Orchid
Photo: © 2008 Jupiterimages Corporation
I have a fair amount of spa experience, some of it relatively…invasive. My bottom has been exfoliated with prickly salt scrubs, my breasts rubbed down with self-tanner, and on a semi-regular basis, I pay good money to fling my feet behind my head while a stranger rips hot wax from between my legs. But when I recently heard about a new New York City "medspa" devoted exclusively to the care of women's genital areas (it's called Phit—Pelvic Health Integrated Techniques), I thought, "Now, this is too much." What could possibly go on at such a place? I contacted the founder, gynecologist Lauri Romanzi, MD, to find out.

The primary purpose of Phit is to promote "pelvic fitness," says Romanzi. "Improving pelvic floor strength with Kegel exercises is very important for bladder control and sexual pleasure, and I wanted to create a place where women would be taught how to do them correctly." Oookay. But in addition to these (very) personal training sessions, Phit offers pricey laser treatments to smooth everything from cellulite to the skin of the outer labia ("Your face isn't the only area that loses volume with age and gets wrinkly"). Oookay! Then there are the most dramatic interventions: surgical tightening of the vaginal muscles and labiaplasty, an operation to "recontour" the inner labia. The former is primarily for women who feel they have lost their vaginal "snugness"; the latter can be performed at any age—usually to address an asymmetry.

Last year, doctors in the United States performed just over 4,500 "vaginal rejuvenation" procedures—not many compared with almost 400,000 breast augmentations and some 450,000 liposuctions, but enough to prompt the American College of Obstetricians and Gynecologists (ACOG) to issue a statement about "the lack of data supporting the effectiveness of these procedures as well as their potential complications, including infection, altered sensation, pain, and scarring." ACOG also says these treatments are not "medically indicated," but New York City plastic surgeon Lawrence Reed, MD, who performs about 20 such procedures a year, argues that in the case of labiaplasty, sometimes reshaping can relieve physical discomfort caused by chafing.

In less extreme cases, though, are we becoming overcritical of our genitalia? "Now that more women are taking off their pubic hair, they're seeing things they didn't used to," says Romanzi. Maybe so, but I think I'll limit any "rejuvenation" to those daily Kegels.