Digital visibility, online engagement and evidence-governance of cosmetic gynaecology in Sri Lanka: A descriptive infodemio-logical study

Background: Cosmetic gynaecology is increasingly visible across search engines, social media and digital advertising. In sensitive health domains, anonymous digital activity may reveal information-seeking that is poorly captured by clinic records.Objective: To describe online interest, social-media engagement and advertising related to cosmetic gynaecology in Sri Lanka and to interpret these signals against contemporary evidence.Methods: This descriptive infodemiological study used aggregated data from July 2023 to July 2025 from Google Trends, Google Keyword Planner, SEMrush, Keywordtool.io, TikTok Creative Center and Meta Ad Library. Search domains included labiaplasty, hymenoplasty, vaginal tightening, vaginal rejuvenation, injectable treatments, clitoral hoodplasty and vulvovaginal platelet-rich plasma therapy. Outcomes were relative search indices, estimated monthly search volume, social/video engagement and advertisement visibility. A targeted narrative evidence synthesis was updated to July 2026.Results: Estimated monthly search volumes were highest for “labiaplasty Sri Lanka” (1,600; 40.46%), “hymenoplasty Colombo” (1,100; 27.81%) and “vaginal tightening Sri Lanka” (950; 24.02%). Western Province showed the highest relative search-interest index (100), followed by Central (72) and Southern (65). TikTok hashtags #VaginalTightening and #LabiaplastySriLanka recorded approximately 850,000 and 420,000 aggregate views, respectively. Meta Ad Library identified approximately 120 related advertisements.Conclusions: Cosmetic gynaecology has measurable digital visibility in Sri Lanka, especially for labiaplasty, hymenoplasty and vaginal tightening. These findings indicate online attention and commercial visibility, not confirmed clinical demand, procedure uptake or user demographics. They support evidence-based counselling, patient education and ethical advertising standard-setting.