{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:03:55Z","timestamp":1773284635978,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T00:00:00Z","timestamp":1628553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100003559","name":"ASERF","doi-asserted-by":"publisher","award":["5063"],"award-info":[{"award-number":["5063"]}],"id":[{"id":"10.13039\/100003559","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite existing anthropometric data in the literature regarding the variation of female external genital anatomy, the ideal aesthetic characteristics have yet to be defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The authors utilized crowdsourcing to better evaluate preferred anatomic characteristics of external female genitalia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Fifty-six total images were digitally created by altering the proportions of the labia minora, labia majora, and clitoral hood. Images with differing ratios were presented in pairs to Amazon Mechanical Turk (Seattle, WA, USA) raters. Three different experiments were performed with each varying 2 of the 3 image characteristics to permit 2-factor modeling. The Bradley-Terry-Luce model was applied to the pairwise comparisons ratings to create a rank order for each image. Preferences for each anatomic variable were compared with chi-squared tests.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 5000 raters participated. Experiment 1 compared differing widths of the labia majora and labia minora and determined a significant preference for larger labia majora width and mid-range labia minora width (P\u2005=\u20050.007). Experiment 2 compared labia minora width vs clitoral hood length and showed a statistically significant preference for wider majoras (P\u2005&amp;lt;\u20050.001) but no significant preference in clitoral hood length (P\u2005=\u20050.54). Experiment 3 compared clitoral hood length vs labia minora width and showed a statistically significant preference for mid-range labia minora widths (P\u2005&amp;lt;\u20050.001) but no significant preference in clitoral hood length (P\u2005=\u20050.78).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Raters preferred a labia majora to labia minora width ratio of 3:1 with minimal preference in clitoral hood length.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjab312","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T16:04:04Z","timestamp":1628611444000},"page":"505-515","source":"Crossref","is-referenced-by-count":7,"title":["Defining Ideal External Female Genital Anatomy via Crowdsourcing Analysis"],"prefix":"10.1093","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5633-1381","authenticated-orcid":false,"given":"Gianfranco","family":"Frojo","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Saint Louis University (SLU) School of Medicine , St. Louis, MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurora M","family":"Kareh","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Saint Louis University (SLU) School of Medicine , St. Louis, MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryce D","family":"Stash","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Saint Louis University (SLU) School of Medicine , St. Louis, MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth X","family":"Probst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey D","family":"Rector","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina M","family":"Plikaitis","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Saint Louis University (SLU) School of Medicine , St. Louis, MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Herluf G","family":"Lund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander Y","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Saint Louis University (SLU) School of Medicine , St. Louis, MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"issue":"3","key":"2022112213590666600_CIT0001","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1097\/PRS.0000000000001000","article-title":"Vaginal labiaplasty: current practices and a simplified classification system for labial protrusion","volume":"135","author":"Motakef","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"2022112213590666600_CIT0002","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/PRS.0000000000000516","article-title":"Aesthetic surgery of the female genitalia: labiaplasty and beyond","volume":"134","author":"Hamori","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"2022112213590666600_CIT0003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/asj\/sjab178","article-title":"The Aesthetic Society\u2019s Cosmetic Surgery National Data Bank: Statistics 2020","volume":"41","year":"2021","journal-title":"Aesthet Surg J"},{"issue":"1","key":"2022112213590666600_CIT0004","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.asj.2008.12.003","article-title":"Female attitudes regarding labia minora appearance and reduction with consideration of media influence","volume":"29","author":"Koning","year":"2009","journal-title":"Aesthet Surg J"},{"key":"2022112213590666600_CIT0005","first-page":"5007","article-title":"Nymphoplasty: classification and technical refinements","volume":"26","author":"Cunha","year":"2011","journal-title":"Rev Bras Cir Plast"},{"issue":"6","key":"2022112213590666600_CIT0006","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1111\/j.1743-6109.2008.00813.x","article-title":"Labiaplasty of the labia minora: patients\u2019 indications for pursuing surgery","volume":"5","author":"Miklos","year":"2008","journal-title":"J Sex Med"},{"issue":"4 Pt 1","key":"2022112213590666600_CIT0007","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1111\/j.1743-6109.2009.01573.x","article-title":"A large multicenter outcome study of female genital plastic surgery","volume":"7","author":"Goodman","year":"2010","journal-title":"J Sex Med"},{"issue":"2","key":"2022112213590666600_CIT0008","doi-asserted-by":"crossref","first-page":"284e","DOI":"10.1097\/PRS.0000000000005883","article-title":"Female genital and vaginal plastic surgery: an overview","volume":"144","author":"Placik","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"6","key":"2022112213590666600_CIT0009","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1097\/PRS.0b013e31818a9b25","article-title":"Aesthetic labia minora and clitoral hood reduction using extended central wedge resection","volume":"122","author":"Alter","year":"2008","journal-title":"Plast Reconstr Surg"},{"issue":"13","key":"2022112213590666600_CIT0010","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1111\/1471-0528.15387","article-title":"Measurements