More young women are tailoring their lady bits than ever before, according to a new report from Transform, a leading cosmetic group in the UK. Research compiled during the last four years found that women between the ages of 18 and 24 seek labia reduction surgery more than any other age group. Transform receives 1,150 labiaplasty requests annually from the 18-24 demographic and attributes the surge to “unrealistic representations of female genitalia in pornographic materials,” despite facilitating these unrealistic representations.

Multiple media outlets have declared the trend “alarming,” but it’s hardly shocking that young women are conforming to vaginal norms established by porn and...well...porn. (Because where else do we regularly see exposed labia that’s not our own?)

Indeed, the term “designer vagina” began popping up in mainstream media just as Internet porn was becoming ubiquitous. In 2000, Salon reported on the “rapidly growing industry” from Dr. David Matlock’s Designer Laser Vaginoplasty clinic in Los Angeles, where women shelled out thousands of dollars to have their “labia modified, vulvae reconfigured.” Some women began electing to remove their entire labia minora (the inner vaginal lips)—a procedure nicknamed “The Barbie” by a Laguna Beach plastic surgeon—which resulted in a prepubescent “clamshell” aesthetic. In 2011, the International Society of Sexual Medicine published a review which found that 87 percent of women who underwent vaginal rejuvenation surgery did so solely for cosmetic purposes.

And it’s no surprise that a generation of women who have been removing pubic hair since they hit puberty are pruning other parts of their vaginas.

Dr. Norman Rowe, a member of the American Board of Plastic Surgery and a practicing surgeon in Manhattan, says his younger patients want their pendulous pudenda tightened and tucked for a “more refined” look. And many point to the hyper-stylized ones in Playboy magazine as models of pussy perfection, he says.

But it’s not just college-age women who are carving up their most delicate parts. Rowe says 75 percent of his patients are in their 30s and 40s. “They want a rejuvenated vagina, to reverse the effects of aging,” he said.

And many of his patients are more self-conscious about how their dangling vaginal lips look in yoga pants than they are concerned about unsightly fleshy protrusions during sex. “Lululemon has played a huge role in the increase in labiaplasty in the U.S., at least in New York,” he says. “I can’t tell you how many women come to me worried about how they look at the gym.”

To be sure, not all labiaplasty patients undergo the procedure for the look. Dr. Ronald Blatt, chief surgeon at the Manhattan Center for Vaginal Surgery, says the “vast majority of women” go under the knife for reasons that aren’t cosmetic. “Large labia minora can cause discomfort during sex or other physical activity.”

As with all plastic surgery, the desired effect may not be worth the risks. “You want to be very careful when you do a labiaplasty, particularly on the labia minora,” says Rowe. “It can lead to all types of cosmetic and functional issues down the road which are difficult if not impossible to reverse.”