On the down low

We worry about our faces, our necks, our boobs, so it’s natural our thoughts get to Down There. But is it a step too far? One fortysomething writer investigates genital rejuvenation to find out

One writer gets frank about what happens when ageing heads south

Ihave to say there are so many surprises in the ageing process. I’d steeled myself for crepey neck and creeping knees, the odd grey pube (easily solved with a quick tweeze or dimming of the lights). But the effects of ageing on my vagina was not something I’d anticipated. Until it happened. Not overnight, but somewhere between the first and third pregnancy, things started to change – to move south. I’d always had a neat little baby’s bottom, so to speak, tight and tidy with discreet inner lips, but now I’d become one of those women in the changing rooms letting it all hang out. My curtains are hardly tripping me up, but they do announce themselves. G-strings can lead to an intimate tangle, certain yoga poses are revealing to say the least. Cycling and running, the chafing, well, let’s not go there. And mostly I don’t. I can live without jogging. No, the real reason I now find myself in a Harley Street clinic, legs akimbo, discussing this unwelcome elongation is sex. After 12 years of marriage and three births, you might think the old girl had earned a chance to put her feet up, but rather unexpectedly my pussy is gearing up for a new chapter, back on the market, dealing with the vagaries of Tinder and casual sex. I worry my womanhood is looking rather long in the tooth; over-accessorised with skin. Never mind a quick scoot around the internet reveals that vaginas are as varied in size and shape as, well, penises; I still feel uncomfortable undressing.

I’ve done my best to cover up, switching from Hollywood to landing strip to full-on bush (thank

God I didn’t laser it all off like KK). But nevertheless, I still feel in the need of expert assistance, so I’ve decided to seek the advice of Harley Street surgeon Angelica Kavouni.

Kavouni conducted several labial reductions for the Channel 4 series Embarrassing Bodies, and now sees a steady stream of clients in her practice, conducting 200 to 250 lip trims a year. Demand for this operation is booming and although there are no official figures, cosmetic surgeon Paul Banwell, who is regarded by BAAPS as a top specialist in this area, says he has seen a 300% increase in requests for labia surgery in the last five years. From 2001 to 2010, NHS figures showed a five-fold increase in vaginal surgery, though the NHS no longer offers labiaplasty, except for reconstructive purposes.

KAVOUNI’S CLIENTS AREN’T YOUNG BARBIE DOLL TYPES

with porn-body aspirations, but mainly women in their forties, often with kids, whose soft tissues and skin elasticity have taken a pounding. And, like me, plenty are single. “Once upon a time, women didn’t see themselves as sexual beings after the menopause, but that’s changing. There’s a dating culture among older women and a new awareness of sex and everything that goes with it,” Kavouni says.

She snaps on latex gloves to conduct an examination, handing me a mirror so I can view the proceedings. “It’s neat but there is extra tissue,” she tells me. A measuring gadget confirms there is around a 2cm overhang. Two centimetres, it turns out, is a common tipping point at which women come to see her. On a scale of one to 10

(10 being the ‘worst’), she estimates I’m a four, compared to other women she has seen. “There can be a lot of tissue, like a hanging bunch of grapes,” she says. “Sometimes

“Two centimetres is a COMMON tipping point at which women consider SURGERY”

the clitoral hood has a lot of folds covering it and women may want to remove those [for easier access].” Others have extra dangling bits, sometimes as a result of tears giving birth. A lot of patients tell her they feel unclean due to the extra tissue and feel the need to wash more, which can lead to thrush. There isn’t a set size she will and won’t operate on, it depends on how the individual is affected – how uncomfortable she is and the impact on her self-esteem.

SO HOW WILL I LOOK, I WANT TO KNOW, AFTER THE TRIM?

She gets hold of the skin and eases it back so I can see. The inner lips, the labia minora, would be tucked away, back in their packaging, but she is not in the business of creating the Barbie look of pre-adolescence. Nor will she operate on the labia majora, but she could use a bit of fat from my stomach to reintroduce a youthful fullness.

She’s aware the operation is controversial. She received two complaints from women’s charities when the term ‘designer vagina’ became popular in the press. In some stories labiaplasty has been likened to Female Genital Mutilation. “There’s a bit of confusion, I think,” Kavouni says. Labiaplasty does not affect the clitoris or ability to climax, and if women want a tidy-up, Kavouni can’t see what the problem is. “I don’t agree with young girls having it – some come asking ‘Am I normal?’ and I reassure them they are – but I don’t see why an adult woman can’t decide for herself, if she feels it will be more comfortable.”

The surgery is certainly not to be undertaken lightly. As with any operation, there are risks. Kavouni isn’t sure I need this op, and nor am I. I’m self-conscious, but it’s not crippling and if a man actually complained about the way I looked down there, I’d show him the door pretty swiftly. The price tag of £4,000 is hardly a snip either; I could buy a whole lingerie collection for considerably less. I decide to sit on it and turn my attention to the inner workings of my vagina. I’m not brave enough, or worried enough, to consider surgical tightening, but there is now a new swathe of treatments on the market promising to offset the ravages of childbirth and tumbling hormones using less invasive means.

One treatment is Femilift, designed to restore thinning vaginal walls to “peak condition” using an Fda-approved laser, and for this I find myself in the sleek clinic of EF Medispa in Kensington. “The laser causes thermal heating to improve circulation and collagen production,” explains resident gynaecologist Dr Asel. “This improves tightness and lubrication, which becomes an issue as women move through the various stages of menopause.”

The laser is delivered through a rounded probe directed around the wall of the vagina. It feels a bit like having a smear test, but not as bad and as soon I yelp Dr Asel turns down the intensity. It’s over in 10 minutes and I’m to abstain from sex for a week and return in a month for the next session. (The treatment costs £4,950 for three sessions, after which most women notice a difference.) Post treatment it feels a bit sensitive and crampy, like

I’m having a period. And then there’s a watery discharge, but it’s all quite normal I’m told and it stops within a week. After two treatments I’m convinced

I’ve plumped up; things feel juicier, livelier. Though there’s also a new man on the scene which has turned up the dial on my sex life. Am I tighter? It’s hard to tell and I don’t want to raise the alarm: right now he seems happy. But the question of the curtains is still on my mind. I decide to conduct a quick survey of men I’m not sleeping with.

“I’ve never met a vagina I didn’t get on with,” says my best male friend when I quiz him. A ‘big labia versus small labia’ thread on Steadyhealth.com yields similar findings: men love vaginas, never mind whether the lips are big or tiny.

So it’s just as well that one night after a party when we’re both a bit drunk, unprompted by me, my new partner just comes right out and tells me how much he loves what I’ve got. “What about it do you love, exactly?” I ask, emboldened by prosecco. To paraphrase (I’ll spare you the language), what he positively relishes is that there’s more to lick and love and tweak… to his mind, big lips are “sexy”. So there we have it, I’m certainly not about to mess with them now. Out and proud I say. The jogging can wait.

“After TWO treatments I’m convinced I’ve PLUMPED up; things feel livelier”