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Objectives: The role of the labia majora in female genital comfort is often underestimated. However, they help protect the pelvic floor, maintain warmth and moisture of the mucousal side, and play a secondary erogenous role.

Introduction: NA

Materials / method: NA

Results: They can be enlarged unilaterally or bilaterally by poorly defined most often benign tumors of fatty origin, which generally require direct excision with a skin resection with an internal, medial, or external scar.
They can significantly involute either with age or during extreme weight loss, which is treated with hyaluronic acid injections adapted to this region or lipofilling whenever donor areas are available.

Conclusion: This possibility should be discussed with the patient, particularly when requesting labiaplasty, as these different options are often overlooked.

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Objectives: Demonstration of the use of PDO threads and biostimulators polylactic acid ( PLLA ) and calcium hydroxyapatite ( CaHA ) in vulvar beautification.

Introduction: Vulvar flaccidity is a frequent complaint during aging, with limited treatment protocols described in the literature. While hyaluronic acid is often used for volume restoration, it may be contraindicated in excessively flaccid tissues. This presentation proposes a structured approach using collagen biostimulators (CaHA, PLLA) and PDO threads as effective and safer alternatives in selected cases.

Materials / method: A retrospective clinical observation was conducted using three biostimulatory approaches for labia majora flaccidity: PDO threads (10 per side), CaHA diluted 1:3 with saline/carboxymethylcellulose, and PLLA diluted at 7.5 mg/mL. Techniques included subdermal fan retroinjection and layering, depending on anatomical needs. Product selection was based on degree of flaccidity, volume loss, and anatomical site.

Results: PDO threads led to improved coaptation and shortening of the labia majora, with better contour and skin retraction. PLLA showed significant improvement in skin quality and structure, especially in full genital treatments. CaHA promoted initial volumization with minimal increase in laxity. All treatments demonstrated high patient satisfaction and visible improvements at 60 days.

Conclusion: Collagen biostimulators and PDO threads offer a reproducible and safe strategy to manage vulvar flaccidity. Product choice must be tailored: PDO for bulky labia, CaHA for mild volume loss, and PLLA for overall skin quality. When properly selected and applied, these techniques achieve natural results without overcorrection or adverse effects.

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