Some women complain of the opposite when it comes to their labia. In this subset of patients (usually post-menopausal from normal hormonal changes), they complain of atrophy and loss of bulk of the labia majora and sometimes mons pubis. This can also happen in massive weight loss patients. This can result in excess loose, wrinkled appearing skin or imbalance between the labia majora and minor with the appearance of enlarged labia minora. There is also a functional component to this problem as women become uncomfortable with activities that have friction in this region (riding motorcycles, horses, or sexual intercourse, for example) because of the lack of padding the labia majora and mons pubis provide. In these patients, a volume enhancement is often needed.
Volume enhancement can be done under local anesthesia or under general in combination with other procedures. Volume enhancement can be done with an array of dermal fillers (most often hyaluronic acids) with a temporary effect. A more permanent alternative is fat grafting, a procedure that involves transferring your own fat harvested through liposuction from unwanted areas and transferring it with small needles to your labia majora and/or mons pubis.
What to Expect: Labia Majora Volume Enhancement
Labiaplasty can be done under local anesthetic in the office as a minor procedure, or it can be done under general anesthesia at a hospital or surgical center, often in combination with other procedures. In patients that may need a larger amount of fat harvested for fat grafting, a general anesthetic may be advised.
The procedure using dermal fillers takes 30-60 minutes. You will be placed in disposable undergarments with padding to collect any drainage. You are restricted from heavy lifting or strenuous activities for 1-2 weeks. You are kept on pelvic rest during those 2 weeks. You can return to activities as tolerated thereafter.
The procedure using fat grafting takes 60-90minutes as it involves harvesting fat from liposuction in unwanted areas (lower abdomen, thighs). If only a small volume is needed, local anesthetic can be used, however, most patients require more fat, especially in the mons pubis region, and general anesthesia is usually necessary. A compression garment is placed. Patients can go home the same day. You are restricted from heavy lifting and strenuous activity for 2 weeks. Pelvic rest is in place for 2 weeks. You can return to work when you are no longer taking oral pain medication. Depending on degree of liposuction, a compression garment post-operatively may be advised.