High Tech for Function
Radiofrequency, CO2 laser, carboxytherapy, hyaluronic acid are low-impact high-tech solutions to improve vulvar aesthetics
Indication
Vulvo-vaginal atrophy due to reduced production of collagen and elastin, urinary incontinence
Technique
Use of the specific endovaginal and vulvar handle to treat different areas, delivering the appropriate fractionated dose of energy.
Procedure
Procedure and number of sessions: 20 minutes per session, for 3-4 sessions spaced one month apar
Postoperative Pain
no
Complications
no issues
Radiofrequency
Indication
Vulvo-vaginal atrophy and laxity due to reduced production of collagen and elastin
Technique
Use of a specific endovaginal and vulvar handle with gentle, relaxing rotational movements for the patient
Procedure duration and number of sessions
20 minutes per session, for 4-6 sessions spaced 15-21 days apart
Postoperative Pain
no
Complications
no issues
Carboxytherapy
Indication
Cutaneous-mucosal atrophy due to reduced tissue vascularization
Technique
Subcutaneous infiltration of CO2 in 2-3 points along the labia majora using a very fine needle
Procedure duration and number of sessions
10 minutes per session, for 6-8 sessions spaced one week apart
Postoperative Pain
no
Complications
No issues
Endovaginal CO2 laser
Indication
Incontinence/Dryness/Laxity.
Technique
Endovaginal CO2 laser
Procedure
20 minutes
Postoperative Pain
no
Complications
Extremely rare
Recovery
immediate
Carboxytherapy involves subcutaneous administration, using very fine needles (30 G), of medical carbon dioxide. For this purpose, a device certified by the Ministry of Health is employed; the infusion system and needles are disposable, and the medical gas is sterile. It does not require anesthesia and is minimally invasive. The treatment is safe, presenting no toxicity (CO₂ is normally produced during respiration, and the gas used is that which is employed in surgical procedures performed laparoscopically). Bruising at the injection site is extremely rare and disappears within a few days. In the areas where the gas is infused, a sensation of crepitus beneath the skin (the “fresh snow” effect) may be felt with the fingers, disappearing after the initial minutes of treatment. When using certified equipment, there is absolutely no risk of embolism, even if, accidentally, CO2 is cannulated and injected directly into a blood vessel. CO₂ is naturally and rapidly eliminated at the end of the treatment.
Application in the vulvar area: indications
• Vulvar Cutaneous Atrophy (aged appearance of the labia majora)
• Vulvo-vaginal Mucosal Atrophy (dryness, itching, vulvo-vaginal discomfort)

Treatment
The treatment lasts a few minutes, is well-tolerated, involves the infiltration of a small amount of gas through an extremely fine needle at only two points in the labia majora, followed by gentle massage. The treatment protocol involves one session every 1-2 weeks for 4-5 times.
Side effects
The appearance of small bruises (livid spots) in the injection area is possible, with spontaneous resolution.
Contraindications to the treatment
Carboxytherapy is generally not used, not only in the vulvar area but also in exceptional cases, in the presence of: Severe respiratory insufficiency, Severe renal insufficiency, Severe heart failure, Treatment with acetazolamide, dichlorphenamide, or other carbonic anhydrase inhibitors, Severe anemia, Severe hepatic insufficiency, Severe arterial hypertension, Previous cerebral stroke, Cardiac tachyarrhythmias, Arterial thrombosis, Thrombophlebitis, Phlebothrombosis, Embolism, Gas gangrene, Pregnancy.

