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Microfat and Nanofat Grafting in Genital Rejuvenation

Menkes S, SidAhmed-Mezi M1, Meningaud JP1, Benadiba L, Magalon G2, Hersant B1.

Aesthet Surg J. 2020 May 9. pii: sjaa118. doi: 10.1093/asj/sjaa118. [Epub ahead of print]

BACKGROUND: Genitourinary syndrome of menopause (GSM) is a major problem in many post- or perimenopausal women. Lipofilling has long been considered to be an effective technique for restoring volume, but the discovery of its trophic proprieties has made it the most widely used method in regenerative medicine.

OBJECTIVES: Microfat and nanofat grafting is a new technique. In this study, we aimed to assess the safety and efficacy of microfat and nanofat grafting for vulvovaginal rejuvenation. METHODS: Women with GSM and who met the inclusion criteria were enrolled. Women received microfat in the labia majora and nanofat in the vagina; follow-up was conducted 1, 3, 6, 12, and 18 months after treatment. The vaginal health index (VHI) and Female Sexual Distress Scale-Revised (FSDS-R) were used to assess improvement in vulvovaginal atrophy, orgasm, and sexual desire post-treatment.

RESULTS:Fifty women were included in this study; their average age was 53 years (range, 45-63 years). The VHI score significantly increased at 1 and 3 months after treatment (p < 0.0001). Moreover, the average FSDS-R score showed a significant improvement at 1- and 3-months post-treatment. This score stabilized from 6 to 12 months but showed further improvement at 18 months. At 6 months post-treatment, for both the scales, data pertaining to 80% of patients appeared normalized. There was a particular benefit noted for dryness and dyspareunia. At 18 months, the results remained stable for all of the patients. No major side-effects were observed.

CONCLUSIONS: There are now many ways to rejuvenate the intimate sphere, but microfat and nanofat grafting seem to offer good results with an autologous procedure. Their use appears promising for genital rejuvenation.