Will a fat transfer (majoraplasty) help the look of the deflated labia majora? (Photo)

Labia majoras seem to wrinkle the more widely spread the legs are. The volume in the majora lips seems to have decreased over the years. Will a fat transfer allow the majora lips to lay against the labia minora while the legs are spread? Could a trim of the excess skin be a solution, or needed in addition to a transfer of fat?

Doctor Answers 6

With deflated labia majora

you have choices... and if there is no endocrine issues, can either have fat grafting (permanent) or dermal fillers (transient) to plump the majora up.  If there is a component of excess skin, then a medial skin excision can be done.  Make sure the incision is at the junction of the hair bearing and hairless skin as I've see scars over the front of the majora that are quite visible.  And know what your surgeons revision policy is, just in case you need it.


Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Will fat transfer help the labia majora look less deflated?

Dear Princessgal,

Thank you for writing in with your questions and sharing your photo.  Aging affects the fat cells under the skin and they shrink over time causing the deflated look.  Also, there is a fat sac under the skin on each side that gets damaged over our lifetime of sitting on them and that can worsen the wrinkled look.

There are several ways to improve the appearance of the labia majora.  Fat transfer is one but overall does not provide a satisfactory look because the fat is reabsorbed by the body over time.  Fillers can have unsatisfactory results as well due to asymmetry, bumpiness, and bodies can react negatively to fillers and have allergic reactions among other problems.

Skin excision alone or skin excision with repair of the fat sac will provide a more youthful appearance to the labia majora.  There is also the non-surgical option of ThermiVa which stimulates collagen in the skin and plumps up the labia majora with three treatments over 3 months without any cutting or downtime.  However, a once a year (can be up to 18 months) maintenance treatment is needed since this is not permanent.  Pictures are available on RealSelf and at the link below.  So you do have options.

Be sure to see lots of before and after pictures and ask how the surgeon you choose addresses complications when they arise.  Please research your surgeon and make sure s/he is aware of the various techniques of labia majora reduction.

I hope this information is helpful and best of luck in your pursuit of tighter labia majora!

Sincerely,

Troy R. Hailparn, MD, FACOG

Cosmetic Gynecology Center of San Antonio

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 27 reviews

Will a fat transfer help the look of the deflated labia majora?

Thank you for sharing your question and photograph.  There are three ways to treat the labia majora - replacement of lost soft tissue volume with the use of fat grafting or dermal fillers, excision of excess skin, or a combination of fat grafting and skin excision.  The best recommendation is through an in-person examination, but it appears that your labia have excess skin that would best be treated by skin excision.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Vulvar fat transfer

Transfer of fat to your vulva will definitely give your labia majora a fuller look. In addition, it appears your labia are a bit too long and asymetrical, thus you might want to consider a labiaplasty too. See details on the link below. Good luck.

Robert L. True, MD
Grapevine OB/GYN
4.9 out of 5 stars 7 reviews

2 types of "majoraplasty"

great question that gets at the core of labia majora aesthetics. Are the outer labia elongated or deflated... or both?

That's what an experienced vulvovaginal surgeon will be able to tell you and determine if you'd benefit from majora reduction, filling with fat or both! This often requires a standing view to determine. That said based on your photo a reduction may suffice. The best way to achieve this is to place a scar at the crease between the inner and outer labia so that no scar is visible. By removing skin only you can actually give the appearance of a plumper labia majora: same amount of fat in a tighter envelope. Make sense? Be super selective with your surgeon. "The local gyn" isn't the right move here. Unless of course they're an expert at this with photos and reviews and an aesthetic practice. 



Labia majora sagging

Dear PG;

Thanks for sharing.  Though your thought processes correct - i.e. add fat and the wrinkles will go away......this is done all too often with less then desirable results. My colleagues in Brazil do this and all to often the patient looks as though they have a baby butt cheeks between their legs as often Brazilian doctors will overly plump this area and makes the woman look like they have a huge bulge in their crotch. 

 To understand how to fix the wrinkles it is often helpful to understand why you have the wrinkles.  Few women have this problem when they are 18 years old so what happens later on in life that patients have this problem?  Well usually this occurs in women as they age for two reasons: 1) as you mentioned (fat loss)  when women gain and lose weight sometimes the body loses more fat in the majora area if this were solely the reason for the wrinkles you would be correct----- just replace the fat   and 2) stretching of the labia minora and majora asking due to swelling especially during both pregnancy and delivery.  If you have ever seen a woman give birth to a child over a 12-24 hours you would realize how unbelievable resilient the woman body  is...... the whole vulva will sometimes have so much edema that the vulva will be 2-3-4 - even10 x  its normal size.  The only way this can happen is if the skin stretches------- completely different then just losing fat in the area.   This is similar to a man losing a 100 lbs and having lose skin around his waist.  To get rid of the wrinkles you could puff it up with more fat   but then he is defeating the purpose of losing weight and what must be done is a resection of the loose excess skin.    This decision is all made at the time of the consult.   Please choose a surgeon who really has experience in this area of cosmetic vaginal surgery and this should be noted on their website.  Many women need  both a skin  reduction and then plumping with either autologous fat or sculptra. The good news is my experience reveals that most patient who have these procedures have very little pain post op.   Please do not let costs or location  dissuade you from choosing the surgeon who will be  the best for you.


John R Miklos MD, FPRMS, FACS, FACOG

Atlanta ~ Beverly Hills ~ Dubai

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.