Vulvar and vaginal laxity
It is a generic term indicating that the structures lack their original firmness, the surface tissues are lax, and the musculature contracts poorly. Results are achieved through a holistic approach, including pelvic floor rehabilitation and local treatments that can be non-invasive, minimally invasive, or invasive depending on the case.
Non-invasive treatments
Indication
Pelvic floor rehabilitation
Procedure
60 minutes
Complications
no
Postoperative Pain
no
Recovery
immediate
Non-invasive treatments
Indication
CO2 Laser, Radiofrequency
Procedure
20 minutes
Pain
no
Complications
no
Recovery
immediate
Femifill® for vulvar laxity + CO2 laser
Indication
Vulvar laxity
Surgical Treatment
Adipose tissue harvesting, appropriate treatment of the same, multi-layer implantation of various adipose preparations + CO2 laser for vulvar.
Procedure
60/90 minutes
Postoperative Pain
Low, especially when using common pain relievers
Complications
Rare (infections, hematomas)
Recovery
2/4 weeks
Femifill® for vulvar and vaginal laxity + CO2 endovaginal and vulvar laser
Indication
Vulvar and vaginal laxity
Surgical Technique
Harvesting of adipose tissue, appropriate treatment of the same, multi-layer implantation of various adipose preparations + CO2 laser for both vulvar and endovaginal applications.
Procedure
60 /90 minutes
Pain
Low, especially when using common pain relievers
Complications
Rare (infections, hematomas)
Recovery
2/4 weeks
Vulvoperineoplasty + Femifill® for vulvar and perineal areas + CO2 laser for vulvar and endovaginal applications
Indication
Severe vulvar and perineal laxity
Surgical Treatment
Harvesting of adipose tissue, appropriate treatment of the same, multi-layer implantation of various adipose preparations + CO2 laser for both vulvar and endovaginal applications.
Procedure
60/90 minutes
Pain
Low, especially when using common pain relievers
Complications
Rare (infections, hematomas)
Recovery
2/4 weeks
Vulvovaginoperineoplasty + Femifill® for vulvar and perineal areas + CO2 laser for vulvar and endovaginal applications
Indication
Severe vulvar and vaginal laxity
Surgical Technique
Harvesting of adipose tissue, appropriate treatment of the same, multi-layer implantation of various adipose preparations + CO2 laser for both vulvar and endovaginal applications
Procedure
60 /90 minutes
Pain
Low, especially when using common pain relievers
Complications
Rare (infections, hematomas)
Recovery
2/4 weeks
Sollevamento del pube
Indicazione
pube molle
Tecnica chirurgica
puboplastica +/- addominoplastica Laser assistita
Procedura
60/180 min , sedazione o anestesia generale, day hospital o ricovero
Complicanze
rare (infezioni, ritardi di guarigione)
Dolore post operatorio
scarso se si utilizzano farmaci antidolorifici comuni
Recupero
4 settimane
The term genital laxity, vaginal or vulvar, is an extremely generic and sometimes inappropriate term that refers to particularly lax vaginal walls and vulvar structures. Laxity can be superficial, often involving deep structures such as ligaments and the muscular system. The treatment of vaginal laxity starts with accurate diagnosis, which must definitively identify the causes of relaxation. In many cases, simply resorting to pelvic floor rehabilitation can bring significant benefits, while in others, CO2 laser has proven effective in improving the trophism of the mucosa and the immediately underlying layers. Radiofrequency is also proving useful, and promising results are seen with focused ultrasound.
In cases of moderate fascial and tissue laxity, the implantation of autologous adipose tissue proves extraordinarily useful in reducing the vulvar and vaginal gaping space, increasing the volume of the walls, and simultaneously inducing regeneration processes in the fascia and mucosa. In cases of more significant laxity, vulvoperineoplasty is performed, involving the removal of a section of perineal and vulvar skin, often including a portion of vaginal mucosa. The fascia is then sutured, and/or the perineal muscle structures are brought closer together. The traction exerted on the ligaments and perineum leads to an approximation of the vulvar walls. To reduce the sometimes negative impact of excessive traction on the pillars, we have developed a procedure that combines suture synthesis with adipose tissue implantation. This technique helps lessen the severity of traction applied by the suture. Adipose tissue implantation, in fact, reduces the vulvovaginal caliber.

Procedures
Correction depends on the degrees of laxity and the damaged structures involved. The procedures aimed at correcting this issue are as follows, starting from the simplest and least traumatic to the most effective but more demanding:
Appropriate hormonal therapy: Taking a correct dose of estrogen-progestin and applying hormone-based ointments helps increase the trophism of the vaginal mucosa and enhances the turgor of the vulva. Unfortunately, not all women can undergo hormonal therapy, either for oncological reasons or due to a reluctance to undergo daily treatment.
Hyaluronic acid implant: The implantation of hyaluronic acid beneath the mucosa increases wall hydration, resulting in increased turgor.
Laser treatments: Laser proves useful in increasing the trophism of the vaginal mucosa and vulvar skin. CO2 and erbium lasers (each with its own characteristics and differences) are also useful for increasing the thickness of the adventitious layer, a fine but important structure just below the skin.
Radiofrequency and focused ultrasound: These are innovative methods aiming to stimulate and strengthen tissues just below the mucosa and skin by heating the tissues. Although these methods show promise, more studies are needed to verify their real effectiveness and the duration of the result.
Lipofilling (adipose tissue transplant): Adipose tissue can be implanted into vulvar and vaginal walls to increase thickness and provide regenerative factors to improve the trophism of mucous membranes and skin. Adipose tissue is injected using a multilayer method, beneath the skin and mucosa, into the partially intramuscular subcutaneous tissue and the lateral part of the vulva called the “fossa ischiatica.” The result is often brilliant and avoids the need for traditional vulvoperineoplasty.
Vulvoperineoplasty: Involves the removal of a section of skin and mucosa and the approximation of underlying tissues. If necessary, muscle pillar synthesis or union of the two ends of the transverse muscle that separates during childbirth may be performed. The fundamental role of pelvic floor rehabilitation should also be emphasized (see relevant section).

Labioplastica secondaria: risultati da correggere
Pre and Post







