In the West, a specific ideal for female genitalia has emerged: one of absence, a "clean slit," attained through the removal of pubic hair and, increasingly, through female genital cosmetic surgery known as FGCS.

In The Perfect Vagina: Cosmetic Surgery in the Twenty-First Century, Lindy McDougall provides an ethnographic account of women who choose FGCS in Australia and the physicians who perform these procedures, both in Australia and globally, while also examining the environment in which surgeons and women come together. Physicians have a vested interest in establishing this surgery as valid medical intervention, despite majority medical opinion explicitly acknowledging that a wide range of genital variation is normal. McDougall offers a nuanced picture of why and how these procedures are performed and draws parallels between FGCS and anthropological discussions of female genital circumcision (cutting). Using the neologism biomagical, she argues that cosmetic surgery functions as both ritual and sacrifice due to its promise of transformation while simultaneously submitting the body to the risks and pain of surgery, thus exposing biomedicine as an increasingly cultural and commercial pursuit.

The Perfect Vagina highlights the complexities involved with FGCS, its role in Western beauty culture, and the creation and control of body image in countries where self-care is valorized and medicine is increasingly harnessed for enhancement as well as health.