Abstract

Objectives: Complexe repairs of the female genital area Introduction: Vulvovaginal pathologies are common but often overlooked. Changes in fashion, increased participation in intensive sports, and the evolving aesthetic standard of a fully shaved, exposed vulva have led to a rise in requests for vulva and labial enhancements. Many patients are young women, as well as women post-pregnancy or post-menopause, who are concerned with changes in the shape, texture, or pigmentation of their external genitalia. The most frequent complaints include asymmetry, excess volume or length, ptosis, dryness, painful scars, and loss of sensation during intercourse. Addressing bot Materials / method: Several techniques are available to enhance the aesthetic and functional aspects of the labia and vulvovaginal region. Excessive labia minora volume, labia majora atrophy, and abnormal labial shapes are treated through longitudinal resections, with V or W plasties used in certain cases. The inverted VY plasty technique is particularly effective for treating labia minora ptosis, reducing the amount of tissue resection while enhancing the clitoral hood. Vaginal tightening, achieved through posterior colpomyorrhaphy combined with intravaginal lipofilling, improves vaginal tone and contractility 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.