Deflated Labia: Causes and Treatments for Labia Majora Volume Loss

Deflated labia, also called labia majora volume loss, flat or sunken labia, or vulvar deflation, describes outer labia that have lost the soft, cushioned fullness they once had. It is one of the most common changes women notice after the menopause or after losing a lot of weight, yet it is rarely talked about. It is not harmful, and for many women it is simply part of how the body changes with time. For others it causes discomfort or affects how they feel about themselves, and it can be treated. Our guide to labia shapes and vulva types shows how much the appearance of the outer labia varies between women.

This guide explains what the labia majora are, why they lose volume, how to tell volume loss from loose skin, what you can and cannot do at home, and how deflated labia majora are treated: with filler, known as labia puffing, with your own fat through labia fat transfer, or, where excess skin is the problem, with labia majora reduction. If your concern is that the inner labia have become smaller or are disappearing, our guide to shrinking labia covers that separate problem.

What Are the Labia Majora?

The labia majora are the two outer folds of skin of the vulva. The name means “large lips”. They run from the mons pubis, the rounded area over the pubic bone, down towards the perineum, and they surround the more delicate structures in the middle of the vulva: the labia minora (inner lips), the clitoris, and the openings of the urethra and vagina.

The labia majora are made of skin over a pad of fatty tissue. After puberty their outer surface is covered with pubic hair, while the inner surface is smooth and hairless. Their job is protective: the fat pad cushions the vulva when you sit, cycle or exercise, and the folds help keep the inner structures moist and shielded from friction and irritants. Their size varies considerably between women and follows body fat to some extent; in a Swiss study of 657 women, the outer labia were longer in women with a higher body mass index^[2].

Labia majora vs labia minora

The labia minora are the thinner, hairless inner folds that sit inside the labia majora. They have no fat pad, are rich in nerve endings and vary widely in length; in many women they extend beyond the outer labia. Deflated labia almost always refers to the labia majora, as they are the part that contains volume to lose. When the outer labia lose fullness, inner labia that were previously covered may start to show.

What Are Deflated Labia?

Deflated labia majora look flatter and less rounded than before. Women describe them as thin, sunken, wrinkled, floppy, flappy or saggy, and some notice that the vulva looks “flat” or that the outer lips no longer meet. The skin may look crinkled, rather like the back of the hand with age, and may feel looser when you move.

Is this normal? Usually, yes. Outer labia range from full and rounded to naturally slim, and they change through life. Some women have always had flatter labia majora, while others notice a change over months or years. There is no medical cut-off at which outer labia become “deflated”; what matters is whether the change bothers you or causes symptoms.

Why Does My Labia Majora Look Deflated?

Volume loss in the labia majora usually has more than one cause, and the causes tend to add up over time.

Menopause and falling oestrogen

Oestrogen helps maintain the thickness, moisture and elasticity of vulval and vaginal tissue. As levels fall around the menopause, the skin of the vulva thins and the labia lose fullness. Doctors now group these changes, together with vaginal dryness and some urinary symptoms, under the term genitourinary syndrome of menopause (GSM), which an international consensus panel defined as including changes to the labia majora and minora, clitoris, vaginal opening, vagina, urethra and bladder^[1]. Our guide to treatment options for vaginal atrophy explains the internal changes.

Ageing skin and fat

Collagen and elastin, the proteins that keep skin firm and springy, decline steadily with age. Fat pads throughout the body also shrink and shift, which is why the face and the backs of the hands lose fullness. The labia majora age in the same way, so they look thinner and more wrinkled even in women who have not gone through the menopause.

Weight loss

The labia majora contain fat, so losing a significant amount of weight, whether through diet, weight-loss medication or bariatric surgery, can leave them noticeably flatter and looser. Rapid weight loss is more likely to leave loose skin, as the skin has less time to adapt. Women who have lost a lot of weight may also notice loose skin over the mons pubis; see our guides to intimate surgery after massive weight loss and the upper pubic area.

Pregnancy, childbirth and breastfeeding

Pregnancy swells and stretches the vulval tissues, and a vaginal birth can stretch the labia further. Afterwards, much of the elasticity returns, but some women are left with looser outer labia. Breastfeeding lowers oestrogen for a time, which can temporarily make the vulva look thinner and feel drier.

Genetics and natural anatomy

How much fat your body stores around the vulva is partly inherited. Some women have naturally slim outer labia from puberty, and some lose volume earlier than others.

Skin conditions and other causes

Smoking accelerates skin ageing. Rarely, conditions that cause loss of fat tissue can affect the labia. Lichen sclerosus, an inflammatory skin condition, can change the vulval skin so that it looks pale, shiny or crinkled and can alter the shape of the labia; it needs medical treatment, and the NHS guidance on lichen sclerosus ↗ explains the symptoms to look for.

