Sultan of Skin

Flesh insight from an esteemed St. Louis plastic surgeon

Leroy Young, a short, pot-bellied man with a tan, smooth complexion, sits at his cluttered desk on a recent afternoon and Googles "large labia."

"Look," he exclaims. "There are places that franchise it now, like McDonald's." He's talking about labiaplasty, a surgical procedure that eliminates excess skin from a woman's inner or outer vaginal lips.

Young, one of the nation's pre-eminent plastic surgeons, has just emerged from a post-operative exam with a 22-year-old patient and is eager to compare her result with some cyber-erotica. "Get this," he says, clicking on a link to "Designa Vagina Lips to Die For." The doctor chuckles as he reads an entry from a commenter who calls himself "Rich48.": "So you have big lips. Or small lips. Or maybe one is longer than the other. SO WHAT? From a purely cosmetic point of view, why would you risk a medical procedure to change it? Who will ever see it besides your GYN and your lover?"

Liposuction is  the most popular cosmetic surgery nationwide.
Jennifer Silverberg
Liposuction is the most popular cosmetic surgery nationwide.
Master skin sculptors: C.B. Boswell, Leroy Young, Rob Centeno.
Jennifer Silverberg
Master skin sculptors: C.B. Boswell, Leroy Young, Rob Centeno.

"Gotta give him credit," says Young, who, until a few years ago, tended to agree with Rich48's assessment.

Young had recently opened a private practice after 21 years in academic medicine, and he and his two partners fully expected to offer the standard bill of fare — tummy tucks, breast implants, liposuction, face lifts. But labiaplasties? Never. Then, one winter morning, he was leaving a consultation with a breast-augmentation patient when the woman said, casually, "Oh, doctor? By the way: My labia reallybother me. Could you do anything about it?"

Young took a step back into the room and was quiet for a moment. "Let me see here," he finally said, hunkering down to take a look through his square, oversize glasses. The woman's inner labia extended a few centimeters beyond her outer lips. "I told her she seemed normal to me, but she wouldn't buy it," Young recalls. "She kept insisting: 'It bothers me with certain pants, and when I'm intimate, and I want [the extra skin] removed.'

"I thought it was crazy," the 60-year-old physician continues. "I thought it had something to do with pornography. Maybe, you know, her boyfriend had said: 'You don't look like the pictures in the magazines.'"

Young says he's never perused an issue of Playboyin his life, and when it comes to understanding what men might expect of their lovers, the doctor considers himself no authority. He married the first girl he ever kissed and, after they divorced, he wed his second-ever girlfriend.

"In my first year of medical school, we had to do a psychiatry rotation," Young recalls. "You had a whole questionnaire of stuff you had to go through with patients. Well, there I am on my first day, and I start off with this attractive woman. I'm going down my list, and I get to the question, 'Have you ever had kinky sex?' The woman kind of pauses, and says, 'What do you mean?' I said to her, 'I was hoping you would know.'"

And so, in the name of research, the doctor went trolling through cyberspace and was quickly reassured to find a range of labia sizes and shapes described as attractive. "I even found a tribe in Africa where the women stretch their lips, because they think it's beautiful," he remembers.

Young would soon discover that functional issues drive some of the growing demand for labiaplasties. "These women feel really stressed out when they first come in. They have issues related to their clothes, particularly swimsuits, or to hygiene," Young explains. In the end, he decided to go through with his first labiaplasty, and now performs several a month, at $3,000 per surgery.

The 22-year-old patient Young saw moments ago was a timid blonde who had her inner labia trimmed in the hospital. "I think it looks awesome," Young told her. When she didn't respond, the doctor held a mirror between her legs. She glanced down and smiled.

Back in his Creve Coeur office, Young closes the "Designa Vagina" page and calls up his favorite labia-related site. "Here we go — the-clitoris-dot-com. This one is really good." Young points the mouse over a wrinkly set of lips, dismissing them as "a head of cauliflower" before scrolling down the Web page to a pearly pair and pausing.

"A rosebud. It's pink; it's pretty. Yep, she could be in any magazine."


Leroy Young is a hopeless romantic. He composes love poems for his wife and dissolves into tears while watching Hoosiers.His prized possessions are his mother's petunias and the cane-bottom rocking chairs from the old family farm in Kentucky. He drinks Coors Light and sauerkraut juice and cleans his own toilets every Sunday. The doctor washes his hair with soap, gets his dress-down clothes straight off the racks at Wal-Mart.

"When I first knew him he wore blue socks with everything," says his wife, Jill.

"He would be the last person in the world to have plastic surgery himself," adds his daughter, Ann Elizabeth Mohart.

Young drives a used Ford Ranger. Before that, he drove a dented fifteen-year-old station wagon with missing hubcaps that he nicknamed "Vulva the Volvo."

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