๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Case 81-1
Case 81-1
Labiaplasty extended wedge technique: A 24-year-old female with labia minora hypertrophy presents for labiaplasty. Physical examination shows excess labia minora protrusion beyond the labia majora in the standing position. Lithotomy view reveals hyperpigmentation of the labia minora, thickening of the leading edge of the minora and mild asymmetry. Before and after pictures at 4 months postop are shown.
Labiaplasty extended wedge technique: A 46-year-old female presents with labia minora hypertrophy for labiaplasty. Physical examination shows asymmetrical protrusion of the mid labia minora beyond the majora in the standing position. Lithotomy position shows pigment along the distal edge of the minora, a bilateral double fold and asymmetry of the minora. Before and after pictures at 4 months are shown.
Fillers may be used in lieu of fat for volume enhancement of the labia majora. The advantage of fillers is that they are readily available and may be used in patients with minimal fatty donor sites. As of now, only one product, a highly cross-linked hyaluronic acid mixed with mannitol, has been developed specifically for vulvar use (Desirial Plus, Laboratoires Vivacy, Archamps, France). This product currently has CE approval in Europe for volume enhancement and the treatment of vulvovaginal atrophy.
The technique for injection of hyaluronic acid requires the patient to be marked in the standing position and then injected in the lithotomy position. Local anaesthesia is injected in small wheals for cannula access as with fat injection. Additional local anaesthesia should be injected along the path of the filler placement to reduce discomfort with filler injections. The depth of infiltration is into the deep dermis and subcutaneous fat. Optimal filler volumes are less than those with fat, as the hyaluronic acid will hydrate with time, though at least two to four syringes of product are required in cases of moderate fat atrophy.