Why are my outer lips wrinkly?

Wrinkling of the labia majora is very common and usually reflects thinner skin and less fat beneath it, from age, hormonal change or weight loss. Wrinkled outer labia are not a sign of illness on their own. White, shiny, itchy or sore skin is different and should be assessed by your GP.

Saggy Labia Majora: Volume Loss or Loose Skin?

It helps to work out which of two problems you have, as they are treated differently.

• Volume loss. The outer labia look flat, hollow or wrinkled, but there is not much spare skin. Restoring volume with filler or fat is usually the answer.
• Loose or hanging skin. The outer labia hang down, fold over or swing when you move, and there is clear excess skin, often after major weight loss or with age. Adding volume alone may make these labia look heavier; removing the excess skin with labia majora reduction is often more appropriate.

Many women have some of both. A surgeon will examine you lying and standing to judge the balance, and may suggest combining treatments. If the inner labia have become more prominent as the outer labia have deflated, some women choose to reduce the inner labia at the same time with labiaplasty.

Side Effects of Deflated or Loose Labia

Deflated labia are not dangerous, but they can cause:

• Discomfort and chafing, as thinner outer labia offer less cushioning and loose skin can rub or flap, particularly during exercise or in tight clothing.
• Irritation and dryness, especially when the change is linked to the menopause.
• Exposure of the inner labia, which can then rub on clothing.
• Self-consciousness about appearance, sometimes affecting intimacy and confidence.
• Changes in sensation or comfort during sex in some women, often linked to dryness rather than the volume loss itself.

How to Plump Labia Majora Naturally: What Actually Works?

Many women search for how to plump the labia majora naturally or how to make the labia puffy without treatment. Honest answer: there is no cream, oil, supplement, massage or exercise that will rebuild lost fat in the outer labia, and creams sold as “tightening” products have no good evidence behind them. Pelvic floor exercises strengthen the muscles around the vagina, not the labia.

What can help:

• Vulval moisturisers and emollients improve dryness and make the skin feel more comfortable.
• Vaginal oestrogen, prescribed by your GP, improves the symptoms of vaginal atrophy, according to a Cochrane review of 30 randomised trials^[8]. It can improve the comfort and quality of vulval skin, though it will not restore the fat pad. The NHS page on vaginal dryness ↗ explains the options.
• Weight gain will often add some fullness back, but it is not a practical treatment for most women.
• Stopping smoking slows further skin ageing.

Deflated Labia Treatment: How to Restore Volume

When volume loss bothers you, there are two main ways to restore fullness to the labia majora: hyaluronic acid filler and your own fat. Neither changes the inner labia.

Labia puffing with hyaluronic acid filler

Labia puffing, also called labia majora filler or labial puff, uses a hyaluronic acid gel injected under the skin of the outer labia to restore volume and smooth wrinkling. After numbing cream, and local anaesthetic if needed, the filler is placed with a fine needle or small cannula. The treatment takes about half an hour, there is little or no downtime, and the result lasts around 9 to 12 months before the body gradually absorbs the filler and a top-up is needed.

The evidence for labia majora filler has grown. In a 2026 randomised controlled study of 76 women aged 40 to 65 ↗, those who had hyaluronic acid filler had significantly better sexual function and aesthetic improvement scores at six months than women who had no treatment, with only mild, short-lived local reactions and no serious adverse events^[3]. A 2025 multicentre study of 72 women ↗ found that 97% rated their outer labia as improved 12 weeks after filler, with improvement rates above 92% throughout a year of follow-up^[4], and an earlier study of 54 women still found significant improvement 12 months after a single treatment^[5]. These studies are relatively small and some were not controlled, so longer-term data are still limited. Possible side effects include swelling, bruising, tenderness, lumpiness and, rarely, infection or blockage of a blood vessel. Hyaluronic acid filler can be dissolved if needed.

Labia fat transfer

Labia fat transfer, also known as labial fat grafting or lipofilling, uses your own fat instead of filler. Fat is removed with gentle liposuction from the tummy, flanks or inner thighs, processed to remove fluid and damaged cells, and then injected in small amounts into the labia majora to restore volume and smooth the contour. At Centre for Surgery it is carried out under local anaesthetic with sedation or under TIVA (total intravenous anaesthesia).

About 30 to 50% of transferred fat is naturally reabsorbed in the first few months, so your surgeon allows for this, and the result improves as swelling settles over around three months. The fat that survives is long-lasting, although a smaller top-up is occasionally needed. Swelling and bruising are common at first; most bruising settles within two weeks, a compression garment is worn over the donor area for six weeks, and sex, swimming and strenuous exercise wait until around six weeks. The evidence comes mainly from smaller case series: in one study of 21 women who had fat transfer to the labia majora combined with a conservative inner labia reduction, 81% were satisfied or very satisfied, with no infections^[6]. Our guide to fat transfer vs filler for labia puffing compares the two in detail.

