The labia majora become saggy with aging. Although filling with hyaluronic acid provides significant rejuvenation, it can also lead to the formation of true vulvar testicles if poorly indicated, especially in excessively flaccid vulvas, which do not support any further volumization. In these cases of excessive flaccidity, we believe that collagen biostimulators would be the best initial treatment, as their injection would lead to the replacement of dermal collagen and improvement in laxity, without a significant increase in volume. We have been using calcium hydroxyapatite, l-polylactic acid, and PDO threads since 2019, with good results.

Keywords: Vulva; Collagen; Genitalia, Female; Rejuvenation

To simplify the procedure and increase lip augmentation safety, we have developed the KISS - Keep Injection Simple and Safe lip filler technique. To be simple, the method recommends only the evaluation of four anatomical parameters and the filling of five labial areas. To be safe, the injection is performed only in the supramuscular plane, using cannulas with a blunt tip, inserted in four entries: two in the upper lip and two in the lower lip. Fillers are injected in specific anatomical vectors for lips volumization, projection, contour improvement, and support of cupid’s bow and lip corners.

Keywords: Hyaluronic acid; Dermal fillers; Lip

Despite the therapeutic success described by recent studies, the procedure of labia majora augmentation lacked systematization in order to achieve more assertive and reproducible results. To this end, we developed the vulvar anatomical vector technique, in which we mapped five anatomical structures of the vulva where the injection of hyaluronic acid is capable of promoting coaptation, augmentation, reduction of prolapse, and/or improvement of the skin quality of the labia majora. This technique has allowed us to precisely define the sites to be injected and estimate the adequate volume and type of hyaluronic acid to achieve the intended results.

Keywords: Hyaluronic Acid; Vulva; Dermal Fillers; Rejuvenation; Female Genitalia.