Abstract

Objectives: OBJECTIVES: We recently did publish the article "PDO threads, calcium hydroxyapatite, and l-polylactic acid for vulvar flaccidity - indications, technique and results", in the indexed scientific journal Surgical and Cosmetic Dermatology. (https://doi.org/10.5935/scd1984-8773.2023150192) Our objective is to share with medical colleagues the excellent results we have obtained with the use of collagen biostimulators in female genital aesthetics. Introduction: INTRODUCTION: Aging brings loss of fat and collagen from the labia majora (LM), making them flaccid. Although volumetric loss is intrinsically associated with such looseness, as it is a pending area, filling with hyaluronic acid (HA) can increasing the fall of the tissues already hanging. We have been treating LM laxity with excessive skin sagging through the application of injectable collagen biostimulators (BT). We did use pdo threads (PDO), calcium hydroxyapatite (CaHA) and l-polylactic acid (PLLA) and we have achieved excellent results. Materials / method: MATERIALS/METHOD Since 2019, 20 women, between 30 and 60 years were treated. Only flaccid and pending L.M were addressed, as shown below: - Bulky LM, which should not receive any additional volume, were treated with PDO; - LM who needed minimal initial volumization were treated with CaHA; - when it was desired to treat the entire genital area, involving LM and pubic mound, PLLA was chosen. The three products were inserted into the subcutaneous tissue. Results: METHOD The three products were inserted into the subcutaneous tissue. CaHA and PLLA injections were performed in a fan technique, by retroinjection, with cannula 22G, 5cm. 01 syringe of 1.5ml of gel with 30% CaHA was diluted in 6ml saline, and 3,0ml was injected into the subcutaneous tissue of each LM. 01 vial with 150mg of PLLA was diluted in 16ml of distilled water and 4ml of lidocaine, with 5ml of the solution being injected into each LM and 10ml in pubic mound. 5 PDO screw threads (29G 52mm) were injected in the upper 1/3 and 5 monofilament PDO (30G 50mm) in the lower 2/3 of each LM. Conclusion: RESULTS Although all patients were satisfied, we observed a higher degree of satisfaction among CaHA group, probably due to its immediate volumizing effect. There was no one complication with PLLA. We have one infection solved with oral antibiotic and 1 PDO extrusion with threads and just one small palpable non visible nodule with CaHA. CONCLUSION The application of BT, especially CaHA, can be an excellent method for the treatment of vulvar sagging. Patient expectations need to be adequate, since BT induce collagen production in such a way that results become noticable not before one month.