LABIA PUFFING

This two-step, in-office procedure typically takes under an hour.

• First, you’ll be given a local anesthetic to numb the labia majora and the area where your surgeon plans to harvest excess fat (often the abdomen or flanks). You may also be given an oral sedative.
• Once you’re numb and relaxed, your surgeon will remove the excess fat via liposuction, using a cannula (a thin tube) to suction it out.
• The fat will be processed and purified.
• Finally, they will inject the purified fat into your labia to create the desired volume, taking care not to overfill (which can reduce the survival rate of the fat cells).

According to a 2017 report in the Aesthetic Surgery Journal, labia majora augmentation with fat transfer has high patient satisfaction and a low complication rate. 

Just be aware that fat injection results can be unpredictable because not all of the transferred fat will survive. Dr. Johnny Franco, a board-certified plastic surgeon in Austin, Texas, explains that “There will be some resorption of the fat (about 30%) initially, but what is still present at three months will be there for years to come.” 

At the three-month mark, you may decide you want to undergo an additional procedure to further increase the volume.

Hyaluronic acid–based fillers, like Juvéderm and Restylane, can temporarily plump the labia majora. A 2016 study published in Aesthetic Surgery Journal showed that hyaluronic acid (HA) injections resulted in significant labia rejuvenation in women, with no reported complications. 

This treatment starts with a local anesthesia injections or numbing cream, to minimize pain. Labia injections can be more painful than facial fillers because the area is so sensitive, so it’s important to make sure the area is sufficiently numb before your procedure starts. 

Next, your provider will then inject the hyaluronic acid into the outer labia, which takes about 20 minutes. 

HA filler results can last 4–12 months, depending on the type that’s used and how your body metabolizes it. After that, you’ll need maintenance treatments.

Some physicians prefer to plump the labia majora with Sculptra, a poly-L-lactic acid filler that stimulates collagen growth over time, to increase padding and improve tissue elasticity. With Sculptra, an initial series of two to three monthly treatments is needed. Results can last up to two years.

Pros

• This labia rejuvenation procedure can improve the appearance of the labia, increase your comfort during high-impact activities, and boost self-confidence.
• Labia puff reviews show high patient satisfaction: RealSelf members give it a 100% Worth It Rating.
• Results of labial puffing via fat transfer can last years and even decades, subsiding only with age.
• Hyaluronic acid filler results are reversible, if you don’t like them or have a complication.

Cons

• Dermal fillers are not yet FDA-approved for labia augmentation, so this is considered an “off-label” use.
• Some RealSelf reviews report an unexpected level of pain and ongoing discomfort after labia puffing.
• With Sculptra injections and fat transfer, you’ll have to wait three months or longer to see your final results
• There is a lack of published studies or standardized protocols for labia majora augmentation. In 2022, the American College of Obstetricians and Gynecologists noted that “women should be informed about the lack of high-quality data that support the effectiveness of genital cosmetic surgical procedures and counseled about their potential complications.”

The labia puffing photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Whether your procedure involves dermal fillers or a fat transfer, you can expect to have swelling, bruising, and a dull ache for the first few days afterward. 

Most patients can walk around fine, but you’ll probably be more comfortable if you take over-the-counter pain medications for up to a week, especially if you’ve had a fat transfer (which also involves soreness in the area where the lipo was performed).

Avoid sexual activity for a week after your procedure, to let your body heal and the fillers or fat to settle. Some providers also recommend avoiding high-impact exercise for up to six weeks after fat transfer, to reduce the risk of fat cell death.

Once the swelling goes down, you’ll see your final result.

A labia puff procedure is considered safe and low-risk in the hands of an experienced provider, especially if you’re having fat grafting. However, it’s good to be aware of these side effects.

Regardless of where they’re injected, all dermal fillers come with these potential risks:

• Swelling
• Bruising
• Infection
• Asymmetry
• Lumps and bumps
• Vascular occlusion, if the filler is accidentally injected into a vein and blocks blood flow

Complications from HA fillers can usually be resolved with a dose of hyaluronidase, an injectable enzyme that melts hyaluronic acid. 

Sculptra cannot be reversed, so any problems (like nodules) are harder to treat. Patients either have to wait for them to resolve on their own, which can take years; have the lumps injected with cortisone or 5-Floururacil, to help break them up; or have them surgically removed.

Fat transfer labia augmentation risks include: 

• Swelling and bruising, which may last as long as six weeks
• Hematoma, an especially bad bruise
• Infection
• Lumps
• Fat embolism
• Fat necrosis
• Asymmetry, if more of the transferred fat survives on one side than the other 
• Disappointing results; according to one study, “fat reabsorbs in our labia majora much more than when injected in other body parts.”

During your consultation, your provider can explain these potential side effects and how to handle them, if they occur.