Demand for cosmetic genital or vaginal surgery may be on the rise, but the Medicare reimbursement for the procedure faces scrutiny as the government looks to reduce the cost to Medicare. 

At present, the cost of female genital surgery (also known as labiaplasty or vulvoplasty), which involves the changing of the size and shape of the vagina, are only reimbursed under Medicare if a doctor deems it a medical necessity. Vaginal surgery for purely cosmetic purposes—also referred to as designer vaginal surgery—is not eligible for reimbursement. According to a report in the Sydney Morning Herald, the procedure, which costs around $4500, is only eligible under the Medicare safety net at present because it falls under the category of operations that can be performed outside hospital, allowing for a dramatic reduction in the cost to the patient.

According to Dr. Allan Parungao, author of A Woman’s Guide to Cosmetic Breast Surgery and Body Contouring, labiaplasty reduces and/or balances the size of the inner lips of the vulva or external female genitals. For women who suffer from large or uneven labia minora (labial hypertrophy), labiaplasty can help give the inner vaginal lips a trimmer and more youthful look.

Labial hypertrophy is considered a medical problem warranting vaginal surgery when it leads to recurrent infections and irritation. Painful sex and embarrassment during intimate relationships, constant moisture, irritation, chafing and recurring infections are frequent complaints of women who suffer from the condition. There is also the discomfort and embarrassment involved with wearing tight fitting jeans or swim wear.

In responding to the news about potential Medicare rebate cuts, the Royal Australian & New Zealand College of Obstetricians & Gynaecologists (RANZCOG) clarified the difference between vaginal and vulval cosmetic procedures.

“Women who are born with anatomical abnormalities, who need lifesaving surgery involving removal of part of the vulva or vagina for cancer treatment or have childbirth trauma may require complex surgery in this area to improve their quality of life” stated the RANZCOG spokesperson, Professor Ajay Rane.

He further clarified that “These medical interventions are in no way related to surgeries performed on women who, for whatever reason, are dissatisfied with the cosmetic appearance of their genitalia and seek a surgical solution, often from practitioners without specialist qualifications in gynaecological surgery”.

Reflecting the concerns of many medical professionals in the field, the College expressed its disquiet that the removal of Medicare rebates for all procedures in these un-related conditions will severely disadvantage women whose medical conditions have already caused them distress and suffering.

There is, of course, another aspect to the whole genital surgery equation, regardless of whether undertaken out of medical necessity or for purely cosmetic reasons: the potential risks and complications involved which can significantly change your life. If you are suffering from some level of discomfort and would like to have genital surgery, with or without the possibility of a Medicare reimbursement, the potential risks and complications should be considered first.

Potential complications of genital procedures such as vaginal rejuvenation, designer vaginoplasty, revirgination and G-spot amplification include:

• Infection
• Loss of sensation or altered sensations
• Pain in the area, or pain during intercourse
• Adhesions and scarring

While Medicare is not designed to pay for cosmetic treatments, by removing this reimbursement, potentially many women for whom this surgery is a medical necessity may have to suffer the physical and emotional consequences.