Objectives: To describe the different nonsurgical EBD treatments as well as biologic (PRP) treatments for vaginal rejuvenation. Also to describe when surgical labiaplasty, external vaginoplasty and clitoropexy is indicated over nonsurgical treatments. To explain the risk, benefits and aesthetic vs functional improvment that can be expected with each type of treatment and when they are indicated. Combination treatments are also discussed in reference to the synergy between them and benefits of each. Introduction: Sexual wellness, hormones, peptides, and improvement of the cosmetic appearance of the genitals are large parts of the author's aesthetic practice. The author has a large plastic surgery practice with multiple associated medical spas in Austin, Texas. Within the practice, one of the most popular treatments for women is labiaplasty with adjuvant treatments. Materials / method: Labiaplasty, perineoplasty and vaginoplasty are often combined with other associated procedures can be combined with this such as the addition of platelet-righ plasma (PRP) and device technology that can improve appearance and sexual function. Female injectables to the genitals are also a large part of the practice and will also be discussed. Results: Within the female sexual wellness arena, the author will present various methods of female enhancement such as "The O-shot" (PRP for the labia and periclitoral/ periurethral area), and various other injectables for the labial area such as hyaluronic acid, Sculptra, hyperdilute Radiesse, and autologous fat transfer (often can be done with radiofrequency microneedling, or noninvasive vaginal laser for tightening and atrophy). Conclusion: Surgical labiaplasty can be peformed with a wide variety of coadjuvant treatments. If surgical treatment is not indicated, then energy-based device technology can be used to enhance sexual satisfaction, tightening internally, SUI, and lubrication. The author shows the gamut of sexual wellness noninvasive treatments offered as well as straightforward and complicated revisional cases of labiaplasty and vaginoplasty.

Disclosures - Jennifer L WALDEN

> Did you receive any funding to support your research for this TOPIC?
No

> Were you provided with any honoraria, payment, or other compensation for your work on this study?
No

> Do you have any financial relationship with any entity which may closely compete with the medications, materials, or instruments covered by your study?
No

> Do you own or have you applied for any patents in conjunction with the instruments, medications, or materials discussed in your study?
No

This work was not supported by any direct or indirect funding. It is under the author's own responsibility