Vaginal aesthetics is a general term for surgical and non-surgical procedures on the external genital area. This page covers one non-surgical option, labia majora filler; surgery is the field of gynecologists and plastic surgeons.

The external genital area (vulva) includes the labia majora (outer lips), the labia minora (inner lips), the mons pubis and the vaginal opening. Their shape and size vary widely, and most differences are normal.

With age, weight changes or after childbirth, the tissues here may become thinner, lose volume or sag. Having any procedure is a personal decision, and suitability is assessed after a detailed conversation and examination.

Complaints such as dryness, pain, urinary leakage or recurrent infections are not the subject of aesthetic procedures and should be assessed by a gynecologist. If such a complaint is found at your examination, you will first be referred to the relevant specialist.

Labia majora filler is the injection of filler into the outer labia to help balance volume loss. Two methods may be considered:

• Hyaluronic acid filler: Hyaluronic acid is a water-binding substance found naturally in the body. It is injected into the labia majora under local anesthesia and can be dissolved with an enzyme if needed.
• Fat injection: Fat tissue is taken with fine cannulas from the abdomen, inner thigh or hip, processed and transferred to the labia majora. This is a more extensive procedure.

The use of cells derived from fat tissue in this area is also being researched, but the evidence is limited. In Türkiye, cell- and tissue-based applications are subject to Ministry of Health regulation and may only be performed within the permitted scope, with the required licenses and approvals.

The suitable method is decided at your examination, based on the tissue and your health history. For general information on filler types, see dermal fillers.

Before treatment, your general health, medicines, allergies and gynecological history are reviewed, and a recent gynecological examination may be requested. An active infection in the area is treated first.

1. The area is cleaned with an antiseptic solution and sterile conditions are prepared.
2. An anesthetic cream or local anesthesia is applied.
3. Hyaluronic acid filler is injected into the labia majora in controlled amounts with a fine needle or cannula.
4. Symmetry between the two sides is checked, and the filler is gently massaged into place.

The procedure is carried out by a doctor in a clinical setting in Nişantaşı, Istanbul, with care for your privacy. It is usually short, and most people return to daily life the same day. Fat injection takes longer and needs different preparation; the area where fat was taken may also swell, bruise and feel tender, so recovery is longer. With either method, risks and expectations are discussed in detail beforehand.

Swelling, tenderness and bruising are expected and usually settle within a few days to a week. Avoid tight clothing and choose cotton underwear; pause cycling, horse riding and intense exercise for a while; keep the area clean and dry, using only the products your doctor recommends; and avoid Turkish baths, saunas, pools and the sea for the first week.

Possible side effects and risks include:

• Common: Swelling, bruising, tenderness and mild pain.
• Asymmetry and firmness: Temporary asymmetry or small lumps that can be felt.
• Infection: Rare, but needs treatment.
• Herpes flare-up: In people with a history of genital herpes, the injection may trigger an outbreak.
• Vascular occlusion: A blocked blood vessel is very rare and needs urgent treatment.

If you notice increasing pain, marked redness, discharge, fever or a change in skin color, contact your doctor without delay.

A follow-up visit is planned once the swelling has settled to assess symmetry; any small correction is discussed only after the tissue has fully settled.

Hyaluronic acid filler is temporary. The body gradually breaks it down, and the effect usually lasts 6–12 months. When it fades, a new treatment can be planned after examination if you wish.

How long it lasts depends on the product and amount used, your metabolism and weight changes, and friction and movement in the area, which may make the filler fade sooner.

With fat injection, part of the transferred fat is absorbed by the body in the first months. How much remains cannot be predicted and varies from person to person; a second session may be planned if needed. For questions before an examination, see the contact page.