title: Labia Majora Augmentation with Hyaluronic Acid Filler: Technique and Results.
abstract: BACKGROUND
  External female genitalia lose elasticity and volume with age. In the literature several techniques address the redundancy of the labia minora, but only few reports describe the augmentation of labia majora with fat grafting. At present, no studies describe the augmentation of the labia majora with hyaluronic acid.
  
  
  OBJECTIVE
  This study aims to present our technique of infiltration of hyaluronic acid filler, analyzing effectiveness, patient satisfaction, and complications.
  
  
  METHODS
  We retrospectively analyzed 54 patients affected by hypotrophy of the labia majora; they were treated with hyaluronic acid filler between November 2010 and December 2014. The Global Aesthetic Improvement Scale (GAIS) filled out by the doctor and the patients was used to evaluate the results 12 months after the infiltration. Complications were recorded.
  
  
  RESULTS
  A total of 31 patients affected by mild to moderate labia majora hypotrophy were treated with 19 mg/mL HA filler; 23 patients affected by severe labia majora hypotrophy were treated with 21 mg/mL HA filler. Among the first group of patients, one underwent a second infiltration 6 months later with 19 mg/mL HA filler (maximum 1 mL). A significant improvement (P < .0001) in GAIS score was observed, both in the scores provided by the patients and by the doctor. A greater relative improvement was observed in patients affected by severe hypotrophy. No complications were recorded.
  
  
  CONCLUSIONS
  Hyaluronic acid infiltration of the labia majora is able to provide a significant rejuvenation with a simple outpatient procedure. We achieved significant improvements with one infiltration in all cases. The treatment is repeatable, has virtually no complications and it is reversible.
  
  
  METHODS
  4 Therapeutic.
authors.affiliation: Dr Fasola is a microsurgeon in private practice in Milan, Italy. Dr Gazzola is a Resident, Department of Plastic Surgery, Università degli Studi di Milano, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Fasola
authors.affiliation: Dr Fasola is a microsurgeon in private practice in Milan, Italy. Dr Gazzola is a Resident, Department of Plastic Surgery, Università degli Studi di Milano, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gazzola
mesh_terms: D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques / Q000009:adverse effects; D000067548:Dermal Fillers / Q000008:administration & dosage* / Q000009:adverse effects; D004954:Esthetics; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D007267:Injections; D008875:Middle Aged; D017060:Patient Satisfaction; D012060:Rejuvenation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014844:Vulva / Q000473:pathology*
chemical_list: D000067548:Dermal Fillers; D006820:Hyaluronic Acid