British gynaecologists warned on Friday that increasing numbers of teenage girls and women are undergoing genital cosmetic surgery, driven in part by unrealistic images of how they should look based on pornography.
The state-funded National Health Service (NHS) performed more than 2,000 labial reduction procedures -- labiaplasties -- in 2010, a five-fold increase in ten years, according to the Royal College of Obstetricians and Gynaecologists (RCOG).
This is "probably the tip of the iceberg compared to the number of procedures that are done in the private sector" where the data is not routinely collected, said Professor Sarah Creighton, a member of RCOG's ethics committee.
She said there had been no similar increase in labial disease in the last decade to explain the trend, suggesting instead a confusion about what represents 'normal' genitalia.
"The misapprehension arises from the prominence of just one type of 'neat' genital appearance, the type to be found prominently depicted in pornography," said Thomas Baldwin, a philosopher who sits on RCOG's ethics committee.
In a new paper, the committee expresses particular concern that teenage girls are undergoing unnecessary surgery, which is often anatomically similar to female genital mutilation -- a crime in Britain.
There is very little data about the long-term risks of labiaplasty, particularly the effect it has on sensitivity and sexual function.
As a result, the committee recommends that genital cosmetic surgery not be carried out on girls under the age of 18, until their external genitalia are fully formed.
"The younger a girl begins her labiaplasty trajectory, the higher the number of operations over her lifetime and the greater the risk of scarring and sensitivity loss," warned the British Society for Paediatric and Adolescent Gynaecology.
The experts also recommend that surgery should not be conducted on the NHS unless it is a medical requirement.
"I hope that when applied, our recommendations will help to reassure many women and girls that they are perfectly normal, they don't need surgery," said Suzi Leather, chairwoman of the RCOG ethics committee.