Deepithelized fasciocutaneous flap for labia majora augmentation during thigh lift

Labioplasty currently entails, other than labia minora reduction, labia majora skin excisional contouring and fat grafting. To restore fullness in a postbariatric patient, a technique was developed for labia majora augmentation using an anteriorly based adipofascial flap raised from the dispensable inner thigh lift crescent. The labiocrural crease delineated the flap medial border while the extent of the thigh redundancy determined its lateral border. A pocket in the labium was created and the flap was inserted. The procedure succeeded on one side and failed on the other, due to postoperative squeezing evacuation of a hematoma retracted the unattached flap. This labium was refilled later with fat grafting. Both for flap-insertion and fatgrafted labia showed almost symmetrical volumes after 1 year. Anatomical studies are necessary to accurately identify the flap blood supply. A large series is required to support the procedure as being safe and reliable. © Springer-Verlag 2010.