The demand for female genital cosmetic surgery (FGCS) has significantly increased in recent years for two reasons: the advancement of surgical operations and the increased attention to women's esthetic and sexual well‐being. Three authors independently analyzed different databases up to April 1, 2024. They selected the relevant data according to inclusion and exclusion criteria. Two team members retrieved and evaluated the full text of the articles for eligibility, extracted the data independently, and included populations, intervention type, and outcomes using a pre‐piloted standard method. Any disagreement over the eligibility of some articles was resolved through discussion with an external collaborator. Considering the growing interest in FGCS procedures, the present review aims to analyze the most up‐to‐date surgical techniques, to provide adequate evidence‐based surgical training, in order to avoid complications. Labiaplasty aims to reduce excess labial tissue. To perform this procedure, it is possible to implement several techniques, that have recently been updated to ensure the lowest rate of complications and the best esthetic result. Vaginoplasty involves strengthening the vaginal wall and repairing vaginal lesions or asymmetries. Perineoplasty, the technique of choice in all scenarios in which perineal trauma occurs, is achieved by strengthening the perineal body and restoring the rectovaginal fascia. Other procedures described are labia majora augmentation, mons pubis surgery, clitoral hood reduction, lipofilling, and hymen reconstruction. Our review emphasizes that robust, evidence‐based training is required before performing such procedures, to avoid ineffective and potentially harmful surgical practices.

Background: Labia majora atrophy is a common consequence of aging, hormonal changes, and medical conditions, leading to anatomical changes that affect both aesthetic appearance and sexual function. Hyaluronic acid (HA)-based fillers represent a promising, minimally invasive approach to restoring volume and improving the structural integrity of the labia majora. However, clinical data on their efficacy and safety remain limited. Objective: To evaluate the efficacy and safety of a cross-linked hyaluronic acid filler for the treatment of labia majora hypotrophy. Methods: This randomised, single-centre, double-arm study included 76 women aged 40–65 years with labia majora hypotrophy, allocated to either a treatment group receiving HA filler injections (n = 40) or a control group with no intervention (n = 36). Primary endpoints included changes in sexual function, assessed using the Female Sexual Function Index (FSFI) at six months, and anatomical assessment using the Motakef classification as an indirect measure of the labia majora proportion. Secondary endpoints included aesthetic improvement (Global Aesthetic Improvement Scale, GAIS), perceived stress (Perceived Stress Scale, PSS), and patient satisfaction. Safety was assessed through the systematic monitoring of adverse events. Results: At six months, FSFI scores significantly improved in the treatment group compared to the control group (p < 0.0001), indicating improved sexual function. GAIS scores demonstrated significantly higher aesthetic improvement in the treated group (p < 0.0001). No serious adverse events occurred, and procedure-related pain was minimal (mean NRS: 1.4 ± 1.2). The treatment was well tolerated, with only transient and mild local reactions reported. Conclusions: The findings suggest that HA-based gynaecological fillers may represent a safe and potentially effective minimally invasive option for labia majora augmentation, with improvements in sexual function, aesthetic appearance, and patient satisfaction. These results should be considered preliminary and warrant further long-term investigation.