Would I benefit from labia puffing/fillers? (photos)

Question

Not sure where to go from here but don't want to do surgery if it won't restore the fullness I once enjoyed. I've had 2 babies (vaginal deliveries) and am 43 years old.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Deflated labia majora have lost fat. It's a normal part of the labia majora "lifecycle". Restoring the fat restores the fullness that was there previously. If there's too much loose skin, however, adding too much fat is not a good idea because you'll wind up deformed with a giant cameltoe. In that situation, skin excision would be a better option. Fillers won't do enough because they are temporary, they don't add enough volume, and even if they did, they would make the labia rock hard. Your next step is to schedule a virtual consult with an expert

Gary J. Alter, MD · Answer

Your labia majora have stretched with possibly fat loss. Skin only can be removed, which will rejuvenate you as significant fat injections to you would most likely cause very large majora. Your skin can be excised and some fat can be injected at the same time if you are fat deficient. The skin excision technique I pioneered leaves a scar on the inside of the majora in the concavity between the majora and the minora and clitoral hood. I have published and lectured extensively on this procedure in textbooks and throughout the world. Many physicians are not comfortable or trained in this procedure resulting in poorly placed scars, asymmetry, and poor results. You need to have the surgeon show photos of his past patients.

Dr. Gary Alter

Beverly Hills, CA - Manhattan, NY

Dr. Gary Alter

Beverly Hills, CA - Manhattan, NY

Ellen A. Mahony, MD · Answer

Hello and Thank you for your question!

As a first step, adding volume to your labia majora is a reasonable choice.  Keep in mind that like all procedures, nothing is a true "one and done."  Expect to do this again.

Common volume options include using your own fat and platelet rich plasma.  Or, using hyaluronic acid fillers with platelet rich plasma.

In my office, both can be done with local anesthesia.

Burcak Tok, MD · Answer

Hello, depending on age and birth, the labia majora may become droopy and saggy. Labia majora autologous fat filling or HA filling, which can be performed under clinical conditions, will be very beneficial for you.

Lori Warren, MD · Answer

First of all I would like to tell you that you look totally normal. Many women as they age lose volume of their labia majora and desire a fuller, more youthful appearance. This can be filled in a couple of different ways. Some people like fat transfers, while others like a procedure called a vampire wing lift. This is a procedure we do frequently that requires the use of your own platelet rich plasma (PRP) and a large molecule hyaluronic filler mixed together and injected to give you back a youthful fullness. The procedure itself is well tolerated by patients, does not require surgery and uses your own PRP to help rejuvenate your vulva. I hope this has helped.

Leyla Arvas, MD · Answer

Hello, the most beautiful and effective method to make the labia look full is fat injection. The amount of fat to fill the labia is taken from a different area by suction and transferred to the labias and reshaped. The effect is long lasting and the look will be natural.

E. Jacob Simhaee, MD, FACOG · Answer

Dear patient
you have an option of Morpheus 8 V or Morpheus 8 to tighten vagina and vulva or just the vulva,
it is a simple noninvasive non-surgical treatment.
you might need 3 treatments.
good luck.

Falguni Patel, MD, FACOG · Answer

Hi, so I agree with my colleagues that an in person consult would be best to start with and surgery with tissue reduction would help greatly.  BUT, having said that, you do have minimally invasive options which may give much improvement.  A combination of AVIVA followed by Morpheus 8 and Morpheus 8 V, may help contract some of the tissue giving a smoother appearance.  The  Morpheus 8 V for the vagina, may give some snugness but it does not replace surgical vaginoplasty.  This is an option for some improvement without traditional surgery.  You may still need fillers for a fuller look, but 50-75% of my patients find themselves no longer needing the fillers.  I hope that helps!

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Most likely a combination of labia majora fat transfer and skin resection will afford you the best overall result.  Hope this helps.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photo. Loss of volume in the labia majora is a common concern for women with a history similar to your own. Most of the volume is made up naturally from fatty tissue. Age and hormonal changes can result in some loss of that volume and the optimal correction is using your own fat (borrowed from the tummy or things or buttocks). This IS a surgical procedure but can be done under local anesthesia under certain circumstances, depending on the patient. Fat injection or "fat grafting" (same procedure, different terminology) my require more than one session separated by about three months or longer to achieve the final desired outcome, but some degree of improvement can be expected with each stage.

Alternatively, a non-surgical approach is the injection of "off the shelf" fillers such as Hyaluronic acid (Restylane, Juvederm) or Hydroxyapatite (Radiesse). These tend to be fairly expensive since multiple syringes may be required, and they always resorb within 9-18 months and would need to be repeated.

Please consult with an experienced board certified plastic surgeon or gynecologist who regularly performs vaginal rejuvenation procedures. He or she should be able to advise you on all of your options. Best of luck to you.