What are options to enhance my deflated and wrinkly labia majora? (photo)

I'm 36 & I've experienced EXTREME rapid aging of my nether regions. I used to have an attractive situation down there but in the past year or so my labia majora have deflated & my minora have gone from pink to dark brown with discoloration of the majora also. I feel like I suddenly look like an 80 year old down there. Is this normal for my age? Can the excess/loose skin be trimmed from the majora, or is there a laser that can possibly improve the quality of that skin? How about the color?

Doctor Answers 11

Deflated labia majora

I reviewed your photos.  You have some excess labia majora skin with some deflation.  If you have fat injections to plump up your majora, then your majora may be bulky in tight clothes.  I developed a majora skin reduction procedure which has minimal scars and eliminates the wrinkling. In some cases, I may remove the excess skin and also inject fat to plump up your majora.  I suggest you include photos standing the determine which is the best treatment- skin removal, fat injections, or a combination of both.  Your labia minora can be reduced, but you also might need a clitoral hood reduction with a clitoropexy to decrease the hood protrusion.  

Beverly Hills Plastic Surgeon
4.7 out of 5 stars 21 reviews

Saggy, wrinkly labia majora and darkening coloration: what can I do??!


I have looked carefully at your photo and understand your concerns regarding the aging process in your genital area. You're still 36; how can you coax your labia (minora & majora) to join the party? There are two good options that will relieve both of your concerns:

1. Fractional pixillated CO2 laser bleaching and shrinkage in a decent non-invasive method for both minimizing labial redundancy and modestly lightening the color. It could be a good less-expensive starting point. The down side it that this method has little long-term evidence-based research behind it (like... does it really work, and how long does it last?  Most docs charge in the range of $2000-2500 for a combined bleaching/labial majora shrinkage.

2. your other option is more expensive (est. ~ $5000-5500) but more certain: a surgical reduction of the redundant labia majora which at the same time would diminish the darkened coloration of the redundant majora.  At the same time if you wished you could have a very minor "trim" (not  full labiaplasty) of the edges of the labia minora; the cost would be modest if combined with the majora.

Best wishes!  Access the weblink below if you wish; the photos are mainly of labia minoraplasties, but there are at least a dozen majoraplasties sprinkled about...

Michael P Goodman MD

Improvement in aesthetics of labia

A surgical majoraplasty to remove the excess laxity of the majora can help reduce the deflated look of your labia majora.  In your case, a small amount off added volume ( fat/ filler)  may be added to the majora once you have healed if needed to enhance the volume as well.  A conservative trim minoraplasty can help with the dark edges of your minora. This can be performed at the same time . To enhance healing and skin quality  , PRP injection in the area, which I perform at the time of my labiaplasties is beneficial . 

In terms of nonsurgical options for the majora laxity,  RF treatments  with no down time like ThermiVA can be a good option, however it is not a long term solution. 

Cheri Ong, MD, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 11 reviews

Labia Majora Fat Injection for Fuller Vaginal Area

I would recommend fat grafting to fill the labia majora.  "Aging" of the vulva can occur for a variety of reasons, childbirth, intercourse, hormonal changes.

Fat grafting first involves liposuction to the tummy and/or inner thighs, and fat injection or grafting into the labia majora.  About half of the fat stays and half gets reabsorbed after fat grafting.

The photo above also demonstrates mild excess of the labia minora (in addition to atrophy of the majora) and clitoral hooding. I would perform a clitoral hood reduction with a very small component of a trim labiaplasty in order to remove the hooding and also restore a normal coloration to the edge of the labia.

The ThermiVa radiofrequency device has shown some promise in tightening the vaginal opening and providing a fuller vulva. This is still somewhat experimental but very low risk, and I would use this as well as part of your treatment.

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 189 reviews

Labiaplasty can help address loose skin

Labiaplasty can certainly help remove the excess skin that exists, however it cannot address any discolouration effectively. Labiaplasty can be performed by laser or be excision. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Labial fillers for the labia minora and majora

Labial fat grafting or Labial fillers may further enhance the interface between the labia majora and labia minora. Our office specializes in labiaplasty surgery and labial rejuvenation.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

What are options to enhance my deflated and wrinkly labia majora?

There are two general types of procedures that can be performed on this region: addition of volume or removal of excess tissue (or both). Based on this photo I would probably recommend an augmentation of what you describe (and what looks like) deflated tissue. The most common material used at present is your own tissue - fat. It's a somewhat more involved procedure than one might think. Fat needs to be removed from one part of your body, prepared for injection (often involving concentrating the fat) and then injected. The post-op period can be uncomfortable and the procedure may need to be repeated for maximum effect but, all thing considered, that's probably what I'd recommend. 

I hope oped that this helps and good luck,

Dr E
Member of RealSelf 100

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Labia Majora rejuvenation

Your labia majors would likely be nicely rejuvenated with volume using your own tissue with fat grafting. You may also consider labiaplasty for your labia minora. Fat grafting will fill the labia majora likely removing the wrinkles appearance and labiaplasty will remove the excess labia minora tissue. Good luck

Gaurav Bharti

Gaurav Bharti, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 115 reviews

Some things can be fixed....

And somethings, cannot.  Here's what I mean:

The problem with the labia major in loss of the natural fatty tissue that is typical with the youthful body.  Although skin can be trimmed when needed, the real solution is add back the volume.  This can be done with fat grafting, which is a technique that allowed taking fat (with small needles) from one part of the body (usually the tummy) and transferring it (with even smaller needles) to area where we need it (typical areas are breast and face, but this has been done by plastic surgeons for the labia major also).

There are no good solutions at this time to the color problem however, so I would not want to see someone in your shoes waste their hard-earned dollars on treatments that won't work.  I think it's just as important to tell patients what's likely to work, as it is to tell them what is NOT likely to work.

Just be sure to see a surgeon who's not only experienced with labiaplasty work, but also with fat grafting.  Also beware that the most common problem with fat grafting is that not all the transferred fat "takes," so it sometimes has to be repeated until enough volume takes for a good result that will make the patient happy.

Best wishes,

Reza Momeni, MD

Reza Momeni, MD FACS
Summit Plastic Surgeon
5.0 out of 5 stars 42 reviews

Deflated Labia Majora

Deflation of the Labia Majora can be treated either with removal of the loose skin or with a plumping procedure involving injection of your own fat into the area.  Good luck!

Sacha Obaid, MD
Dallas Plastic Surgeon
4.8 out of 5 stars 133 reviews

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.