Had Nora Ephron—the celebrated author who penned a tome about hating her aging neck—lived for another 10 years, would she have written a lament about her… vagina?Possibly, given the latest trend in vaginal rejuvenation. If the ‘90s cosmetic surgery procedure of choice was the nose job and the early aughts were fraught with breast augmentations, then the 2010’s have heralded an interesting (if somewhat perplexing) new fascination with altering the pubic area. And much like schnoz work and boob jobs, this new trend seems to appeal to both young and old.

“I would say 60-70 percent of my patients are in their mid-20s,” says Dr. Christine Hamori, a Boston-based plastic surgeon. “There are a few teens who come in with their mom, but most are adult, educated women—nurses and lawyers—not strippers. I’ve done maybe one exotic dancer, but it’s not like the breast implant craze.”

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Blame the rise of the Brazilian bikini wax. Dr. Hamori speculates that all this vaginal fascination may have something to do with the fact that women are confronted by their lovely lady parts in a way that historically has never occurred before. “Grooming habits have changed,” she notes. “With hair removal, women are seeing their anatomy more and making aesthetic judgments about it. Athletes experience rubbing and chafing. There’s an awareness that simply wasn’t there before.” As she enthusiastically points out, these days, no one under the age of 30 has an untrimmed hedge.

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Whether it’s grooming habits, exposure to Victoria Secret models in their sheer skivvies, or the social acceptance of cosmetic alteration in general, there’s no question women are becoming self-conscious about so-called “abnormalities”—that is, unevenness or largeness (cough) regarding what’s between their legs.So what has this Pandora’s box, so to speak, opened anyway? While the scope of vaginal rejuvenation ranges from the vaginoplasty (which aims to tighten), or the sexual sensitivity-enhancing G-spot amplification, the top procedure is the labiaplasty.

An aesthetic procedure, it’s essentially a nip and trim of the labia minora to keep it from peeking out beyond the labia majora when standing upright. The goal is to improve symmetry.In a society that places a high value on youth, it’s no wonder that the au courant aesthetic happens to resemble that of a prepubescent girl: The procedure cuts the labia down so it’s less visible, which is an undeniably child-like trait.

The second most common procedure that Hamori performs involves plumping of the labia majora, which, given the latest plastic surgery landscape, isn’t that surprising either. Z. Paul Lorenc, M.D., a New York City plastic surgeon who does not offer vaginal rejuvenation in his practice, chalks the whole phenomenon up to a natural progression in anti-aging procedures. “What’s interesting is that it reflects our understanding of the aging process in terms of general deflation,” he says. “It’s the same in the perineum as it is in the face and hands—where people are doing all matter of volumizing via fillers. When it comes to plastic surgery in general, I am blown away by the fact that we have missed that concept all these years. Now we realize it’s all about volume.”

Any conversation about vaginal rejuvenation seems colored by the staunch feminist sentiment that this surgery isn’t just uncomfortably reminiscent of genital mutilation (which obviously, is not elective,) but more about pleasing men than personal choice.

While Dr. Hamori acknowledges that some patients may have endured negative comments about their lady parts from guys, she still insists that sisters are doing it for themselves. A recent study led by Dr. Laura Berman of Chicago’s Berman Center may back her up. According to a press release, “the results suggest that the more positive a woman’s genital self-image is, the more likely she will have greater sexual desire, better arousal, lubrication and orgasms, and more satisfaction in her sexual relationships.” (The study, however, was commissioned by feminine hygiene giant Summer’s Eve, so we’ll take it with a grain of pH-balanced bath salt.) Still, if these kinds of alterations are giving genitally self-conscious women more confidence, what’s up with all the judgment?

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The bottom line is that as with any cosmetic procedure, consumers should be wary and do their research. The majority of rejuvenation procedures performed are relatively simple: For example, a labiaplasty uses local anesthesia and takes an hour tops, with about a week of recovery time. They’re not cheap: think between $3000 and $5000. (Fillers can run from about $1200-$2000 and more if fat grafting is involved.)And don’t blindly assume your doctor is qualified. Dr. Hamori warns that as demand grows, OB-GYNs and urologists may “jump on the bandwagon” and offer the procedures, but may not necessarily be experts or great surgeons. She says the best way to find a uniquely trained doctor is to find out if they are specialists, look for before and afters on their website and talk to people online who’ve had it done.We’d suggest having this convo with a younger peer, not say, your grandmother, who is still trying to get used to all those boob jobs of yore.