Women are undergoing surgery to create perfect genitalia amid a "shocking" lack of information on the potential risks of the procedure, a report says.
Research published in the British Journal of Obstetrics and Gynaecology also questions the very notion of aesthetically pleasing genitals.
Operations to improve the appearance of the sex organs for both psychological and physical reasons are on the rise.
But surgeons said the report overplayed the risks of an established procedure.
Researchers from University College London reviewed all the existing studies on cosmetic labial surgery - which generally involves reducing the amount of tissue that protrudes from the lips which cover the vagina. They found there had been little work to document any longer-term side effects.
Labioplasty, as it is known, costs about £3,000 privately and is offered for a variety of reasons: some women complain that wearing tight clothes or riding a bike is uncomfortable, while others say they are embarrassed in front of a sexual partner.
But consultant gynaecologist Sarah Creighton and psychologist Lih-Mei Liao challenged the ethics of offering women surgery to address such insecurities, suggesting it was adverts for a "homogenised, pre-pubescent genital appearance" which created these anxieties in the first place.
They also suggested that any pain apparently caused by protrusion may well have a psychological root - noting that male genitalia protrude far further without causing major discomfort.
Counselling and support could therefore be a preferable alternative to surgery, they argue.
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