bikinirotated-595x400With 45% more labiaplasty surgical procedures performed in 2016 than during 2015, a newly-released study from the International Society of Aesthetic Plastic Surgery shows that labiaplasty is the fastest growing type of cosmetic surgery around the globe.

Labiaplasty, which entails altering the shape or reducing the size of a woman’s labia, has had the most dramatic year-to-year rise in surgeries—even over the world’s most popular cosmetic procedures, such as breast augmentation surgery, liposuction, eyelid surgery, and nose jobs. This trend of rapidly rising procedure rates highlights a seeming gravitation toward vaginal cosmetic surgeries.

In the U.S. alone, the American Society of Plastic Surgeons found that occurrences of labiaplasty surgery rose by 39% over the span of a year, with 9,185 procedures recorded in 2015 rising to 12,666 recorded procedures in 2016. Additionally, the American Society for Aesthetic Plastic Surgery found that just over 5% of these labiaplasty procedures were undergone by girls under 16 years of age.

While the reason behind the rapid rate at which labiaplasty is rising is unclear, the numbers seem to indicate that a substantial population of adolescent girls are feeling insecure about the appearance of their vaginas, whether they have gone through with a cosmetic procedure or not.

Some experts have insinuated that the appearance of vulvae shown in porn is responsible for this dramatic uptick, while others have made the argument that an absence in sex education of photographs depicting vaginas has deprived girls and women of the understanding of what constitutes a normal, healthy vaginal appearance.

A girl named Anna told the BBC, “People around me were watching porn and I just had this idea that it should be symmetrical and not sticking out.”

Feeling the pressure to have a vulva reminiscent of those shown in porn, she was considering having labiaplasty surgery at age 14, but instead opted out.

Some patients elect to undergo labiaplasty as a way to reduce labial pain that may arise during sex, or during day-to-day activities when their labia get caught in their underwear. However, many patients choose labiaplasty for reasons of aesthetics.

“Girls will sometimes come out with comments like, ‘I just hate it, I just want it removed,’, and for a girl to feel that way about any part of her body—especially a part that’s intimate—is very upsetting,” leading adolescent gynecologist Dr. Naomi Crouch said on the BBC’s Victoria Derbyshire Show.