Concept of beauty and aesthetics of external genitalia is inspired by nature and symmetry. Historically, external female genitalia have been likened to a flower. Cltoria-ternatea is a flower aka aprajitha in India which is reserved as a holy flower for daily puja rituals. The holy flower is said to represent the shape of female genitalia. In ancient India, female genital has also been depicted with symbols of fish, double oval, and triangle. The concept of “designer vulva” or “barbie doll vulva” has led to shift in perception of “normal” vagina. The size, shape, texture, and color of the vulva varies with the age, ethnicity, hormonal status, and sexual and personal history. The surge in demand of FGCS (female genital cosmetic surgery (FGCS)) can be attributed to multiple factors:

1. Increased exposure social media, idealization of the perfect body and also perfect genitalia and to an extent internet pornography.
2. Information on internet, pornography, and media has started dictating standard norms for “normal appearance” of the genitalia leaving a large chunk of women feeling anxious, insecure with lower self-esteem.
3. Trend of hairless pubic area with use of lasers or Brazilian wax leading to increase in self-examination of external genital;
4. (unrealistic) expectation by the male partner which are usually derived from the exotic movies, magazines, decreased society inhibitions, cultural change with acceptance of exhibitionist tendencies of human body, and increasing materialism.