Lipofilling for volume augmentation of the labia majora

The labia majora of the vulva correspond to a fold of skin whose composition is the same as on the rest of the body:
the epidermis rests on a connective tissue, the dermis. The dermis will age over the years, as fibroblasts function less well: the drop in hyaluronic acid will lead to a loss of volume, while the drop in collagen will create a vulval slackening.

This can lead to atrophied and sometimes gaping vulvar labia, resulting in both functional (slight increase in the risk of cystitis infection) and aesthetic problems.

To correct lips that are too small, whether constitutive (malformation) or acquired (aging, particularly after menopause), Dr Christelle Santini can offer lipofilling by injecting fat taken from another part of the body.

The fat injected by lipofilling the labia majora will have a dual effect:

• a definitive, volumizing effect: once the fat cells have been attached, they cannot be resorbed (about ¼ of the graft is resorbed in the weeks following lipofilling, which is normal);
• a trophic effect by supplying stem cells from the stromal fraction of adipose tissue, which will rejuvenate the 2-in-1 vulva.

This cosmetic procedure is not covered by social security.

Dr Christelle Santini always performs an intimate examination beforehand, to check indications and contraindications.

This examination must take place at least 15 days before the operation.

A consultation with the anaesthetist is also mandatory if the procedure is to be performed under general anaesthesia or neuroleptanalgesia: it must take place no later than 48 hours before the surgical procedure, to enable the anaesthetist to carry out additional tests if necessary.

All medications containing aspirin should be avoided for 10 days prior to surgery.

It is strongly recommended to stop smoking at least 1 month before and 1 month after the operation to facilitate healing and graft take.

For lipofilling of the labia majora, it is possible to use either a local anesthetic, which allows the patient to be awake but relaxed and insensitive to pain thanks to the combination of an analgesic and a neuroleptic; or a general anesthetic under which you are completely asleep.

This procedure is usually performed on an outpatient basis, with same-day discharge subject to the surgeon's approval.

The fat is first removed by liposuction using a micro cannula or needle (gentle liposuction), depending on volumes, in a discreet area of the body with excess fat cells.

Following this, the fat is centrifuged (Coleman technique) for a few minutes to collect the intact fat cells that can be grafted, and to remove any blood or cellular debris.

Next, Dr. Christelle Santini will inject micro-particles of fat in a scattered fashion (in multiple, diverging directions), amplifying the contact surface between the implanted cells and the recipient tissue, thus ensuring the survival of the grafted fat cells.

The lipofilling technique is therefore definitive, with only the volume of fat cells decreasing in the event of marked weight loss.

Allow an average of 1 hour for lipofilling of the labia majora.

Following this surgical procedure, edema (swelling of the vulvar tissues) often appears, which will disappear completely after 10-15 days, and ecchymosis (bruising) for around ten days.

The result is immediate, but deceptive, as fat cells are resorbed and edema increases the volume of the labia majora.

The final result will actually be obtained 3 months after the operation, with a larger vulva and more toned labia majora.

Injected fat can be resorbed by up to 30%, so a second operation is sometimes necessary to perfect the result, although Dr Santini always takes this resorption into account in his surgical procedure.

• Natural, foreign-body-free results.
• No visible scars.
• Volumizing and slightly trophic effect to rejuvenate the labia majora.
• Need for a fat reserve.

What to do before lipofilling?

• 1 preliminary consultation with Dr. Santini in Paris and quotation.
• Medical photographs may be taken with the patient's consent.
• A 15-day cooling-off period is mandatory.
• Consultation with anaesthetist, blood test.
• Stop smoking at least 1 month before, and stop taking aspirin or anti-inflammatory drugs 10 days before lipofilling.

How does lipofilling work?

• Intimate lipofilling is performed under local anesthesia, neuroleptanalgesia or general anesthesia.
• Liposuction of donor areas and purification of fat to be re-injected.
• 1 to 1.5 hours for lipofilling of the labia majora.
• Most patients return home the same day.

What is the post-operative course of lipofilling?

• No points to remove.
• Follow-up consultation with Dr Santini 7 days to 10 days after genital lipofilling.
• 3 weeks off sport.
• Allow 5 to 10 days off.
• Final result of lipofilling after 3 months.