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Keeping up appearances

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Cosmetic surgery was once solely the domain of Hollywood superstars and the exponentially wealthy, but it’s now so accessible there are clinics where you can ‘freshen up’ on your lunch break, and holidays offer sightseeing, shopping, and a surgery-sculpted ‘new you’, in one convenient package.

Cosmetic surgery.

Australians spend many millions of dollars on cosmetic procedures annually, including facelifts, tummy tucks, liposuction, breast augmentations and eyelifts. An increasingly popular cosmetic procedure, particularly for younger women, is labiaplasty, a procedure for altering the appearance of the labia, typically the labia minora (inner labia).

While many types of cosmetic procedures are now commonplace, Curtin academic, and Top 5 Under 40 scientist, Dr Gemma Sharp’s, research focuses on what factors influence women to choose labiaplasty.

“A recent study of labiaplasty procedures performed in NSW found that labiaplasty was most common in the 25 to 34-year-old age group,” Dr Sharp said.

“My studies over the last few years have focused on identifying the sociocultural factors that influence adolescent and adult women to undergo labiaplasty, and also the effects this surgery has on their psychological and sexual well-being.”

“The reason for focusing on labiaplasty, in particular, was based on reports that it was the fastest growing type of cosmetic surgery shortly before I started my PhD, and I wondered why surgery on a part of the body which is normally hidden was becoming so popular.”

The internet, reality television, social media and pornography, all readily accessible from the phones in our pockets, are windows to a hyper-visual universe where individuals gain attention for, and are rated on, their physical attributes. These attributes – often surgically enhanced and/or digitally altered to conform to a culturally homogenous ideal of beauty – do not reflect the human body in its natural state, and in all its diversity. They do, however, offer a rigidly prescriptive idea of how females should look.

“There is a growing body of research reporting that when girls and women compare themselves to the women shown in social media (both celebrities and peers) it has a negative impact on their mood and body image. We know that body image concerns are one of the main drivers for the development of eating disorders, so this is very concerning,” Dr Sharp said.

Dr Sharp’s research focuses on cosmetic surgery, specifically labiaplasty.

While the reasons for choosing labiaplasty are often a complex interplay between psychology, sexuality and physicality, it seems appearance is a key factor in many women’s decisions to undergo the procedure.

“From my own research, it appears that most women have labiaplasty for a combination of appearance, functional, sexual and general psychological reasons, with appearance motivations being the most common motivation,” Dr Sharp said.

“I found that women who had had greater exposure to genital images in the media, particularly on the internet and in pornography, were more likely to be dissatisfied with their own genital appearance and consider genital surgery.

The majority of women who undergo labiaplasty are satisfied with their post-surgical labial appearance and function, however, according to my research, underlying psychosexual concerns may still remain after surgery.”

While women are far more likely than men to undergo any type of cosmetic procedure, Dr Sharp notes that the men are increasingly experiencing pressures to conform to a culturally sanctioned ideal of physical beauty, and are choosing surgery to help them achieve a particular type of body.

“Men are increasingly becoming consumers of cosmetic procedures. In the USA, nearly 10 per cent of the cosmetic procedures performed in 2016 were performed on men. The five most popular procedures in men in 2016 were liposuction, breast reduction (for gynecomastia), eyelid surgery, nose surgery and facelift,” Dr Sharp said.

“An area of research I started investigating in late 2016 involved male genital cosmetic procedures, in particular, penile girth enhancement. Although this research is still in progress, it would seem that some of the same sociocultural factors impacting on how women feel about their genitals are also influencing how men perceive their penile size.”

Changing how people perceive their bodies, and feel about them, is a very complex business. According to Dr Sharp, teaching both women and men to think critically about the images they are exposed to via the internet, social media and pornography, and whether they accurately reflect the diversity of the human body in its natural state, or a more constructed ‘version’ of beauty that is unachievable without surgical intervention, is an essential first step in cultivating a healthy body image.

“I think we are still looking for how best to promote positive body image in girls and women. Educating girls and women about the unrealistic nature of media representations is one method so they become more critical of the images they view,” Dr Sharp said.

“Another issue to focus on is promoting what our bodies can do/the functions our bodies perform rather than emphasising body appearance.”

As recently selected for the Radio National’s prestigious Top 5 Under 40 program, an initiative that offers five of Australia’s most talented scientists the opportunity to develop their communication skills and discuss their work on a national platform, Dr Sharp will have the opportunity speak widely on the issue of a healthy body image, and the rise in cosmetic surgery for both men and women.

“Top 5 Under 40 represents a brilliant opportunity for me to raise awareness of the topic of genital appearance in the public domain. This is a topic that is not often addressed in any form of media or society in general. It will give me a chance to educate both genders about genital anatomy and the functions of the different parts of these organs,” Dr Sharp said.


Dr Gemma Sharp is an academic in the School of Occupational Therapy and Social Work. She holds a Bachelor of Science Honours degree in Molecular Biology, a Masters degree in Oncology, a Diploma in Languages in Japanese, a Graduate Diploma in Psychology, a Bachelor of Behavioural Sciences Honours degree in Psychology and a PhD in Clinical Psychology. Her PhD research completed at Flinders University in South Australia in 2016 focused on the predictors and outcomes of female genital cosmetic surgery. Gemma is also a Clinical Psychologist Registrar in private practice. Her clinical interests include body image and weight concerns as well as eating disorders. Dr Sharp was recently one of only five scientists selected nationally to participate in Radio National’s Top 5 Under 40 Initiative.

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