Abstract

Objectives: Bringing functional and aesthetic improvement by lipofilling and its combination with surgical treatments for female intimate surgery Introduction: Vulvovaginal pathologies are common but often overlooked. Changes in fashion, increased participation in sports, and the rise of a fully shaved vulva have led to a demand for vulva and labial enhancements. Many patients are young women, or those post-pregnancy or menopause, concerned with changes in the shape, texture, or pigmentation of their genitalia. Common complaints include asymmetry, excess volume, ptosis, dryness, painful scars, and loss of sensation. Addressing both aesthetic and functional issues is essential for satisfactory outcomes. Materials / method: Several techniques enhance the aesthetic and functional aspects of the labia and vulvovaginal region. Excessive labia minora volume, labia majora atrophy, and abnormal shapes are treated with longitudinal resections and V or W plasties. The inverted VY plasty technique is effective for labia minora ptosis. Vaginal tightening through posterior colpomyorrhaphy combined with lipofilling improves vaginal tone. Injections of hyaluronic acid or fat transfer treat atrophy, dryness, and restore fullness. Results: All patients demonstrated aesthetic and psychological improvement following surgery. Notably, the procedures led to enhanced sexual satisfaction and self-esteem. No painful postoperative scars were observed; in fact, there was a marked improvement in episiotomy-related pain, especially when lipofilling was combined with the use of thin absorbable sutures for vulva and labial reshaping. Dissatisfaction among patients was rare and primarily arose from unrealistic expectations regarding labia minora reduction or misconceptions about the ideal vulvar appearance. Conclusion: The shape and volume of the labia minora are psychologically significant, particularly for young women who suffer from asymmetry or volume excess. As women age, especially after multiple pregnancies, many seek vulvovaginal enhancement. A combination of genital lipofilling, labia reshaping, and vaginoplasty can provide significant aesthetic and functional benefits, improving not only physical appearance but also psychological well-being.