J Menopausal Med.  2017 Apr;23(1):63-68. 10.6118/jmm.2017.23.1.63.

Rejuvenation Using Platelet-rich Plasma and Lipofilling for Vaginal Atrophy and Lichen Sclerosus

• Kim SH
• Park ES
• Kim TH

• KMID: 2378226
• DOI: http://doi.org/10.6118/jmm.2017.23.1.63

Abstract

Vaginal atrophy is a common condition among peri- and post-menopausal women. Symptoms of vaginal dryness, pruritus, irritation, loss of subcutaneous fat, sparse pubic hair and dyspareunia occur due to decreased estrogen level. Estrogen-based treatments are effective. But many patients are reluctant to be treated due to health concerns. As alternatives, we explored the efficacy of platelet-rich plasma (PRP) and lipofilling. A 67-year-old female patient with vaginal atrophy was referred to our department. Treatment using estrogen cream had failed to improve patient's symptoms. Diminished volume and aged look of genitalia were also major concerns. We treated her using lipofilling mixed with PRP. A total of 40 cc of autologous fat mixed with PRP was transferred to labia majora. Lipofilling with PRP relieved the clinical symptoms. Missing fullness and tone was corrected and the augmented volume was well maintained. White patchy lesions of lichen sclerosus on labia minora also improved. Lipofilling with PRP relieved symptoms, restored contour of the labia majora and achieved remission of lichen sclerosus on labia minora. As vulvar lesions were repaired and the aged appearance of genitalia was rejuvenated, both functional and cosmetic outcomes were satisfactory. Lipofilling with PRP can be effective for vaginal atrophy and lichen sclerosus.

Keyword

Platelet-rich plasma; Rejuvenation; Vaginal diseases; Vulvar lichen sclerosus

MeSH Terms

Aged
Atrophy*
Dyspareunia
Estrogens
Female
Genitalia
Hair
Humans
Lichen Sclerosus et Atrophicus*
Lichens*
Platelet-Rich Plasma*
Pruritus
Rejuvenation*
Subcutaneous Fat
Vaginal Diseases
Vulvar Lichen Sclerosus
Estrogens

Figure

• 

  Fig. 1 Initial photographic finding of labia majora demonstrating diminished volume and loss of tone.

• 

  Fig. 2 (A) A centrifuge and (B) SmartPreP® APC-30 kit (Harvest Technologies, Plymouth, MA, USA) used to prepare autologous platelet-rich plasma.

• 

  Fig. 3 Transfer of autologous fat mixed with platelet-rich plasma into the subcutaneous layer of labia majora.

• 

  Fig. 4 (A) Photographic finding 1 week and (B) 1 year post-operatively. Note that augmented missing fullness and persistent volume restoration of labia majora.

• 

  Fig. 5 Photographic finding 1 year post-operatively. Note that resolution of white patchy lesions on labia minora examined by a gynecologist colleague.

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