"The First Cut is the Deepest" : a psychological, sexological, and gynecological perspective on female genital cosmetic surgery

In recent years increased numbers of healthy women and girls have been seeking female genital cosmetic surgery (FGCS) for esthetic reasons and/or to enhance sexual functioning. This phenomenon is associated with the development of a new vulvovaginal standard due to Internet pornography and the increased exposure of female genitalia. This strict standard may negatively affect women's psychological health and cause increased insecurity, which may drive even teenagers to seek FGCS. Psychological counseling is recommended to inform women that surgery is not a definitive solution to treat psychologically based pain or dysfunction. Moreover, there is no robust evidence supporting the effectiveness of FGCS, especially regarding sexual enhancement, as underlined by major scientific societies. The importance of a definite regulation of FGCS should be emphasized and be based on an ethically-oriented, multidisciplinary model aimed at providing exhaustive information on all gynecological, sexological, and psychological concerns raised by this type of surgery.