Assoc. Prof. Süleyman Eserdağ, MDCosmetic Gynecologist & Sexual Therapist
Fellow of European Committee of Sexual Medicine (FECSM)
Editor of the Book ‘Female Aesthetic and Functional Genital Surgery’

Hyaluronic Acid Treatments in Cosmetics

Hyaluronic Acid Treatments in Cosmetics

Hyaluronic acid filler injections are among the non-surgical aesthetic applications for the external genital area in women. The augmentation process of the outer lips of the genital area is mainly performed for aesthetic purposes (labia majora augmentation). It is preferred to rejuvenate the sagging, sunken, wrinkled external genitalia and remove wrinkles and depressions. In this article, you will find answers to questions such as "How are the external genital area hyaluronic acid filler injections done, advantages, is it a painful procedure, is there any harm, to whom and why?"

Fillings made to the skin are known by names such as "injectable implants", "soft tissue fillers" or "wrinkle fillers". The most preferred fillers in cosmetics and regenerative medicine are hyaluronic acid fillers.

Hyaluronic acid fillers are the most commonly preferred materials to provide fullness and augmentation of the outer (large) genital lips.

What is hyaluronic acid?

Hyaluronic acid (HA),or “Hyaluronan” with its other name is a kind of sugar, has a linear, high molecular weight (between 0.1-10 million daltons) and 'polysaccharide' structure formed by D-glucuronic acid and N-acetyl-D-glucosamine found in the skin and cartilage structure of mammals. It is derived from the Greek terms "hyalos" (glassy, ​​transparent) and uronic acid. It is also the basic building block of the connective tissue and intercellular region.

How is hyaluronic acid produced?

Hyaluronic acid is generally obtained by direct isolation from animal sources or by fermentation methods from “streptococcal bacteria”. Animal sources include a comb, spinal cord, skin, and joint fluid. In recent years, sea creatures have also been used in production. Hyaluronic acid obtained from microorganisms by the "fermentation" method is of high purity. Its molecular dimensions also vary according to the type of source from which it is isolated.

Mechanism of Hyaluronic Acid Fillers

Hyaluronic acid fillers are frequently used in dermatology and cosmetology due to its plumping, moisturizing, collagen remodeling (stimulating collagen production),anti-aging, anti-inflammatory, and anti-edema properties. It also plays an important role in maintaining the vitality of the skin with its water-holding feature. It is one of the most hydrophilic (water-holding) molecules in nature; 1 gram of HA can absorb 6 liters of water.

What is collagen remodeling?

Collagen remodeling means stimulating of new collagen production, so ensures anti-aging effect into the tissues. Tightening and rearranging of the current collagen fibers are also provided. Hyaluronic acid fillers, vaginal laser treatments, genital radiofrequency, and genital mesotherapy injections are major applications in cosmetics for collagen remodeling.

Indications of Hyaluronic Acid Fillers in Cosmetic Medicine

Hyaluronic acid fillers are indicated extensively in cosmetic medicine and aesthetic dermatology.
The most common uses of hyaluronic acid in aesthetics: 

  • Elimination of signs of aging (anti-aging effect)
  • Treatment of wrinkles around the lips and eyes
  • Lip augmentation
  • Resurfacing of facial lines

Hyaluronic Acid Injections for Genital Area

Hyaluronic acid injections can be injected to the upper, lower, and lateral walls of the vagina and the submucosal tissue. For the purpose of G-shot (Orgasm vaccine),1/3 is applied to the lower and anterior vaginal wall. It can also be injected to the perineum, vagina entrance, and big genital lips.

The Areas to be Avoided

Hyaluronic acid fillings are not injected into the clitoris, on the inner genital lips, or the clitoris. Since it is an expensive substance, it is important to use it effectively.

Hyaluronıc Acid Fillers: Areas, Details, Indications, Advantages

Hyaluronic acid has been widely used in the genital area for aesthetic and functional indications, especially in recent years.

I – Functional Indications of Hyaluronic Acid Fillers

Vaginal Dryness Treatment

In particular, vaginal dryness, which is caused by the effect of the decreasing estrogen hormone after menopause, is an important sexual problem. If this situation is in the form of "surgical menopause", which begins with removing the uterus and ovaries, menopausal complaints are experienced much more intensely.

