The New York Post is reporting that women in New York are getting labiaplasties to look and feel better in tight athletic wear. They quote a patient, Veronica R., as wanting to “look like Barbie.”

According to the Post, on the Upper East Side in New York there are apparently “a large number” of women who want to look “sleeker in so-called athleisure wear, made from Lycra-like fabrics that often compress the area.” They are “keen to avoid” camel toe while “working out at top exercise venues such as SoulCycle, Barry’s Bootcamp and the Fhitting Room.”

I think it is very important to note that camel toe (or labial cleavage) is not the result of an anatomic abnormality. If a woman pulls fabric really tightly between her legs her labia majora and minora will overhang as women, unlike Barbie, have a vagina and labia.

To prevent camel toe/labial cleavage with surgery requires flattening not just the labia minora (what we usually think of with labia reduction surgery) but the labia majora as well. I am not a plastic surgeon, so the idea of operating on anatomically normal tissue without disease isn’t for me, but I do understand that cosmetic surgery helps many people feel more comfortable with their body.

However, making the vulva a flat surface so skin-tight Lyrica fits better isn’t a modest reshaping of the labia minora it’s the equivalent of cutting the nose off so you don’t have a nasty bump in your scarf. Reducing the labia to prevent camel toe in these kinds of overly tight clothes would have to involve significant reductions of both the labia majora and minora — essentially creating an anatomically pre-pubertal vulva.

The labia majora and minora (the outer and inner lips) have lots of nerve endings, that’s why they feel good when touched in the right way. Could drastically reducing the size and altering shape affect pleasure or sexual function? The labia also provide physical protection for the more sensitive skin at the vaginal opening (the vestibule). When these are essentially removed, we don’t know how that might impact susceptibility to vaginal infections. We know before puberty the vestibule (vaginal opening) is at greater risk of getting chronically irritated due in part to the lack of labial coverage. We just don’t know the long-term (or even the short-term) ramifications. This surgery isn’t a small trim of the labia minora; it can’t be with what the surgeon and patient have described to the New York Post.

I’ve worn some pretty tight Spandex in my day and am anatomically average (as a GYN I am qualified to make that call) and have only experienced camel toe when clothes have been seriously ill-fitting or clearly too small. If I can make my Wonder Woman bottoms fit without the dreaded camel toe, I just have to wonder exactly how tight these clothes are? And if they are that tight how does one exercise in them?

If you are worried about camel-toe as a gynecologist who specializes in vulvar conditions, I would recommend following the advice of a stylist and not a surgeon.

Keep in mind that Barbie has no vulva (no mons or labia) or vagina, so considering a genitally neuter toy as an anatomic ideal is pretty scary. Meanwhile, I wonder what the plastic surgeons who specialize in flattening the labia to prevent camel toe in Lycra would say to a woman who wants to remove her nose?

Jennifer Gunter is an obstetrician-gynecologist and author of the Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

Image credit: Leah-Anne Thompson / Shutterstock.com