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Breast and Labial Surgery in Adolescents

Obstet Gynecol; 2017 Jan; ACOG Committee Opinion

The American College of Obstetricians and Gynecologists (ACOG) has issued an interim update regarding breast and labial surgery in adolescents. The update, which is intended to clarify medical indications and reflect legal considerations of performing genital surgery on females younger than 18 years, states that surgical correction (labiaplasty) in girls younger than 18 years should be considered only in those with significant congenital malformation, or persistent symptoms that the physician believes are caused directly by labial anatomy, or both. Physicians should be aware that surgical alteration of the labia that is not necessary to the health of the adolescent is a violation of federal criminal law.

The ACOG makes the following recommendations regarding breast and labial surgery in adolescents:

  • The obstetrician–gynecologist caring for adolescents should have good working knowledge of nonsurgical alternatives for comfort and appearance as well as knowledge of indications and timing of surgical intervention and referral.
  • When adolescents seek medical treatment, the first step is often education and reassurance regarding normal variation in anatomy, growth, and development.
  • Appropriate patient counseling and assessment of the adolescent’s physical maturity and emotional readiness are necessary before surgical management or referral.
  • Individuals should be screened for body dysmorphic disorder. If an obstetrician–gynecologist suspects an adolescent has body dysmorphic disorder, referral to a mental health professional is appropriate.


Breast and labial surgery in adolescents. Committee Opinion No. 686. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017:129:e17–9.