Dr. Bernard Stern, an Alexandria, Va., ob/gyn certified in plastic surgery, who has performed nearly 3,000 vaginal rejuvenation procedures, acknowledged there were practitioners who were not properly trained but said it was up to women themselves to check for credentials and photos of results.
"I never suggest to any woman that she 'needs' vaginal cosmetic surgery," said Stern.
While Stern said he never explicitly tells women his procedure will make them more sexually attractive, his website, with a photo of him leaning over a sexy woman's backside on an exam table could suggest otherwise. The woman is wearing high heels and smiling.
Stern told ABCNews.com that he requires all his patients to undergo psychological testing before he will perform vaginal rejuvenation procedures, and he often turns women away, particularly if their husbands or partners are pressuring them to have the surgery.
All Stern's patients must sign a three-page consent form that explains the potential risks and benefits of vaginoplasty and labiaplasty.
"I have never had a patient lose sensation from a vaginoplasty and from a labiaplasty (done properly). The only thing lost is pain from stretching, pulling, getting stuck," said Stern.
"I am not guaranteeing increased sexual response," he said. "If a woman perceives her labia and or vagina as improved from vaginal cosmetic surgery, it can affect her quality of life and self-esteem, and therefore she may experience increased female sexual response."
The American College of Obstetricians and Gynecologists and Iglesia's biggest criticism of vaginal rejuvenation is the absence of blind studies, the scientific gold standard that requires the subject or the investigator (or both) is unaware of which subjects are in the experimental or control groups.
Stern said he had developed his own techniques that his studies have found to be safe. He acknowledged, though, that his studies were "retroactive" -- he surveyed patients after he'd treated them.
Berliet, the writer who went undercover to investigate vaginal rejuvenation for the Atlantic, said the doctor she saw was upfront about the risks and potential rewards of vaginal rejuvenation.
She doesn't fault the medical profession as much as a society that places more value on cosmetic surgery than sex education.
Berliet cited an August 2011 study in the British Journal of Medicine that found 40 percent of women who'd asked about genital reconstruction "reported the desire to go through with it even after being informed that their labias were normal."
"Young girls should know what anatomy looks like," said Berliet. "Male genitals just hang out and you can sense a variation in what a penis looks like. But girls' are tucked between their legs, and they assume the worst in the body part.
"We are a culture that embraces plastic surgery in other ways to improve ourselves," she said. "It's scary."