In her 'Editors Choice' this week, Fiona Godlee confesses to using this debate to give her "a chance to re-ignite a related controversy" and goes on to criticise cosmetic gynaecology. Whilst to an extent sharing her evident belief that this is society gone mad, its nevertheless perplexing as to why any logical person might focus on this tiny area of anatomy rather than surgery surrounding breasts, ears or abdominal walls. In all fairness, does our editor feel the same need to speak out when she sees a girl walking down the street with a bolt through her nose, or a disfiguring and irremovable tattoo across her neck? And if not, then why not? Surely we either crusade against all forms of the 'alteration of the non-pathological appearance' (Sir Harold Gillies's excellent definition of cosmetic surgery) or else we accept them all equally according to the dual mantras of 'caveat emptor' and 'patient choice'?

Competing interests: None declared