Labia Majoraplasty: Deep Contouring with a Multivector Modification.

backgroundProcedures addressing the external genitalia, particularly labia minora, have become increasingly popular in aesthetic surgery. However, the labia majora is often overlooked despite its essential contribution to the overall genital harmony.

methodsThis study presents a multivector modification technique for labia majoraplasty aimed at restoring a youthful, smooth contour. Twenty-four patients presenting with sagging, wrinkling, and loss of adipose volume in the labia majora were included. A longitudinal incision along the interlabial sulcus and a transverse incision along the anogenital junction were combined. Deep tissue plication with delayed-absorbable sutures was performed for contouring before skin trimming and layered closure.

resultsPatient age ranged from 39 to 58 years, and 12 patients (50%) were active smokers. The median operative time was 55 minutes. No intraoperative or postoperative complications were observed during the follow-up period. Mild postoperative edema resolved spontaneously within 4 weeks. At follow-up, patients reported subjective improvement in aesthetic appearance and functional comfort, while preserved sensation and well-concealed scars were noted clinically.

conclusionsThe described multivector labia majoraplasty technique appears to be a feasible approach for addressing labia majora ptosis and contour deformity by combining multidirectional skin excision with deep tissue support. Early outcomes in this preliminary case series were encouraging; however, larger comparative studies with validated outcome measures and longer follow-up are required to confirm long-term efficacy and durability. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.