But primarily, doctors say, aggressive marketing and fashion influences like flimsier swimsuits, the Brazilian bikini wax and more exposure to nudity in magazines, movies and on the Internet are driving attention to a physical zone still so private that some women do not dare, or care, to look at themselves closely.

"Now women shave," said Dr. Gary J. Alter, a plastic surgeon and urologist with offices in Beverly Hills, Calif., and Manhattan who has come up with his own "labia contouring" technique. "Now they see porn. Now they're more aware of appearance."