As my colleague Laura Fitzpatrick reported last year, the “designer vagina” trend is on the upswing, with a growing number of young women seeking out surgery to trim, sculpt and perfect their private areas. Yet while more women may be going under the knife in hopes of improving their intimate aesthetics, according to research published in the British Journal of Obstetrics and Gynaecology, many do so without fully understanding the risks of such procedures. What’s more, the BBC reports, the study’s authors question whether creating “perfect genitals” should even be a legitimate goal in the medical community.

Most frequently women seek labioplasty—which involves trimming back protruding labia and can cost some $5,000 (£3,000)—because they say their physical appearance causes embarrassment and discomfort in front of sexual partners, or that excessive tissue causes physical discomfort. Yet, the authors say, while their analysis of 40 research articles on the procedures revealed that most patients report satisfaction with the results and few complications, that there has been little investigation of long-term effects of these surgeries, including how they may impact future sexual satisfaction or whether they introduce any potential complications into childbirth.

Plastic surgeons who regularly perform labioplasty say that the warnings about long-term complications or side effects are exaggerated and merely meant to scare women away from what they deem a simple, straightforward procedure that most often makes women feel more comfortable about their own bodies. “This is a procedure which we have been doing since the 1970s. Any operation performed poorly carries risks, but when it’s done properly there are very few issues at all,” plastic surgeon Angelica Kavouni tells the BBC. And, Kavouni says, when she sees patients who don’t have a physical problem with excessive tissue or discoloration, for example, she advises them against the procedure.

Still, the current study’s authors argue, regardless of widely reported satisfaction with labioplasty, more research is needed to accurately assess long-term risks, and also to determine whether counseling might benefit women who are considering the procedure—even physical discomfort may in fact be a psychological consequence of insecurity, they suggest. And in the meantime, they believe it’s important to emphasize that the notion of perfect genitals is a myth. As consulting psychologist Lih-Mei Liao told the The Times, women shouldn’t let “advertisements that prescribe a homogenized, prepubescent genital appearance standard for all women,” influence their perceptions of what is healthy—and attractive—in their own bodies.