Aahhh... The "hype" of Labial Puffing. Same as the hype of all of the "minimally invasive"/ transfer/ "non-invasive approaches. You have to keep coming back! Every 6 months, every year, every couple of years. Practitioners should accurately inform their patients as to length of effectiveness, and many do. But in my opinion, most do not. Women (& men) are used to "coming back" for therapies (look at Botox!). Labial puffing is not permanent. If nanofat + PRP is utilized, perhaps the results are greater than simple fat transfer; both are greater than "fillers." But (as of course in a surgical approach), the practitioner's experience is also key. So: what to do after you've deflated? 3 choices: leave things as they are; be "re-puffed;" or undergo a permanent surgical fix. The re-puffing will cost you less, but needs to be re-done & re-done (again, lasts longer with nanofat + PRP + experienced practitioner.) Re: surgery, the procedure is called a "labia majoraplasty." There are several techniques: Classical; Modified Classical/"teardrop;" simple "Labial Lift;" and the "Unified" labia minora/majoraplasty techniques described by Alinsod (vertical approach) and Goodman (wedge approach). I would be happy to give you my opinion re: your personal best approach if provided with a photograph. Check out Cosmetic Gnyecologists and P.S's websites for lots of B&A photos... Very Best, Michael P Goodman, MD, FACOG, IF; AAACP. Davis/Sacramento, CA, USA