46, 6 kids & hormonal changes - need advice on improving appearance of labia (Photo)

Hello, the procedures that can be performed in the clinic with local anesthesia seem suitable for you, fillers for sagging, PRP treatment for rejuvenation of the labia majora, laser or RF procedures can be applied.

With your legs closed, it's not possible to make a complete assessment of the degree of sagging that you are experiencing. If it's mild sagging, a thermal technology such as internal RF (radiofrequency) such as Renuvion/J-Plasma produces a gentle contracting and can be done under local anesthesia. External RF is less effective for the same degree of sagging. If it's more than mild sagging, thermal technologies are not enough and you might need to consider small skin excisions and lifts. I've been treating this condition for over two decades and I speak from vast experience. It would be best for you to schedule a virtual consultation.

Thank you for your question and the photo. You're in luck because even a few years ago we didn't have technology that could help. Now we have different devices that can help tighten things back up on the inside and externally. I suggest looking into radiofrequency based technologies such as ThermiVa. It's typically 1 treatment once a month for 3 months. I would stay away from laser based technologies though. You get much better results with RF. You can check out some of our before and after technologies on our website and we have a couple of youtube videos where I explain all the ways to improve form and function with minimal to no downtime. I hope this helps! Dr. Dima

Thank you for your inquiry! A Vaginoplasty procedure can be performed to increase vaginal tightness and Labiaplasty to reduce the size of your labia minora / labia majora. Both procedures can be combined and done together in one surgery. We would love to meet with you in person! Schedule a consultation with a Board-Certified Plastic Surgeon like myself to help you reach your goals and create a surgical plan for you!

Hi, thank you for your question. Vaginal tightening involves creating small incisions to join loose vaginal muscles and shorten them, as well as tightening the vaginal opening through dissolvable sutures. If you're hoping to address excess skin ("saggy"-ness), you may want to explore a labiaplasty which involves the excision of labial tissue. In terms of skin lightening, that is not a procedure I offer at my practice, but you're more than welcome to come in for a consultation to discuss your concerns further.

When considering options for improving the appearance of the labia, particularly in the context of hormonal changes and multiple childbirths, there are several minimally invasive procedures that may be helpful:

Laser Treatments: Laser therapy can be used to tighten the skin and improve pigmentation. This non-surgical option can help stimulate collagen production, leading to firmer and more youthful-looking skin.

Radiofrequency (RF) Treatments: Similar to laser treatments, RF technology can tighten skin by stimulating collagen production. It is a non-invasive option with minimal downtime.

Fillers: If fuller labia are acceptable, dermal fillers such as hyaluronic acid can be injected to add volume and improve shape.

Topical Treatments: There are topical creams available that can help with pigmentation issues, though these may take longer to show results and are less effective for tightening.

ThermiVa: This is a non-surgical, non-invasive treatment that uses controlled radiofrequency energy to gently heat tissue and stimulate natural collagen production. It can help with both tightening and improving appearance.

It is important to consult with a board-certified dermatologist or plastic surgeon to discuss your specific concerns and determine the best treatment plan tailored to your needs. They can provide more detailed information on the effectiveness, risks, and recovery associated with each option.

Great question—and you're not alone. At our practice, we specialize in helping women like you feel confident and revitalized with minimally invasive solutions. For concerns like sagging or changes in the labia, we offer non-surgical options like laser or radiofrequency skin tightening and PRP treatments to improve tone, texture, and collagen. If you're open to a small in-office procedure, labia majoraplasty or labia puffing with fillers or PRP can restore a more youthful, fuller look without significant downtime.
We also address the underlying hormonal shifts with personalized hormone optimization, which often improves skin quality, mood, libido, and overall well-being.

There are many non surgical treatments that can address both appearance and functionality of the vaginal area and labia. Empower RF offers three options for this including Morpheus8V, FormaV, and VTone. They can be combined with other non surgical treatments as well including Aviva which is a nonsurgical scarless labiaplasty and EvolveTite which stimulates collagen production to give a more youthful appearance. You can learn more by visiting my website or a provider near you.

It’s always a patient’s choice issue. The advice based on vulval photo is either of two things1. Leave Alone2. A reduction Labioplasty designed as you wish. You might want to consider an outcome that ensure that the inner labia end within the outer labia, often suggesting 50-75% or more reduction by excision method

Several minimally invasive vaginal rejuvenation treatments tighten loose skin in the vulvar area, mons pubis, labia major, and menora, and sagging skin on the clitoral hood. They also tighten the inside of the vaginal canal and the opening, as well as enhance and improve sensation, lubrication, arousal, and orgasm. In addition, the same treatments are FDA-approved for urinary incontinence in women. My favorite is EmFemme 360 combined with V-tone. If there is moderate to severe laxity, loose skin, and urinary incontinence I also will consider Morpheus 8- V.