Labia minora that protrude past the labia majora are aesthetically unsatisfactory to some women. Patient preference is for minimally invasive procedures with little or no downtime and minimal scarring. Fat grafts and crosslinked hyaluronic acid have been used to treat the labia majora and mons pubis for aesthetic improvement of the external female genitalia. Here, the author describes a simple and effective technique for addressing hypotrophic labia majora by injecting diluted Calcium Hydroxylapatite (CaHA).

A 22-year-old post-labiaplasty patient with a protruding clitoral hood was treated with 6 ml diluted CaHA in two treatment sessions with a time interval of 6 weeks using non-traumatic cannulas. At 3 months a significant improvement in the appearance of the external genitalia was observed. No serious side effects were noted and results lasted beyond 12 months.

The rationale for using CaHA is twofold: CaHA-induced neocollagenesis improves skin laxity and the product's volumizing capacity corrects volume deficiency. Knowledge of local anatomy is crucial to avoid complications.

The use of CaHA can be a valuable, well-tolerated and long-lasting addition to available treatments for the aesthetic improvement of the female genitalia. Further studies are necessary to evaluate long-term safety and efficacy in larger cohorts.