The Rise of Below-the-Belt Surgery

Minimally invasive vaginal rejuvenation procedures continue to grow in popularity—with just about every device company now offering hand pieces with clever names designed to treat the genital area, and this enthusiasm may be siring a burst of interest in male genital cosmetic surgery, too.

“The rise in female rejuvenation has really stimulated men to ask about treatments they may not have considered in the past,” says Jason Emer, MD, a dermatologic surgeon in Beverly Hills, CA. “Also, while more men are becoming obsessed with their bodies (Cross-Fit era), they not only want contour, chiseling, structure, they want their penises to look good, feel good, have strength and longevity, and increased size.”

For example, Scrotox (the kitschy name for the off-label use of Botulinum toxin to the scrotal area) reportedly helps to reduce sweating and delete wrinkles, and can also make the scrotum appear larger.

In addition to offering Scrotox injections, Dr. Emer often combines platelet-rich plasma (PRP), Cellutone by BTL Aesthetics, and LightPod Neo for a more robust penile rejuvenation. “We have a protocol of three monthly PRP injections with Aerolase deep tissue heating with microsecond YAG technology and Cellutone shock/vibration therapy to improve blood flow to the penile tissue, increasing vitality, sensitivity, the ability to get erections, and pleasure during sex.”

It really was the proliferation of non-invasive devices (and the Kardashian sisters' love of them) that put vaginal rejuvenation on the map, says Bruce E. Katz, MD, Director, Juva Skin & Laser Center in New York City and Director of the Cosmetic Surgery & Laser Clinic at Mt. Sinai Hospital in New York City.

“The Kardashians really put it in prime time as did grooming trends, since this area is no longer covered up,” he says.

There's more to it, adds Lara Devgan, MD, a plastic surgeon in New York City and an attending plastic surgeon at Lenox Hill Hospital. “Social mores have changed, and society, in general, and women, in particular, are more comfortable talking about their bodies and asking about things that were previously kept secret.”

This may explain the uptick in labiaplasty and penile enlargement surgery as well as the minimally invasive procedures. The American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery reported increases in labiaplasty in 2016, and there was a 16 percent increase in the number of penile enlargements performed from 2014 to 2015, according to the International Society of Aesthetic Plastic Surgery (ISAPS).

Dr. Devgan says that labiaplasty is the fastest growing procedure in her practice. She does not offer non-invasive vaginal rejuvenation yet, but likely will start to in the near future due to patient interest and demand. These are not solely aesthetic procedures. “They also offer functional benefits for women of all ages,” she says.

“I do not perform ‘Scrotox' and I haven't had a patient ask for it, but, in general, we are in a different era and patients are less inhibited about talking about things that bother them,” she adds.