‘I’m going in,’ announces Dr Shirin Lakhani, needle in hand and torch strapped to her forehead.
Beside her sits a large, whirring machine with a highly intimidating attachment which looks a little like something you’d find in an adult shop.
It is 10am and I am witnessing the first appointment of the day at Dr Lakhani’s sexual rejuvenation clinic, Elite Aesthetics.
Since she opened the doors in 2013, women have been flocking here for the most intimate kinds of nip and tuck procedure.
The demand for so-called vaginal rejuvenation has leapt 40 per cent since 2015. But Dr Shirin Lakhani says the main problems she encounters are incontinence and vaginal atrophy (pictured: Dr Shirin Lakhani, left, with The Mail On Sunday’s Eve Simmons, right)
First up is 57-year-old Denise, a married mother of four from Kent, who seems oddly unfazed that she is about to have a £1,200 treatment that involves injections into her genitals.
The jab contains a protein extracted from Denise’s blood. It is said to ‘plump’ the vaginal wall, easing dry skin and soreness, and improving problems with incontinence, all of which can go hand-in-hand with childbirth and the menopause.
It will, according to Dr Lakhani, make Denise feel – and look – 20 years younger ‘down there’.
Eight minutes later she hops off the table, without the vaguest hint of discomfort (she’d had numbing cream applied to the area before being injected) or embarrassment.
‘It gives me peace of mind. I’d do it again over and over and over,’ says the furniture designer, who runs a thriving small business.
But I couldn’t help wonder, why would an accomplished woman with a loving partner do such a thing?
It was this very question I hoped to answer when, earlier this year, I became the first journalist to be granted access to both of Britain’s leading facilities offering treatments such as these.
I’ll admit, I had a few preconceived ideas about what I’d find. But the reality was far from what I had expected.
THE EVER-INCREASING DEMAND FOR A DESIGNER VAGINA
The demand for so-called vaginal rejuvenation has leapt 40 per cent since 2015, with the market estimated to be worth at least £2 billion by 2021.
Labiaplasty, in which the skin on either side of the vagina is cut back in order to ‘improve’ the appearance, is the fastest-growing cosmetic operation in the world, four times more frequent than five years ago.
In the UK, hundreds of clinics now offer non-surgical treatments using injections, lasers and other devices to plump and tighten the intimate area.
There is limited evidence to show that they are effective, or even safe. But there is celebrity endorsement.
Social media star and mother-of-four Kim Kardashian has spoken candidly about having a procedure to ‘tighten and smooth’ her private parts.
And the reality show of the moment, Love Island, which features an array of young women wearing nothing but swimwear that leaves little to the imagination, is said to be another driving force.
Dr Lakhani, a former GP, says her patients are primarily, ordinary middle-class, middle-aged women (stock image)
So I assumed the clientele would be twentysomethings, vain and sex-obsessed – and in pursuit of a ‘designer vagina’, which is the slightly pejorative term often used about such treatments. In fact, patients were, primarily, ordinary middle-class, middle-aged women.
Dr Lakhani, a former GP, explains that the main problems she encounters are incontinence and vaginal atrophy, a thinning, drying and inflammation of the vaginal walls that affects one in seven post-menopausal women, and causes discomfort, particularly during sex.
‘You don’t just hit the menopause, give up and die,’ she says. ‘Women run businesses, they date, they have active sex lives. Why should they have to put up with painful sex and incontinence for half their lives?’
I assumed Denise was either newly single or having a midlife crisis. In fact, she has been happily married for 28 years and leads a fulfilled, peaceful life. She isn’t body-image obsessed, nor is she into anything unusual sexually.
In fact she had a hysterectomy aged just 35, after pre-cancerous cells were found in her womb. This, and having four children, left her internal tissues dry and inflamed, and the muscles weak.
Crucially, incontinence was a huge problem for her.
‘I’d leak on to chairs during meetings and always had sanitary towels poking out of my handbag,’ Denise remembers. ‘Once I slipped when I was out shopping. I got up and realised I’d wet myself.’
