotypical male viewpoint of the labia, and now women are being more vocal with what they want. I find it strange that national societies in the U.S. and Canada have a negative attitude toward these procedures because it will only push them underground and the results will be negative."

Like anything else involving cosmetic tinkering, the question of whether this is empowering to women or just another example of pandering to unattainable societal (read: patriarchal) norms inevitably comes up.

"Is genital surgery empowering? You could argue that it is if a woman carries out her choice and feels, at least in the short run, a little better," argues Elke Reissing, a psychology professor at the University of Ottawa. And while she admits that there are more self-actualizing ways for women to boost genital confidence – pelvic floor physiotherapy, for instance, or short-term sex therapy – she doesn't think cosmetic or surgical options are necessarily negative. If nothing else, it has us talking openly about vaginal confidence.

“The increased media exposure to women’s genitals is a complex phenomenon, but I believe it can contribute positively to women’s feelings about the variability of their bodies,” she says. “We objectify and sexualize women’s bodies a lot, but at the same time, there is much more range in what is considered beautiful. How we groom and care for our vulvas is another opportunity of choice.”

Editor’s note: (July 15, 2019) An earlier version of this article incorrectly stated Dr. Shah’s medical specialty as a cosmetic dermatologist. This version has been corrected.

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