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Cosmetic Genital Surgery

Cosmetic genital surgery is elective, aesthetic surgery. It is distinct from reconstructive operations for trauma, oncologic resection, lichen sclerosus, FGM/C or congenital anomaly (see 04e Genital Reconstruction) and from gender-affirming surgery (see 04k Gender-Affirming Surgery). The atlas is divided by the two patient cohorts that drive technique selection: male cosmetic (augmentation phalloplasty, girth enhancement, suspensory-ligament division, suprapubic lipectomy, Penuma, scrotal aesthetic procedures) and female cosmetic (FGCS) (labiaplasty, clitoral hoodoplasty, labia majora augmentation, monsplasty, surgical vaginoplasty or energy-based devices, hymenoplasty, regenerative and fat-grafting techniques). Each sub-page hosts its own Decision Framework and Treatment Database. For the clinical-conditions framework on small penis syndrome (SPS) / penile dysmorphic disorder (PDD) see Small Penis Syndrome.

Society positions and evidence quality. The SMSNA 2024 position statement recommends against graft-and-flap penile augmentation outside a research protocol, recommends silicone sleeve implants only with IRB oversight, long-term safety endpoints and no patient cost, and restricts sliding/slicing techniques to IRB-supervised research by experienced prosthetic surgeons, and states that data on temporary HA and PLA fillers are limited.[1] It requires that penile dysmorphic disorder be ruled out before invasive enhancement.[1] The EAU 2026 guideline strongly recommends against grafts, biodegradable scaffolds and subcutaneous penile implants for girth enhancement, and against HA, other soft-tissue fillers or autologous fat injection in men with PDD.[4] It gives a weak recommendation for those injections in eligible men without PDD.[4] ACOG Committee Opinion 795 (2020) states that female genital cosmetic procedures are not medically indicated without a clinical indication and that their safety and effectiveness have not been established. It advises assessment for body dysmorphic disorder (BDD) if indicated.[2] The FIGO 2025 statement asserts that it is ethically inappropriate for obstetrician-gynecologists to recommend, perform or refer patients for cosmetic genital surgery.[3] The FDA 2018 safety communication warned against energy-based devices for "vaginal rejuvenation" and vaginal cosmetic procedures, for which the agency had not cleared or approved such devices.[5]

See Also​

References​

1. Trost L, Khera M, Köhler T, et al. Cosmetic penile enhancement procedures: an SMSNA position statement. J Sex Med. 2024;21(6):573-578. doi:10.1093/jsxmed/qdae045

2. Committee on Gynecologic Practice, American College of Obstetricians and Gynecologists. Elective female genital cosmetic surgery: ACOG Committee Opinion No. 795. Obstet Gynecol. 2020;135(1):e36-e42. doi:10.1097/AOG.0000000000003616

3. Capito L, Antsaklis A, Gupte S; FIGO Committee on Ethical Aspects of Human Reproduction and Women's Health. FIGO statement: cosmetic genital surgery. Int J Gynaecol Obstet. 2025;170(1):11-14. doi:10.1002/ijgo.70203

4. European Association of Urology. "EAU Guidelines on Sexual and Reproductive Health: Penile Size Abnormalities and Dysmorphophobia." 2026. EAU guideline

5. New Zealand Medicines and Medical Devices Safety Authority. "The USFDA warns against use of energy-based devices to perform vaginal 'rejuvenation' or vaginal cosmetic procedures: FDA safety communication." Medsafe Safety Information. 2018. Medsafe notice