Labia majora reduction for loose skin

Where the main problem is loose or hanging skin rather than lost volume, labia majora reduction (labia majoraplasty) removes the excess skin, with the scar placed in the groove between the inner and outer labia so that it is well hidden. Published experience is limited to small series; one 2026 report of 24 women with sagging, wrinkling and volume loss described no surgical complications and improved appearance and comfort, while noting that larger studies are needed^[7]. Some women benefit from combining a skin reduction with fat transfer.

Do lasers or radiofrequency help deflated labia?

Energy-based treatments are sometimes promoted to tighten vulval skin. They do not restore lost volume, and good-quality evidence for their effect on the labia majora is lacking. Centre for Surgery does not offer radiofrequency vaginal treatment. Our Fotona laser treatments are used for internal concerns such as vaginal atrophy, laxity and stress incontinence, described on our vaginal laser treatment page, not for labial volume.

Filler or Fat Transfer: Which Is Better for Deflated Labia?

Neither is better for everyone. Filler suits women who want a quick, non-surgical treatment with no recovery, who would like to see the effect before committing to anything longer-lasting, or who do not have enough spare fat. It needs repeating roughly once a year. Fat transfer suits women who want a long-lasting result without repeat injections, who have some fat to spare and who are happy to have a minor operation with a short recovery. Many women start with filler and later move to fat transfer. Where loose skin is significant, neither is enough on its own, and a skin reduction may be needed. Our comparison of labia puffing vs labiaplasty explains how these treatments differ from reducing the inner labia.

Treatment for Deflated Labia at Centre for Surgery

At Centre for Surgery, women with deflated or saggy labia majora are assessed by a GMC-registered surgeon at our CQC-regulated hospital at 95–97 Baker Street. Your surgeon will examine you, establish whether volume loss, loose skin or both are responsible, check for any skin condition that needs treating first, and explain the realistic result, risks and alternatives of each option, including not having treatment.

Filler is given in clinic with numbing cream and local anaesthetic. Fat transfer and labia majora reduction are day-case procedures under local anaesthetic, local anaesthetic with sedation or TIVA (total intravenous anaesthesia), depending on the procedure, and the surgeon who assesses you is the surgeon who performs your procedure. Our labiaplasty nursing team is all-female, and we only treat adults aged 18 and over. Finance is available; see our finance options.

Frequently Asked Questions

Treatment for Deflated Labia in London

If deflated, wrinkled or saggy labia majora are causing discomfort or affecting your confidence, a consultation with a surgeon can establish whether filler, fat transfer or skin reduction would help most. Find out more about labia fat transfer at Centre for Surgery.

Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation

References

1. Portman DJ, Gass MLS; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause 2014;21(10):1063–1068. doi:10.1097/GME.0000000000000329
2. Kreklau A, Vâz I, Oehme F, et al. Measurements of a ‘normal vulva’ in women aged 15–84: a cross-sectional prospective single-centre study. BJOG: An International Journal of Obstetrics and Gynaecology 2018;125(13):1656–1661. doi:10.1111/1471-0528.15387
3. Fasola E, Dridi D, Degliuomini RS, Buzzaccarini G, Benini V, Salvatore S. Performance and safety of hyaluronic acid-based gynaecological filler for labia majora augmentation: a randomised controlled study. Life (Basel) 2026;16(7):1141. doi:10.3390/life16071141
4. Boucher F, Eychenne C, Gurriet B, et al. Evaluation of the efficacy and safety of hyaluronic acid injection for volume restoration of the labia majora: ESOLANE study. International Urogynecology Journal 2025;36(6):1243–1253. doi:10.1007/s00192-025-06094-1
5. Fasola E, Gazzola R. Labia majora augmentation with hyaluronic acid filler: technique and results. Aesthetic Surgery Journal 2016;36(10):1155–1163. doi:10.1093/asj/sjw083
6. Hersant B, Jabbour S, Noel W, et al. Labia majora augmentation combined with minimal labia minora resection: a safe and global approach to the external female genitalia. Annals of Plastic Surgery 2018;80(4):323–327. doi:10.1097/SAP.0000000000001435
7. Kurt A, Ozturk S. Labia majoraplasty: deep contouring with a multivector modification. Aesthetic Plastic Surgery 2026;50(18):7688–7694. doi:10.1007/s00266-026-06149-8
8. Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews 2016;(8):CD001500. doi:10.1002/14651858.CD001500.pub3