I can think of no finer way to inaugurate the ISCG Blog than to explore the history of cosmetic vaginal surgery. Where possible I have linked to online translations for reference and scholarship.
Soranus of Ephesus, a Greek physician who practiced in Alexandria and later in Rome from the end of the first century to the beginning of the second century AD, provided the first written record of surgery performed on the female genitalia for cosmetic effect. In a 6th century Latin translation by Muscio of his 4-volume treatise entitled Gynaecology, he describes the excision of a hypertrophied clitoris for cosmetic reasons and to diminish excessive sexual stimulation. He credits the procedure to Philumenus (not the 3rd century Philumenos), one of his older Greek contemporaries:
The patient was placed in a lithotomy position and held in place by able bodied assistants. The surgeon grasped the clitoris with broad toothed forceps and cut above the instrument...Bleeding was controlled by cold compresses soaked in vinegar and styptic powder.
Philumenos of Alexandria, in the third century AD, described excision of the hypertrophied clitoris because it was considered "ugly and disgraceful." His work was abstracted by the Byzantine physician Aetios of Amida in his 4th century work Sixteen Books on Medicine. The practice of excising the nonhypertrophied clitoris originated in Egypt in an effort to prevent any desire for coitus in premarital girls and not out of any cosmetic motivation.
In the seventh century AD, Paulos of Aegina, another Byzantine physician describes two distinct operations in his Medical Compendium in Seven Books. The first operation is his technique of excision of the hypertrophied clitoris, which he refers to as the nympha. The second operation is an excision of enlarged labia minora which he refers to as cauda pudendi or pudendal tail:
The cauda is a fleshy excrescence arising from the mouth of the womb, and filling the female pudendum, sometimes even projecting externally like a tail; and it may be removed in the same manner as the nympha.
The suturing of vaginal lacerations at childbirth forms the basis for all modern vaginoplasty techniques. The procedure was first described circa 1050 AD by a female physician, Trotula di Ruggiero of La Scuola Medica Salernitana, the first medical school in Europe. She wrote Treatments for Women as well as contributions to another work De Ornatu Mulierum (Women's Cosmetics) which, in addition to two other works written subsequently by other medieval physicians comprised the compendium commonly known as The Trotula.
1. Cosmetic vaginal surgery can be traced back to the Greek physician Soranus of Ephesus, in first century AD.
2. Labiaplasty was first performed by the Greek physician Paulos of Aegina, in the seventh century AD.
3. The origins of vaginoplasty began with the female physician Trotula di Ruggiero of Salerno, in the 11th century.
Marco A. Pelosi, III, MD, is a cosmetic gynecologist, surgeon, lecturer & cofounder of the ISCG. You may contact him directly at email@example.com