French Porn, Designer Vaginas, and The Demise of the Paper Clip

out of all the reviews i recieved today the most profound thing i found out about myself was that i was that i have the same name as a french porno star. a lot of very well thought out complements, concerns, and pieces of advice came my way today, but that was the comment that stuck out.

i really don’t have much else to say tonight as i am all worn out from moving a couch. couches are heavy. they’re heavier when you have to move them with your dad i think. that made sense to some of you. to the rest of you who didn’t get it, if you read this journal long enough you’re going to find out later…

so in lieu of a short entry, and to make up for last night’s lacking of one, i offer you these two pieces of news… one that seems nightmarish because it has come to pass, and the other, because it seems nightmarish that it came to pass, but not really… in that order…

The latest fad from La-La Land: a ‘designer vagina’
By Lynda Gorov, Globe Staff, 08/23/99

BEVERLY HILLS, Calif. - The clear plastic model of a vagina on Dr. David Matlock’s otherwise empty desk is flawless, both anatomically and aesthetically. It is intended as the ideal. It’s what his female patients want.

Along with the more accepted cosmetic surgeries such as breast augmentations, eye lifts and tummy tucks, Matlock offers what his publicist discreetly describes as an essential service for women with a certain physical dysfunction. Advertisements for his Beverly Hills medical practice, featuring an array of barely clad beauties, put it more bluntly: ‘‘Ladies. If you are self-conscious about showing `The Full Monty’ there is a solution. ... You won’t believe how good sex can be!’’

That controversial - and clinically unproven - promise has pulled women by the hundreds into Matlock’s salmon-and-cream surgical center, all of them eager, many of them desperate, for the latest trend in self improvement: plastic surgery to enhance sexual pleasure. Whether driven by vanity or medical necessity, they are willing to pay thousands of dollars and to undergo resculpting, tightening and trimming via Matlock’s laser. Afterward, many speak of the doctor in a tone approaching reverence.

‘‘Thank God, because Dr. Matlock gave me back my life,’’ said Maria, 34, an image consultant and mother of two from Chicago whose difficult childbirths left her with a misshapen vagina and other, painful problems. ‘‘They say sex doesn’t matter. It does. In fact, before sex was so uncomfortable it probably resulted in my divorce. Now I’m functioning like a normal human being.’’

For his part, Matlock sounds like a man sure of what women want and glad to give it to them. In some cases, he’ll even restore hymens in brides-to-be. But the gynecologist and board-certified plastic surgeon sounds proudest of what he calls ‘‘laser vaginal rejuvenation,’’ the one-hour procedure that has brought patients from around the country to his marble office suite and landed him on shockjock Howard Stern’s radio show. He says he’s performed more than 1,000 of them in the last decade or so, almost half of them since the ad began running 18 months ago.

As even Matlock concedes, his is a modified version of an operation to correct vaginal relaxation and related symptoms. One cause can be prolapse, a collapse of the bladder or uterus into the vaginal canal, when pelvic muscles and ligaments are damaged or weakened. More often, it manifests itself in stress urinary incontinence, that sometimes accompanies exercise, coughing or sexual intercourse after childbirth.

Matlock readily explains his technique in precise clinical terms. But it’s not his choice of instrument, laser over scalpel to reduce bleeding, that has gotten women’s attention. It’s his pitch, centered around sex.

He claims to be one of a few doctors willing to perform the surgery to enhance sexual gratification.

Most other doctors, he said, would try and convince a woman that her ‘‘symptoms’’ are the normal side effects of aging and dissuade her from having the surgery.

‘‘I’m saying, `Yes, I’ll do it.’ ... This is involving the quality of life,’’ he said.

But it’s a feature of the surgery that some other doctors dispute. While Matlock cites Masters and Johnson on the importance of ‘‘frictional forces,’’ they say there is no proof that vaginal tightening improves sex except in the most extreme cases and can, in fact, cause unnecessary scarring and make intercourse painful. Repairing a leaky bladder, as opposed to restoring it to its normal position should also have no effect on the vagina, they say.

