The labia majora (outer labia) are the folds of skin that surround the inner labia on both sides in the external genital area. Augmentation may be considered for volume loss that becomes noticeable due to structural features, aging or weight changes.
Assessment
The treatment area and the material to be used are determined after an examination. The assessment covers the degree of volume loss, the skin structure, any excess or sagging skin and the person’s expectations. If there is active infection or inflammation in the treatment area, the procedure is postponed. Conditions such as a bleeding disorder, a history of severe allergy, pregnancy and breastfeeding are discussed separately beforehand.
Methods
- Hyaluronic acid filler: a gel filler is injected beneath the skin of the labia majora. Hyaluronic acid is gradually absorbed by the body, so its effect is temporary and repeat treatment may be needed. If necessary, it can be dissolved with an enzyme called hyaluronidase.
- Fat injection (fat transfer): fat tissue taken with a thin cannula from another part of the person’s body is prepared and then injected into the labia majora. Part of the transferred fat is absorbed by the body over time, so the result varies from person to person and further treatment may be needed. Bruising, swelling and changes in sensation may also occur where the fat is taken.
Which method is suitable is decided by considering together the degree of volume loss, whether there is an area from which fat can be taken and the person’s preference.
After the procedure
In the days after the procedure there may be swelling, bruising, redness, pain and tenderness. How long to avoid intercourse, tight clothing and strenuous exercise is discussed beforehand.
Possible risks and limitations
The most serious risk of filler treatments is accidental injection of the material into a blood vessel; this can disrupt blood flow and lead to tissue loss. Palpable lumps (nodules), movement of the filler, infection, asymmetry and allergic reactions are other possible risks. With fat injection, the transferred fat may harden, or fat necrosis or oil cysts may develop.
How long the result lasts varies with the material and individual characteristics; scientific data on filler treatments for genital aesthetic purposes are limited. Publications on labia majora augmentation are few, and most are small studies without a control group; long-term results are not well known.