Reconstructive surgery improves the function of a body part, while cosmetic surgery changes the aesthetics of essentially normal anatomy. You can think of it like a nose job: a surgeon can restructure the interior nasal cavities to help you breathe better or reshape the nose, just for the sake of appearances. It's a critical distinction, because the American College of Obstetricians and Gynecologists evaluates surgeries and outcomes to fix functional problems, such as urinary incontinence. But ACOG remains skeptical and cautious about cosmetic vaginal surgery because of its risks and lack of scientific data on safety and effectiveness. Some vaginoplasty procedures, for instance, were originally developed as reconstructive surgeries to repair birth defects when the vagina was malformed, too short, or absent (such as in vaginal agensis), so that a girl could grow up to have normal urination, menstruation, and intercourse.