Sex with her husband was a no-go, reserved for a few times a year and only, ‘if he was lucky’.
She says: ‘When you’re in pain, you don’t feel sexy.’ Two years ago, having read about Dr Lakhani’s services, she phoned to make an appointment. It was a call that she says changed her life.
One of Dr Lakhani’s patients, Denise, a mother-of-four who had a hysterectomy, said incontinence was a huge problem for her. She had ‘The O-Shot’, or platelet-rich plasma therapy, which is said to plump and tighten damaged vaginal tissue (stock image)
Denise was recommended ‘The O-Shot’, also known as platelet-rich plasma therapy.
This is a jab of protein harvested from the patient’s own blood, and it is said to plump and tighten damaged vaginal tissue, increasing sensitivity during sex.
It is, to say the least, considered a ‘controversial’ treatment.
Much of the research on it has been conducted by Dr Charles Runels, an American doctor who both invented it and profits from it. Independent studies are yet to report changes to internal, vaginal tissues.
Nora Nugent, consultant plastic surgeon and representative of the British Association Of Aesthetics And Plastic Surgeons, says: ‘There’s risk of bleeding, bruising, infection and no robust evidence to show it to be safe or effective.
Dr Lakhani admits she is reliant on ‘patient feedback’ because ‘scientific studies are limited’.
But Denise is evangelical. ‘My sex life today is more active than it’s ever been. I’d honestly recommend the treatment to anyone,’ she says.
Dr Tracey Sims, who heads up Liverpool’s Intimate You, the only other UK clinic specialising in this area, sees a similar demographic.
‘Most need relief from damaged vaginal tissue or a weak pelvic floor, caused by the menopause or childbirth,’ she tells me.
‘Hormone replacement therapies help but don’t correct the sagging and tearing of the skin, and pelvic floor exercises don’t work for everyone.’
FILLERS, PEELS AND THE QUEST FOR PERFECTION
While most of Dr Lakhani’s patients opt for functional treatments, a small number are enticed by the purely cosmetic.
An array of lotions and potions, costing £500 plus, are offered to make the labia plumper, lighter and more symmetrical.
Hyaluronic acid or a woman’s own fat can be injected into the labia majora (the outer folds of the vulva) to ‘plump’ out the sagging skin and improve symmetry.
Discolouration can be treated too, using either acid or lasers applied to the labia and inner thigh to break down the pigment in the skin.
During my visit, 45-year-old Sunita Shah has her first ‘intimate’ chemical peel.
Sunita Shah, 45 (pictured), had a chemical peel on her intimate area to improve the discolouration on the surrounding skin
The accountant is a regular in Dr Lakhani’s clinic, having had three different types of incontinence treatments. Sunita says: ‘Now that’s sorted, I’d like to improve how I look in that area.’
‘Who’s looking?’ I ask.
‘My husband,’ she says, ‘but he isn’t bothered either way, he loves me whether I get this done or not. It’s not for anyone else, it’s about how it makes me feel.’
Sunita has been happily married for almost 25 years and has two teenage children.
Since the menopause, five years ago, she’s felt increasingly self-conscious about ‘dark and saggy’ skin in her nether regions, caused by a lack of oestrogen.
Dr Lakhani says: ‘Women of all ages remove their pubic hair nowadays. So you can see everything, and some women don’t like it when things start to change with age.’
In the treatment room, Dr Lakhani first numbs Sunita’s intimate area using an antiseptic wipe laced with anaesthetic, before applying medical-grade acid to her outer labia. Within ten minutes, the acid breaks up the skin, helping it to shed.
Dr Lakhani invites me to take a look. Fighting the overwhelming urge to stay near Sunita’s head, I walk down and take a peek – the skin is already at least two shades lighter than her inner thigh.
Any pain? ‘Can’t feel a thing, just a bit of tingling,’ she chirps.
