BACKGROUND: The increasing requests for enhancement of labia majora during body outline reshaping surgical procedures have garnered special attention. This study focuses on the complications associated with such combined procedures and introduces the thigh-to-labium adipo-fascial flap technique. MATERIAL AND METHODS: The flaccidity of the labia majora was addressed with autologous fat grafts in 26 patients during abdominoplasty and with adipo-fascial flap from the medial thigh in two patients during thigh lift. The procedure was performed concurrently with mons tacking in ten cases and with edge labiaplasty in four cases. Additionally; a concomitant mammoplasty was performed in 18 cases. Technical details and complications are presented. RESULTS: The follow-up period for 16 patients ranged from two months to several years. Six patients experienced complications: three (10.7%) related to the tummy tuck, two (8%) to the labial fat grafting, and one the thigh-to-labium flaps. A life-threatening respiratory event in one case was due to excessively tight placation of abdominal wall. A contact burn of the insensate distal abdominal flap was reported in one case. Recurrence of mons ptosis required re-tacking in another. Resorption of over half the volume of the grafted fat necessitated revision in two patients. A labium majus lost prominence in the early postoperative days due to regression of its filling flap from forced evacuative squeezing manipulations of a developed hematoma. CONCLUSIONS: Combining labia majora lipofilling genital and body contouring surgeries may lead to serious complications. Labial fat grafts may experience resorption, while the thigh-to-labium adipo-fascial flap can durably maintain the achieved fullness. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Ahmed A. El Danaf (Mon,) studied this question.