Mostly, though, Matlock’s critics question hyping the cosmetic angle, regardless whether a woman has an actual physical problem or only a tendency to buy into the latest trend. His sex enhancement surgery costs anywhere from $3,500 to $8,000.

‘‘I worry absolutely that this will be the next thing they’ll tell women is wrong with them,’’ said Dr. Malcolm Lesavoy, a professor of plastic and reconstructive surgery at the University of Californa/Los Angeles and chief of both specialties at Harbor/UCLA Medical Center. ‘‘If you have a problem and things aren’t working correctly, that’s a different story. But do it for yourself, not for your husband, not for your boyfriend, not because your agent sent you in. ... Don’t be duped.’’

Matlock too says he wants women to focus on their own needs, not anyone else’s. He says anyone with a sexual dysfunction such as anorgasmia, or the inability to achieve orgasm, is best treated with therapy. He also says if more doctors were sensitive to women’s complaints, he wouldn’t be inundated with inquiries from potential patients. He wouldn’t be getting requests for training sessions from other doctors around the country. And don’t get Matlock started on the help that would be available if men had similar dysfunctions. He ticks off the scores of devices available to impotent men and all the medications. Few, after all, questioned the necessity of Viagra, not even the insurance companies who often refuse to pay for vaginal rejuvenation.

Matlock himself seems to turn few patients away. Instead, he offers one anecdote about a divorcee whose husband left her for a younger woman, another about a woman who made her husband pay $1,000 every time they had sex after the surgery and still another about women whose sexual partners have small penises.

The goal is post-virginal, pre-childbearing condition, he says.

In testimonial after testimonial, patients whose names and numbers Matlock provided swear by his technique and say they don’t know what they would have done had they not found him. None says she had the surgery purely for cosmetic reasons, although Matlock says a fair number do.

Jessica, a 30-year-old woman from Riverside, Calif., cites a litany of medical problems she had before seeing Matlock, from extensive cramping to heavy bleeding to eventual loss of bladder control. She had no complaints about sex before, she says, but was delighted at the unexpected improvement. She has since recommended the procedure to several friends.

‘‘It was like I didn’t even know I had this problem until afterward,’’ said Jessica, who, like most of the other patients, did not want her full name used. ‘‘I was like, `Wow.’ ‘’

Another patient, a 25-year-old student from Orange County who did not want her name used at all, had the same reaction after having her labia remodeled in what Matlock has dubbed ‘‘designer laser vaginoplasty.’’

‘‘I’ll just get graphic because that’s what it’s about,’’ she said. ‘‘It’s cleaner, it’s more hygienic. ... It’s sculpted. It looks nice. It’s perfect. Honestly, I feel sexier.’’

Results like that have made designer vaginoplasty Matlock’s second most popular, one usually done for aesthetic reasons. Sometimes women bring along copies of Playboy centerfolds and tell him they want theirs to look like that. In turn, Matlock nips with the laser and plumps with liposuctioned fat, restoring the area to its youthful shape and sheen.

‘‘I say designer because the woman’s the designer and the doctor’s her instrument,’’ said Matlock, who is not the only doctor who performs this procedure but is among those helping to popularize it.

As Matlock sees it, anything that increases a woman’s confidence stands to improve her sex life. His patients tell him as much, and so does his booming business. Still, the emphasis remains on the physical rather than the psychological.

‘‘If you look at the human sex response cycle - expectation, plateau, orgasm, resolution, it’s very complex,’’ Matlock said. ‘‘All the senses are involved. The brain is involved. I will not begin to think I can deal with all of that. What I say is that I can deal with one part, and that’s all I’m trying to do, and that is enhanced sexual gratification.’‘

This story ran on page C01 of the Boston Globe on 08/23/99.