Labia majora is the skin area on both sides of vulva which contains hair-bearing skin over a fatty pad that is continuous with the Mons pubis. Labia major augmentation is a procedure which is carried out in this area to correct the deflation that has happened due to time. As women become older several changes take place in the labia majora including: loss of fat, and change in the quality of skin and colour.
There are two options in order to increase the volume and overcome the deflation:
Using fat (autologous fat):
In this procedure patient’s own fat is used which is natural and may lead to permanent result. However, results are variable in patients and can be disappeared in some patients. Fat availability is another important factor; some patients have the least available fat for replacement.
Hyaluronic acid fillers are the main cosmetic fillers that are used. They are used for temporary purposes, however they are readily available and procedure of applying them is quick and simple.
The procedure takes between 15 and 30 minutes. Commonly the fat is removed from the body via tumescent Lipo-sculpturing procedure. In this procedure, a combination of local anaesthetic and adrenaline which is called tumescent inserted into the area which fat is removed and then fat is suctioned out. In the next step, the fat is processed and washed with a double antibiotic solution. Prepared fat is injected into the labia major by using a special cannula.
It needs to be considered that after the procedure there might be some bruising, swelling, pain and loss of sensation in the treated area. Sensations in the area return once nerves start to regenerate feeling, swelling may last up to several months and pain is treated by prescribed medications. The process and duration for recovery may vary from person to person. The results of the procedure can be seen after several weeks.
Labia-Vaginoplasty is categorised as a constructive or cosmetic procedure for the vaginal canal and its mucous membrane. The term Labia-Vaginoplasty is generally used to describe cosmetic reconstructive and corrective vaginal surgery, and another term, neo-vaginoplasty, is used to specifically describe the procedures of either partial or total construction or reconstruction of the vagina, and commonly the entirety of the vulvo-vaginal complex.
Vaginoplasty is a procedure which involves the tightening of the loose muscles and tissues which are in the front or back of the vaginal walls, it is specifically done at the entry point to the vagina. Sometimes it is required to remove surfeit vaginal skin in order to decrease the diameter of the vagina. This procedure results in a smaller and tighter vaginal canal. The tightening of the vaginal walls can result in more satisfaction during intercourse due to higher friction.
There are three different types of Labia-Vaginoplasty surgery:
This is commonly known as vaginal rejuvenation. This procedure partially excises and tightens the muco-cutaneous tissue of the labia and lower vagina. This is done most commonly to combat vaginal loosening due to childbirth or ageing, but can be performed to increased sexual satisfaction or emotional confidence.
Is performed when the vagina is damaged or lost due to:
- Acquired causes: trauma, childbirth, cancer or radiation.
- Congenital diseases: Vaginal hypoplasia.
This procedure reconstructs that vaginal canal to preserve fertility and sexual function.
Constructive Labia-Vaginoplasty (Neo-vaginoplasty):
Is the construction of a vagina where one did not previously exist. This procedure is performed on gender reassignment patients, or females that were born without a vaginal canal.
Mons pubis, also called the pubic mound, is the fatty tissue located over the pubic bone. The mons pubis is contiguous with the vulva and at the bottom is divided into the labia majora. The skin in this area is covered with hair follicles and underneath the skin is mostly fatty tissue; within the fatty tissue there are a number of nerves and blood vessels.
Pregnancy, weight gain, and the natural ageing process can cause the mons pubic to become lax, prompting women to seek treatment to overcome this condition; women may become self-conscious of their appearance due to the prominence of a lax mons pubis.
In addition, there are other symptoms such as:
- A dragging sensation
- Feeling of a bulge
- Impression of carrying a weight particularly when moving around
- Irritation when wearing tight clothes
- Increased sweating
There are different treatments for this problem. There can be a little doubt the most effective way to reduce the size of the mons pubis in overweight women, is by sensible weight loss. However, this cannot be effective for all women and they need to consider other options such as liposuction or surgical reduction to achieve the desired result.
In some cases, the problem is that the skin in that area hangs down loosely and is excessive without the presence over abundant fat tissue. This problem is mostly caused by age-related thinning and stretching of the skin with loss of subcutaneous connective tissue. In rare cases these feature result from massive weight loss where fat deposits have been eliminated but the stretched skin remains.
Elevation of the mons pubis is a surgical treatment which helps to lift the mons pubis. The operation may be carried out under a general anaesthetic or regional block. However, local anaesthesia is always applied to the wound. The length and nature of the incision is determined by the size and shape of the mons pubis. The wound is typically elliptical so that the final wound, when closed, is transverse. During the surgery, a wedge of the fat layer is excised taking care with hemeostasis. The amount of fat removed must be judicious in order to achieve the desired outcome. Surgery is covered by intravenous antibiotics given during and an oral course of antibiotics to be taken for up to 7 days after surgery. Most of the activities including driving or returning to work could be started after two weeks. Although more than 90% of healing has taken place by 6 weeks, it will take an extra 6-10week period for the skin wound to completely heal.
Another treatment which is used to reduce mons pubis is liposuction. In this method liposuction is applied to flatten and reduce a bulging pubic area by removing excessive fat in that area. Liposuction of the mons pubis is a relatively straightforward procedure that can produce some dramatic results. The only requirement is that the skin should have good elasticity, because liposuction of the mons pubis can make loose skin even looser once the fat is removed. If the pubic area was big enough to stretch out the skin, the skin will droop, and liposuction won’t be enough. This procedure may be performed alone or in conjunction with elevation of the mons pubis.