Context
A great deal of women suffer the daily issues of urinary incontinence and sexual dysfunction related to vulvovaginal atrophy. Clinical signs include: dryness, lack of lubrication, discomfort and pain. Common causes are: menopause, hysterectomy, radiotherapy, chemotherapy, and the lesser evils including the first trimester of pregnancy, administration of medicines (contraceptive pills, anti-depressants…) etc. Research has shown that at least 50% of menopausal women suffer from vulvovaginal atrophy (VVA) which affects their sexuality.
Menopausal symptoms
Warning signs are: changes in the vulva, vagina, urethra or bladder involving dryness, burning, irritation, pain etc. Symptoms are uncomfortable: urinary incontinence, infection, dyspareunia, dysuria or atrophy.
Vuvlovaginal Atrophy (VVA) Pathophysiology
VVA combines a decrease in epithelial proliferation, a reduction of glycogen synthesis, an elimination of lactobacillus (pH dependent), an ischemia, a decrease in fluid transudation.
Benefits of the procedure
It leads to an improved vascularization, a renewal of collagen synthesis, tissue regeneration, restoration of lactobacillus stock and of fluid transudation for hydration, stimulation, restructuration of vaginal mucosa and labia majora.
Why fat?
The emulsified suspension injected avoids using foreign agents and limits the risk of rejection. Extraction of the patient’s fat is also fast and painless. After harvesting (with Puregraft®), we obtain a stroma vascular fraction (SVF), endothelial cells including progenitor cells, hematopoietic stem cells, fibroblasts, pericytes and the most important adipose-derived stem cells (ADSCs) in proportion of 2-10% of SVF, responsible for the regeneration and stimulation of bioactive factors and cells.
Advantages of the procedure
This natural emulsion has great regenerative capabilities. Its collection as well as its injection is made easy thanks to the fine needles or cannula used. Puregraft® is also FDA approved and CE marked. The procedure is safe, having been confirmed by clinical studies and can be completed in around 2 hours.
"Microfat and Nanofat Grafting offers ease, speed, security and patient satisfaction with very few adverse reactions."
Feedback
The study conducted by Dr Menkes recruited 50 patients suffering from vulvo-vaginal troubles and labia majora atrophy with an average age of 53. A fat sample was collected from the inner side of the knee, or from abdominal wall or thighs. Microfat was injected in the labia majora and Nanofat in the vaginal walls. Follow-up visits took place at 1, 3, 6, 12 and 18 months after injection.
"Results show a stable improvement in dryness and pain after one year."
In summary, the procedure is painless, well tolerated, and efficient. Results include good tissue regeneration, significant capacity for cell growth and notable paracrine activity. All signs point towards Microfat and Nanofat Grafting being a very simple, fast and effective technical procedure which dramatically improves vulvovaginal atrophy in just one treatment.
Dr Sophie MENKES, Aesthetic Doctor, Medical Director, Forever Institute, Geneva, Switzerland.
