Female genital cosmetic surgery procedures have gained popularity in the West in recent years. Marketing by surgeons promotes the surgeries, but professional organizations have started to question the promotion and practice of these procedures. Despite some surgeon claims of drastic transformations of psychological, emotional, and sexual life associated with the surgery, little reliable evidence of such effects exists. This article achieves two objectives. First, reviewing the published academic work on the topic, it identifies the current state of knowledge around female genital cosmetic procedures, as well as limitations in our knowledge. Second, examining a body of critical scholarship that raises sociological and psychological concerns not typically addressed in medical literature, it summarizes broader issues and debates. Overall, the article demonstrates a paucity of scientific knowledge and highlights a pressing need to consider the broader ramifications of surgical practices. "Today we have a whole society held in thrall to the drastic plastic of labial rejuvenation."( 1 ) "At the present time, the field of female cosmetic genital surgery is like the old Wild, Wild West: wide open and unregulated"( 2 ).