The first-line treatment for vaginal dryness is local estrogen medications in vaginal cream or suppository forms. However, even if they are locally effective, estrogen treatments are not recommended for those treated for breast cancer or at risk of cancer. Vaginal laser, radiofrequency, PRP, and hyaluronic acid treatments can be recommended as an alternative approach for these patients.

For vaginal dryness, the hyaluronic acid injection can be applied alone or in combination with energy-based treatments. According to our observations, the success rate is higher with combined treatments.

Hyaluronic acid can moisten the vaginal mucosa due to its water-holding feature. It also stimulates collagen production, especially in cases of atrophic vaginitis.

Vulvar Vestibulitis Treatment

Hyaluronic acid injections can be preferred for the treatment of the "vulvar vestibulitis" problem, which manifests itself with the complaint of not having any intercourse or painful intercourse due to excessive sensitivity at the vaginal entrance known as the "vestibular region".

Hyaluronic acid both stimulates collagen synthesis in this region and provides an anti-inflammatory effect. Collagen remodeling and resolution of the pain problem during intercourse can take up to a month.

Hyaluronik Asid Enjeksiyonu

Injection of hyaluronic acid into painful areas due to vulvar vestibulitis.

G-Shot (G-Spot Augmentation)

The purpose of fillers made to enlarge the G-spot area is to increase sexual pleasure. This is known as “G-shot” or “G-Spot Augmentation” procedure.

Elevation of the Perineum

Slight elevation of the perineum with the hyaluronic acid injection can positively affect sexuality by increasing the stimulation of the anterior vaginal wall during sexual intercourse and slightly narrowing the vaginal entrance.

Perineal Scar Treatments

Especially the scar formation due to vaginal birth(s) and the depressions in this area can be corrected with cross-linked hyaluronic acid fillers. In addition, the sexual intercourse pain problem (dyspareunia) due to the scar can also be treated. For this reason, hyaluronic acid fillers provide both aesthetic and functional benefits.

Very satisfactory results can be obtained by applying high-density hyaluronic acid fillers containing the “collagenase” enzyme to the area of ​​birth suture scars.

II- Aesthetic Indications of Hyaluronic Acid Fillers

Genital Area Filling

Aesthetic problems of large lips can be resolved in a short time with hyaluronic acid injection.

The most common application areas of genital area filling applied to the large lips are summarized below:

Enlargement of outer (bigger) genital lips (labia majora augmentation):

  • If the outer (large) lips are smaller than normal, to ensure growth or to hide the deformations of the inner lips
  • Elimination of sagging and wrinkles in the bigger gental lips

Elimination of symmetry problem:

  • If one lip has a different structure compared to the other, if it is larger or smaller, it is preferred to provide balancing.

Causes of Labia Majora Sagging

Depending on different reasons, sagging, wrinkles and depressions may occur in the labia majora. Some of the causes of labia majora sagging:

  • Fast weight gain and loss
  • Smoking
  • Stressful life
  • Aging
  • Menopause
  • Collagen loss due to genetic predisposition

Labia Majora Rejuvenation

Hyaluronic acid can be applied to the labia majora for functional and aesthetic purposes in younger ages and in menopause. Labia majora hyaluronic acid injections are also known as “Labia majora rejuvenation” and thus, the genital area can gain a fuller, brighter, and younger appearance. Genital radiofrequency, vulvar laser, genital PRP, and genital mesotherapy injections are also used for labia majora rejuvenation.

How is labia majora augmentation done?

Genital area labia majora augmentation is a simple procedure performed in the clinic, outpatient, and under local anesthesia. The entire application takes only 5-10 minutes on average and is quite painless. No downtime needed, and just after the labia majora HA filling, it is possible to return to social life on the same day. There is a prohibition of sexual intercourse for only five days; other than that, there are no restrictions.

You can find more detailed information under the heading "Hyaluronic acid treatments for genital area”.


In this section, you will find some of the hands-on aesthetic genital surgery (cosmetic gynecology) courses, trainings and meetings given by Assoc. Prof. Süleyman Eserdağ.

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Assoc. Prof. Süleyman Eserdağ, MDAssoc. Prof. Süleyman Eserdağ, MDCosmetic Gynecologist & Sexual Therapist
Fellow of European Committee of Sexual Medicine (FECSM)
Editor of the Book ‘Female Aesthetic and Functional Genital Surgery’
+90 (530) 763 34 00
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