i.  Labiaplasty

The labia minora (inner lips of the female genitalia) are generally well hidden by the labia majora (outer lips) in childhood. From the onset of the puberty the labia minora lengthen and are therefore no longer hidden.The extent of lengthening will vary from person to person. Inner lips that protrude significantly beyond the outer ones are generally not desirable by most women. Even if the size is initially acceptable changes occur with age and especially during pregnancy. Very long inner lips or even asymmetrical ones can be anatomically corrected with good aesthetics. The procedure can be easily performed under local anaesthetic at a lower cost to that of the operation under a general anaesthetic.

ii.  Fat injection to labia majora

The labia majora are the outer lips of the female external genitalia. Plump ones are the hallmark of youth. With aging there is a natural tendency for them to lose the fat from within. This loss also further exaggerates the protrusion of the labia majora. The best management for improving the aesthetics is by fat injection which can restore the plumpness. Fat is harvested from another part of your own body. The area for harvest is chosen in accordance with area with excess. The effect of this permanent. However with further aging you may experience some loss of the fat. Uncommonly though if the labia majora are very sac like then some of form of reduction may be needed in addition.
The effect of this is permanent

iii.  Mons reduction

The mons is the portion of the pubic area just above the external female genitalia. It has natural a tendency to accumulate fat. It is a secondary female characteristic but in some women the fat accumulation may be excessive especially with weight gain. Frequently though any intended weight loss is not accompanied by fat loss from the mons. The treatment of choice is liposuction if the area needs to be restored to the patient's desire. In general the procedure is usually combined with other procedures like external genitalia rejuvenation or a tummy tuck. Mons reduction is a useful adjunct to a mummy make over.

iv.  Vaginoplasty (vaginal tightening)

The vagina undergoes dynamic changes in the lifetime of the women. The prepartum vaginal cavity is generally not capacious. It dialates during sexual arousal and during intercourse. The sexual satisfaction for both partners is usually good if the fit is "hand in glove". Sometimes a change in partner may be the source of a looser fit if the former partner is significantly larger than the present. The usual scenario is most frequently irreversible stretch in the walls of the vagina as a result of natural childbirth. The sexual partners then feel a loss of sexual satisfaction. If no future pregnancies are planned or alternatively a future natural birth process is not desired, then the size of the vaginal cavity can be diminished.

This can be achieved with use of a CO2 laser, which ablates the mucosa of the vagina. The surface of the vagina then re-epithelialises. This process is accompanied by collagen deposition in the inner portion of the wall of the vagina resulting in tightening in the wall with accompanying decrease in the size of the vaginal cavity.

Another method of tightening the vagina is by decreasing the diameter by resecting part of the wall of the vagina and repairing it. In addition the muscles of the perineum are tightened by suture plication of the muscles and the entrance opening in to the vagina from the outside is also decreased. The aim of the surgery is restore the vagina within limits of the presenting anatomy to the prepartum state.