Female genital cosmetic surgery (FGCS) is increasing in popularity in the Western world. With substantial debate over the implications of these surgeries on women’s health, it is of critical importance to examine this new social phenomenon. This analysis aims to contribute to the debate by examining the processes that may shape a women’s perception that her vulva is in need of surgical alteration, in the absence of any medical indications. The discussion applies a social constructionist framework to examine how external factors may shape a woman’s perception of her vulva, highlighting  several negative constructions of the female genitalia (as abnormal, unhealthy, unfeminine, dysfunctional and problematic) which circulate within both patient and medical resources. These constructions may be internalised, rendering requests for FGCS logical if not inevitable. For many women the true solutions are social, and rest upon the challenging, questioning and deconstruction of negative perceptions and misinformation.