Weaver believes labioplasty often preys on women's feelings of insecurity. Doctors should instead be trained to explain to them that genital appearance can vary greatly and surgery is not the answer. ''She doesn't have to conform to a picture that she might have noticed in a girlie magazine.''

Labioplasty can cost anything from $4000 to $10,000. Plastic surgeon Dr Kourosh Tavakoli told the ABC he had been performing it for seven years, with the number of patients doubling annually. He blames less qualified practitioners, such as ''GP surgeons'' working in their poorly lit offices, for most health problems linked to the procedure. Eighty per cent of his clients have had a labioplasty for ''cosmetic and psychological reasons'' - chiefly discomfort during sex or being unable ''to wear a leotard or (swimming) cossie''. The procedure, he claims, can bring about ''a mental transformation''.

It's seems astounding that women would endure such pain and cost merely to look subtly different in a leotard. Far more plausible is a link between the widespread availability of porn, the popularity of Brazilians and the growth of labioplasty. Left to their natural hirsute state, how many people would even notice the shape of their genitals?

A recent article in the British Journal of Obstetrics and Gynaecology reported on a qualitatative study of six women who'd had labioplasty. (In Britain, the incidence of this surgery has doubled in the past five years). All felt as if their original genital appearance was odd. Yet most revealed uncertainty about what ''normal'' women's genitalia should look like.

The women reported anxiety about their sexual partners seeing or touching their genitals. While some spoke of discomfort, the authors noted that this, rather than appearance, might be emphasised as a way of legitimising their request for surgery. After the procedure, the women were less self-conscious, but their expectations of better sex were not necessarily met.

Importantly, the authors noted that the vagina is often negatively represented in wider culture and depicted as ''a viable site for beautification and normalisation''. Women's magazines ''present a social norm that women's genitalia should be invisible and that there should be a smooth curve between the thighs with no protruding labia''.

Raunch culture has a lot to answer for here. And as the shape of the vagina becomes a crazy new source of angst, we still don't even have an affectionate word to describe it. Where is the cosy, non-threatening equivalent to ''willy''? This linguistic absence speaks volumes about social attitudes towards female genitalia. Meanwhile, the c-word endures as a form of abuse.

Weaver thinks genital appearance should be taught in high school sex education classes. People need to know, he says, that there are as many different labial shapes as there are nose sizes.

It's hard not to see a further irony in this disturbing trend. While women overseas are often powerless to resist genital mutilation, women here are paying for surgery that may be harmful or utterly superfluous.

Suzy Freeman-Greene is a senior writer.

Source: The Age