Within a week, the darker, outer skin will fall off completely, revealing a lighter, softer layer underneath. ‘I can’t wait to look like a 20-year-old again,’ Sunita tells me before heading off.
Dr Sims and Dr Lakhani have the same method of dealing with these patients: they show them images of healthy vaginas, to convince them they are indeed normal, and provide emotional support (stock image)
Of course, I’m incredibly sceptical about all of this. There is no medical reason to undergo these treatments. And offering them perpetuates myths that the way women’s bodies look naturally is, somehow, wrong.
Dr Lakhani attempts to reassure me: ‘Sunita’s skin is much more pigmented than a usual case,’ she says, ‘but vaginas and vulvas do come in a wide variety of shapes and sizes. If I don’t think there’s a problem, I’ll send people away.’
The number of patients Dr Sims refuses for this reason is increasing. She says: ‘Girls in their 20s or even younger are convinced they don’t look right because of something a partner has said.’
Dr Sims and Dr Lakhani have the same method of dealing with these patients: they show them images of healthy vaginas, to convince them they are indeed normal, and provide emotional support.
DO TREATMENTS WORK… AND ARE THEY SAFE?
Another popular treatment at both clinics involves a probe-like, heat-emitting device being inserted into the vagina. This is supposed to strengthen the muscles internally and plumps the skin externally, although independent studies are yet to prove this to be true.
The machine used by Dr Lakhani is called the UltraFemme360, while Dr Sims has something called a MonaLisa Touch.
Studies carried out by the manufacturers suggest that three sessions, about six to eight weeks apart, can effectively reduce incontinence for up to a year.
Last year the US health watchdog the Food And Drug Administration warned against the use of these devices for fear they could cause burns.
Dr Adeola Olaitan, consultant gynaecologist at University College London, says: ‘These are considered safe if used correctly, although some, particularly laser devices, carry a higher risk of burns.
‘I know post-menopausal patients who have found it useful for vaginal dryness.’
Another popular treatment at both clinics involves a probe-like, heat-emitting device being inserted into the vagina. This is supposed to strengthen the muscles internally and plumps the skin externally, although independent studies are yet to prove this to be true
The aesthetics industry – which these clinics fall under – is vastly unregulated, meaning anyone can carry out these procedures.
Just as you don’t need a qualification to inject Botox into someone’s face, nor do you need one to use heat-emitting device in the vagina.
But Elite Aesthetics and Intimate You are both, voluntarily, regulated by the Care Quality Commission, the body that checks medical facilities to ensure patients aren’t at risk.
They are subject to the same regular, rigorous checks as doctors’ clinics.
Dr Lakhani’s last appointment of the day is with 55-year-old business manager Natasha (not her real name).
The mother-of-three has made a 200-mile round trip for her second round of UltraFemme360 treatment in the hope the hot probe will heal internal damage caused by childbirth.
She hopes the treatment will make sex, ‘at least bearable’.
Has she noticed a difference after her first session?
‘It’s a bit less painful, but I still don’t often feel in the mood.’
The exchange depresses me.
Studies carried out by the manufacturers suggest that three sessions can effectively reduce incontinence for up to a year. But the US’s Food And Drug Administration warned against the use of these devices for fear they could cause burn. (UltraFemme360 pictured)
After all the talk of helping patients’ bodies work better, isn’t this just the beauty industry cashing in on women’s insecurities?
Dr Jen Gunter, US gynaecologist and author of the forthcoming one-stop-shop intimate health book, The Vagina Bible, thinks so.
‘It is very easy to make women feel ashamed about their bodies,’ she tells me. Unnecessary procedures are offered to women when they are vulnerable, usually undressed during an intimate examination. If a doctor starts recommending it, women will feel they need it.’
Natasha admits: ‘I thought if I improved this part of me I’d feel more confident about the rest of my body. It’s a bit like if you’re feeling a bit miserable or insecure, you might have some Botox to boost your confidence.’
Has it worked? ‘Maybe, but probably I need to work on how I feel about what I see when I look in the mirror, instead of trying to change the reflection.’