Botox, breast enlargement or liposuction are pass�.  The new cosmetic surgeries are vaginal reconstruction and hymenoplasty. Vaginal reconstruction or rejuvenation is a surgical procedure, where the lining of the vagina and the muscles around it are tightened. According to doctors, the vagina can become stretched from ageing and childbirth. Vaginal rejuvenation is known to enhance sexual pleasure for women as the process reduces the size of a woman's labia minora, designed to increase sexual gratification and reduce forms of incontinence.

More and more women - usually from the upper class and upper-middle class - are going in for vaginal reconstruction. "Cases of vaginal rejuvenation are certainly increasing. Women who come to us are usually in their 30s or 40s, have been sexually active for several years and have had normal deliveries," says P K Talwar, plastic surgeon at the Indraprastha Apollo Hospital, New Delhi. Talwar adds that on an average, Apollo gets five-to-six cases every month.

The increasing numbers are proof that more women are asserting their sexual needs. "I separated from my husband recently and I am in another relationship. I wanted to present a newer self to my partner who means a lot to me. So, I decided to go in for vaginal reconstruction in 2005," says Mohita Bisht, 36, who underwent this surgery at Ganga Ram Hospital in New Delhi.

"Earlier, mostly women (between 35 and 45 years of age) from the upper class were coming for this surgery, but now we have women from middle class families also wanting it. Most want to reinvent their sexual life and enjoy it more," says Talwar.

Vaginal rejuvenation costs somewhere between Rs 15,000 and Rs 25,000 (1US$=Rs 45). It is not a very complicated surgery, is usually performed with the help of local anaesthesia, and doesn't involve much of a risk. More cases for hymenoplasty are also emerging in metro cities in India. Many girls and young women who have had premarital sex and are earning well opt for these surgeries just before getting married.

"Referrals for hymenoplasty are indeed more than what they used to be, say, five years ago. Most of my patients are Indians, though some are from abroad, including a few NRIs. Most are unmarried girls who have had premarital sex and are now getting married to another man and want to present themselves as virgins," says Dr Milind Wagh, Consultant Aesthetic and Reconstructive Surgeon at L H Hiranandani Hospital in Mumbai. The cost of such a surgery is also between Rs 15,000 and Rs 25,000.

Hymenoplasty is basically reconstruction of the broken hymen tissue at the entrance of the vagina. The hymen tends to break at the time of the first sexual intercourse, often causing a little bleeding. However, doctors emphasize that sexual intercourse is not the only way a hymen may be broken. Physical exercise, including stretching, horse riding or cycling can also cause the hymen to break. A fall or long term use of tampons can also tear the hymen. In many societies, including India, an `intact' hymen is considered proof of sexual inexperience.

Despite dramatic changes in the last 50 years, these societies still expect girls/women to be sexually inexperienced at the time of marriage. So, hymenoplasty helps girls recover their `innocence'.

Feminists worldwide have criticised this growing trend, which they say is the result of desperate social pressures to keep women subservient to men. In fact, some activists say hymenoplasty is like female genital mutilation!

In India, among many families, a bride's virginity is still considered the best wedding gift to the groom. Research says that hymenoplasty actually results in women feeling pain all over again during sexual intercourse. Feminists find this very disturbing. Undergoing a surgery only to enhance pain is both destructive and regressive, they believe. In fact, the demand for hymenoplasty is considered a very dangerous trend. It implies that women who have had a sexual history will not be accepted in society, and will have to be `reborn' to find social acceptance.

Although in India, the demand for hymenoplasty has not reached alarming proportions, feminists are concerned that even a few cases of `revirgination' can set the women's rights struggle back by several decades.