Is elective vulvar plastic surgery ever warranted, and what screening should be conducted preoperatively?

Area of Science:

• Sexual Medicine
• Women's Health
• Plastic Surgery Ethics

Background:

• Elective vulvar plastic surgery sparked debate within the International Society for the Study of Women's Sexual Medicine.
• A published controversy format was proposed to engage journal readers on this sensitive topic.
• The discussion highlighted the need for expert opinions on vulvar health and surgical interventions.

Purpose of the Study:

• To explore the ethical considerations surrounding elective vulvar plastic surgery.
• To provide evidence-based opinions on surgical interventions in sexual medicine.
• To stimulate further research in a under-discussed area of women's health.

Main Methods:

• Six experts in vulvar health and sexual medicine were invited to submit opinions.
• Participants included individuals involved in the initial online discussion.
• Opinions were evidence-based, addressing safety, efficacy, and ethical principles.

Main Results:

• Patient autonomy is crucial, but counseling is necessary to address normal anatomical variations.
• Ethical practice requires procedures to be based on long-term safety and efficacy, not just opportunity.
• Vulvar plastic surgery's ethicality varies, requiring careful consideration of medical ethics principles.
• Specific ethical challenges were highlighted, particularly concerning reinfibulation surgery for victims of female genital cutting.

Conclusions:

• Vulvar plastic surgery may be considered if it aligns with patient preference after thorough counseling.
• Procedures must be conducted safely and ethically, not solely for the purpose of performing surgery.
• The decision-making process should balance patient autonomy with professional ethical obligations.