of a \u2018normal vulva\u2019 in women aged 15-84: a cross-sectional prospective single-centre study","volume":"125","author":"Kreklau","year":"2018","journal-title":"BJOG"},{"issue":"5","key":"2022112213590666600_CIT0011","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/j.1471-0528.2004.00517.x","article-title":"Female genital appearance: \u201cnormality\u201d unfolds","volume":"112","author":"Lloyd","year":"2005","journal-title":"BJOG"},{"issue":"1","key":"2022112213590666600_CIT0012","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2214\/AJR.14.13022","article-title":"Pairwise comparison versus Likert scale for biomedical image assessment","volume":"204","author":"Phelps","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"2022112213590666600_CIT0013","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jss.2018.06.032","article-title":"Systematic review: online crowdsourcing to assess perceptual speech outcomes","volume":"232","author":"Sescleifer","year":"2018","journal-title":"J Surg Res"},{"issue":"1","key":"2022112213590666600_CIT0014","doi-asserted-by":"crossref","first-page":"e0227686","DOI":"10.1371\/journal.pone.0227686","article-title":"Transforming assessment of speech in children with cleft palate via online crowdsourcing","volume":"15","author":"Sescleifer","year":"2020","journal-title":"PLoS One"},{"issue":"1","key":"2022112213590666600_CIT0015","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1093\/asj\/sjw143","article-title":"What do our patients truly want? conjoint analysis of an aesthetic plastic surgery practice using internet crowdsourcing","volume":"37","author":"Wu","year":"2017","journal-title":"Aesthet Surg J"},{"issue":"5S Suppl 4","key":"2022112213590666600_CIT0016","doi-asserted-by":"crossref","first-page":"S307","DOI":"10.1097\/SAP.0000000000002389","article-title":"Applied online crowdsourcing in plastic and reconstructive surgery: a comparison of aesthetic outcomes in unilateral cleft lip repair techniques","volume":"84","author":"Suchyta","year":"2020","journal-title":"Ann Plast Surg"},{"key":"2022112213590666600_CIT0017","first-page":":238-247","article-title":"The dynamics of micro-task crowdsourcing: the case of Amazon MTurk.","volume-title":"WWW '15: Proceedings of the 24th International Conference on World Wide Web","author":"Difallah","year":"2015"},{"issue":"3","key":"2022112213590666600_CIT0018","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/LGT.0000000000000308","article-title":"The size of labia minora and perception of genital appearance: a cross-sectional study","volume":"21","author":"Lykkebo","year":"2017","journal-title":"J Low Genit Tract Dis"},{"issue":"5","key":"2022112213590666600_CIT0019","doi-asserted-by":"crossref","first-page":"428.e1","DOI":"10.1016\/j.ajog.2012.06.056","article-title":"Interest in cosmetic vulvar surgery and perception of vulvar appearance","volume":"207","author":"Yurteri-Kaplan","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"2022112213590666600_CIT0020","doi-asserted-by":"crossref","first-page":"NP517","DOI":"10.1093\/asj\/sjy321","article-title":"Major motivators and sociodemographic features of women undergoing labiaplasty","volume":"39","author":"Dogan","year":"2019","journal-title":"Aesthet Surg J"},{"issue":"4","key":"2022112213590666600_CIT0021","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1097\/PRS.0000000000003181","article-title":"Why women request labiaplasty","volume":"139","author":"Sorice","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"10","key":"2022112213590666600_CIT0022","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1093\/asj\/sjaa038","article-title":"Do genital cosmetic procedures improve women\u2019s self-esteem? A systematic review and meta-analysis","volume":"40","author":"Sharp","year":"2020","journal-title":"Aesthet Surg J"},{"issue":"3","key":"2022112213590666600_CIT0023","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.jsxm.2019.11.272","article-title":"Perception of labial size and objective measurements-is there a correlation? A cross-sectional study in a cohort not seeking labiaplasty","volume":"17","author":"Widschwendter","year":"2020","journal-title":"J Sex Med"},{"issue":"1","key":"2022112213590666600_CIT0024","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.bjps.2011.08.006","article-title":"Concepts in aesthetic breast dimensions: analysis of the ideal breast","volume":"65","author":"Mallucci","year":"2012","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"10","key":"2022112213590666600_CIT0025","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1093\/asj\/sjz287","article-title":"Anterior and posterior commissuroplasty: taking labiaplasty to the next level","volume":"40","author":"Turin","year":"2020","journal-title":"Aesthet Surg J"},{"issue":"4","key":"2022112213590666600_CIT0026","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1093\/asj\/sjv023","article-title":"Labia minora reduction techniques: a comprehensive literature review","volume":"35","author":"Oranges","year":"2015","journal-title":"Aesthet Surg J"},{"issue":"4","key":"2022112213590666600_CIT0027","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1007\/s00266-013-0149-6","article-title":"Composite reduction labiaplasty","volume":"37","author":"Gress","year":"2013","journal-title":"Aesthetic Plast Surg"},{"issue":"10","key":"2022112213590666600_CIT0028","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1093\/asj\/sjx056","article-title":"Labia majora augmentation: a systematic review of the literature","volume":"37","author":"Jabbour","year":"2017","journal-title":"Aesthet Surg J"},{"issue":"1","key":"2022112213590666600_CIT0029","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/asj\/sjv092","article-title":"Labia minora, labia majora, and clitoral hood alteration: experience-based recommendations","volume":"36","author":"Hunter","year":"2016","journal-title":"Aesthet Surg J"}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjab312\/40395228\/sjab312.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/42\/5\/505\/47194165\/sjab312.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/42\/5\/505\/47194165\/sjab312.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T14:26:28Z","timestamp":1669127188000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/42\/5\/505\/6347510"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,10]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,8,10]]},"published-print":{"date-parts":[[2022,4,12]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjab312","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2021,8,10]]}}}