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Perineal pigmentation can be corrected with skin lightening creams such as Melarase followed by Melapeels to address pigmentation through exfoliation. Raffy Karamanoukian MD
I would suggest visiting a board certified plastic surgeon in person, to discuss all possible options surgical and non-surgical.Thank you for your question and for sharing your picture!
Thanks for RealSelf question. I might offer fat grafting to fill out these "wrinkled" areas... But best to seek IN PERSON examinations...