Autologous Fat Grafting Combined With Platelet-Rich Plasma in the Treatment of Female Genitourinary Aging: A Retrospective Study.

BACKGROUND

Female genitourinary aging (because of childbirth, menopause, weight changes, and aging) causes genital shrinking, vaginal laxity, dyspareunia, and urinary issues, impairing quality of life. Current treatments (lubricants, hormone creams, and laser) are temporary, have drawbacks, or lack clear guidelines. Autologous fat grafting (AFG) enables safe volumization, and platelet-rich plasma (PRP) promotes tissue repair, but evidence for their combination here is scarce.

OBJECTIVES

The aim of this study was to explore the clinical efficacy and safety of AFG combined with PRP in female external genitalia and vaginal rejuvenation.

METHODS

A retrospective study included 38 patients (January 2020 to December 2024) with genital/vaginal aging who received combined AFG (mons pubis, labia majora, G-spot, and perineum) and PRP. Postoperative evaluations were performed with the Vaginal Laxity Questionnaire (VLQ) and the Female Sexual Function Index (FSFI), and complication monitoring was conducted.

RESULTS

Postoperative VLQ scores rose from 2.45 ± 0.81 to 5.03 ± 1.15 (P = .027). All 6 dimensions of the FSFI (sexual interest, sexual arousal, vaginal lubrication, orgasm, sexual satisfaction, and dyspareunia) and the total FSFI score also significantly improved (all P < .05), with a mean total FSFI increase of 9.0 ± 2.3 points (a ≥4-point increase is clinically meaningful); 92.1% (35/38) were "very satisfied" with appearance/tightness. Only 2 (5.3%) experienced mild redness (resolved with oral antibiotics); no severe complications occurred.

CONCLUSIONS

In this small cohort with limited follow-up, AFG combined with PRP treatment appears to improve the external appearance of female external genitalia and vaginal aging and enhance genital function, improve patient-reported sexual function (based on FSFI) and reduce urinary system problems.

LEVEL OF EVIDENCE: 4 (Therapeutic).