Radiofrequency for aesthetic and functional rejuvenation of the female genital area
The technique is based on dynamic quadripolar radiofrequency. Its goal is to address various gynecological issues, both aesthetic and functional, by stimulating a regenerative response in the tissues where needed.
How it works: When dynamic quadripolar radiofrequency reaches the tissues, the selective heating it produces induces a series of beneficial reactions:
- Improves microcirculation in the tissues.
- Increases hydration of the delicate mucosa, reducing vulvovaginal atrophy common in almost all menopausal women, which is responsible for dryness, burning, itching, and dyspareunia (pain during intercourse).
- Stimulates the natural production of collagen, a fundamental substance that regulates the amount of water in the skin, restoring elasticity and firmness to the vulvar area and vaginal canal.
- Reduces vulvar and vestibular pain, improving quality of life.
- Counters mild stress urinary incontinence.
- Improves tissue trophism, i.e., local oxygenation and nourishment, with positive repercussions both aesthetically and functionally in the treated area.
- Provides a lifting effect, making the tissues firmer and more elastic, giving a younger appearance to the vulvar area and a sensation of increased tone at the introital level.
A typical session
Before starting a treatment cycle, a thorough gynecological examination is necessary, also aimed at excluding that gynecological issues have a “pathological” origin (such as acute vaginitis or cystitis). Once specific causes that require pharmacological treatment or other suitable therapies are ruled out, the doctor establishes the protocol. The session involves:
- Vulvar application: A thin layer of gel is applied, and a handle is gently passed with rotating movements over the entire area of the labia majora for only 10 minutes.
- Vaginal application: The introduction of an ergonomic handle made of biocompatible material into the vagina, which conveys electromagnetic waves. This part lasts no more than 20 minutes.
In some cases, both treatments may not be necessary, depending on the specific situation and treatment indication. The dynamic quadripolar radiofrequency treatment is very pleasant, with a sensation of mild warmth that never becomes excessive, as the equipment is equipped with a temperature detector and motion sensor.
After treatment
The treatment has no side effects and leaves no lingering effects of any kind. In fact, the protocol does not involve any recovery time. After the treatment, it is possible to resume all normal daily activities and immediately return to one’s sexual life. The treated tissue is entirely unharmed and does not show any signs of trauma.
Fractional CO2 in female genital rejuvenation: background
Normal biological processes such as childbirth, hormonal imbalances associated with aging, and weight variations can cause damage to tissue collagen, altering the tone and thickness of the mucosa in the vaginal wall and weakening the muscles of the pelvic floor, which, among their functions, also provide support to pelvic organs. These anatomical changes often lead to symptoms that negatively impact the quality of women’s lives, hindering them from leading a normal life.

Indications for CO2 Laser treatment
Vaginal Dryness and Infections: These are common issues in the pre and post-menopausal periods and are often linked to tissue hypotrophy or atrophy, such as the vaginal mucosa and the introitus of the vagina. The latter is the area where painful symptoms, even during sexual activity, often manifest. CO2 laser treatment stimulates the vaginal mucosa, improving lubrication and normalizing pH, thereby reducing the discomfort associated with symptoms typical of Genitourinary Syndrome of Menopause (GSM), such as burning, dryness, itching, and pain. The somewhat repaired mucosa in its functions and appearance is less prone to recurrent infections and microabrasions, typical of atrophic mucosa.
Stress Urinary Incontinence (SUI): SUI is a form of urinary incontinence where the involuntary loss of urine occurs due to intra-abdominal pressure. It is a common symptom in women who have had multiple vaginal childbirths, as normal bladder functions are controlled by the bladder itself, sphincters, and pelvic floor muscles. Aging leads to hypotrophy and weakening of tissues, including the mucosa and pelvic floor muscles. When associated with natural childbirth, this can result in involuntary urine leakage during activities such as sneezing, coughing, or lifting weights. CO2 laser treatment generates pinpoint microablation with a good thermal effect that stimulates the formation of new collagen and contracts elastic fibers. This leads to a slight increase in the thickness of the vaginal walls, providing new support for the urethra adjacent to the anterior vaginal wall. The result is a more or less stable reduction in symptoms of mild SUI over time.
Vaginal Tightening: This is a condition where the vagina and pelvic structures may have lost their tone and resilience, causing dissatisfaction during sexual intercourse. CO2 laser treatment, by directly acting on the mucosa of the vaginal walls, improves tissue sensitivity and strengthens the walls through collagen regeneration. The result is an improvement in sexual satisfaction.

How a session of vaginal CO2 laser is conducted
The treatment is outpatient and lasts a few minutes, very well tolerated by patients. The laser energy is generated through a holographic lens that creates 81 microchannels in a 9×9 grid. These columns penetrate deeply into the submucosa, keeping the surrounding tissue intact and allowing for faster healing. The treatment is performed using a disposable probe inserted into the vagina that rotates 360°, covering the entire vaginal wall and ensuring safety and hygiene. Two weeks after the treatment, the micro-ablative process stimulates the formation of new collagen, completely regenerating the vaginal wall. It is advisable to abstain from sexual activity for about a week, but other normal daily activities can be resumed immediately.