It isn't entirely clear what is driving the increased anxiety many women are now experiencing about their vulva. One theory is that pornography is driving this trend, and that there is some sort of ideal vulva represented in porn. But as Stoya, a prominent porn star, has noted, pornography, in general, may not unequivocally be the culprit (post here - not that she's claiming that pornography doesn't have an effect on preferences). She also notes that men don't really seem to care about the size of their partners' labia.
Another theory suggests that the increase in labiaplasties is the result of marketing by plastic surgeons. So, for example, a woman visits a plastic surgeon's website for some other procedure, and sees marketing for labiaplasty, which presumably indicates that larger or asymmetrical labia are problematic. This is potentially internalized, leading to a desire to seek out labiaplasty.
Assuming pornography is responsible, however, it isn't clear if women are feeling down on their vulva because they're watching pornography and comparing themselves (specifically to those actresses with small inner labia - most actresses have average or larger labia), or if men's consumption of pornography is affecting male preferences, leading to demands about their partners' vulva (perhaps the more likely explanation?). If average and smaller labia are supposedly more desirable, then why are there very popular web sites out there dedicated to the worship of large labia (e.g., here - very NSFW)? It's also possible that the vulva is simply another part of the body that can cause anxiety, and that the more media exposure vulva dissatisfaction gets, the more anxiety that is created.
There's very little good data addressing this issue. Here is one of the few studies:
Miklos, J. R., & Moore R. D. (2008). Labiaplasty of the labia minora: Patients’ indications for pursuing surgery. Journal of Sexual Medicine, 5, 1492–5.
They found that 37% of women who underwent labiaplasty did so only for cosmetic reasons. Another 31% went through the procedure for both functional and cosmetic reasons. The other 32% had labiaplasty only for functional reasons. Overall, 6.9% stated that they were influenced by their partners (in 2 of 9 cases, by female partners!).
The paper can be found here.
Anyway, another project about labiaplasty and women's relationships with their vulva, despite the misleading name (vagina?):
From the artist's (Jamie McCartney) statement:
For this, my latest major sculpture, I cast, over the course of 5 years, the vaginas (well the vulva area in fact) of hundreds of volunteers. The Great Wall of Vagina is an exploration of women's relationships with their genitals. When I assembled the first panel of 40 casts in summer 2008, I stepped back disappointed. I realised the sculpture would need to be much bigger to have the impact I wanted. From this original piece (called Design A Vagina) has grown an epic sculpture. The final piece now has 400 casts arranged in 10 panels of 40.
"Why did I do it and what's it all about?" I hear you ask. Well, it became clear to me whilst working on a not dissimilar piece for a sex museum that many women have anxiety about their genital appearance. It appalled me that our society has created yet one more way to make women feel bad about themselves. I decided that I was uniquely placed to do something about it.
The sculpture comments on the trend for surgery to create the 'perfect' vagina. This modern day equivalent of female genital mutilation is a bizarre practice which suggests that one is better than another. Taste in nothing is universal and any desire for 'homogyny' could be very misguided. 400 casts arranged in this manner is in no way pornographic, as it might have been if photographs had been used. One is able to stare without shame but in wonder and amazement at this exposé of human variety. For the first time for many women they will be able to see their own genitals in relation to other women's. In doing so they may dispel many misconceptions they may have been carrying about what women look like 'down there'. The sculpture is serene and intricate and it works on many levels.
His website is here.