{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:47:13Z","timestamp":1782467233517,"version":"3.54.5"},"reference-count":24,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":153,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Dermal fillers hyaluronic acid (HA) blended with calcium hydroxylapatite\u2013carboxymethylcellulose (CaHA\u2013CMC) for facial indications is increasingly being adapted for body applications, offering both volumizing and regenerative benefits to the skin. In its hyperdilute form, CaHA functions as a regenerative biostimulator, effectively inducing the synthesis of key extracellular matrix components, whereas HA provides immediate volumization. Vaginal rejuvenation, with or without surgery, is also gaining attention with reports of off-label use of fillers for labia majora augmentation; however, analyses of hybrid approaches remain limited. This report outlines a technique utilized in 2 patients in which, following labia minora reduction, the labia majora were volumized using a combination of fillers with the aim of improving both skin quality and enhanced volumetric support. Patients who had previously undergone labiaplasty 6\u2005months prior, presenting with mild-to-moderate laxity of the labia majora, received a single treatment of combined CaHA\u2013CMC and HA injected into the subdermal plane. Outcomes were evaluated after 3 and 20 months for skin texture, firmness, adverse effects, and patient satisfaction levels. Posttreatment, improvements to skin quality, flaccidity, volumization, and dermal integrity were observed for both patients. High patient satisfaction was similarly reported, along with no adverse effects nor prolonged downtime typically associated with more invasive surgical alternatives, such as fat grafting. The treatment presented here offers a promising solution for postlabiaplasty patients seeking further labia majora rejuvenation, offering preliminary evidence of the safety and efficacy of hybrid fillers for addressing laxity.<\/jats:p>\n                  <jats:p>Level of Evidence: 4 (Therapeutic)<\/jats:p>\n                  <jats:p\/>","DOI":"10.1093\/asjof\/ojag101","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T11:42:16Z","timestamp":1780141336000},"source":"Crossref","is-referenced-by-count":0,"title":["When Labiaplasty is Not Enough: Rejuvenation of the Labia Majora Using Hybrid Calcium Hydroxylapatite With Hyaluronic Acid Filler for Increased Satisfaction and Uniform Results"],"prefix":"10.1093","volume":"8","author":[{"given":"Genevieve F","family":"Caron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"2026062605065620500_ojag101-B1","author":"Astute Analytica"},{"key":"2026062605065620500_ojag101-B2","author":"The Aesthetic Society, Statistics 2022"},{"key":"2026062605065620500_ojag101-B3","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1093\/asj\/sjw083","article-title":"Labia majora augmentation with hyaluronic acid filler: technique and results","volume":"36","author":"Fasola","year":"2016","journal-title":"Aesthet Surg J"},{"key":"2026062605065620500_ojag101-B4","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1097\/DSS.0000000000000733","article-title":"Soft-tissue augmentation with hyaluronic acid filler for labia majora and mons pubis","volume":"42","author":"Hexsel","year":"2016","journal-title":"Dermatol Surg"},{"key":"2026062605065620500_ojag101-B5","first-page":"010","article-title":"Use of calcium hydroxylapatite for augmentation of the labia majora and mons pubis","volume":"2","author":"Van Loghem","year":"2017","journal-title":"Sci J Clin Res Dermatol"},{"issue":"2 Suppl 2","key":"2026062605065620500_ojag101-B6","first-page":"153","article-title":"A new hyaluronic acid polymer in the augmentation and restoration of labia majora","volume":"31","author":"Zerbinati","year":"2017","journal-title":"J Biol Regul Homeost Agents"},{"key":"2026062605065620500_ojag101-B7","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.45728","article-title":"A novel hyaluronic acid filling technique for restoring volume of the labia majora","volume":"15","author":"Tarabini","year":"2023","journal-title":"Cureus"},{"key":"2026062605065620500_ojag101-B8","first-page":"1","article-title":"The role of calcium hydroxylapatite (Radiesse) as a regenerative aesthetic treatment: a narrative 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Dermatol"},{"key":"2026062605065620500_ojag101-B12","doi-asserted-by":"publisher","first-page":"257","DOI":"10.2147\/CCID.S106551","article-title":"Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation: a literature review.","volume":"9","author":"Prasetyo","year":"2016","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"2026062605065620500_ojag101-B13","author":"Yutskovskaya"},{"key":"2026062605065620500_ojag101-B14","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1093\/asj\/sjae196","article-title":"Calcium hydroxylapatite in regenerative aesthetics: mechanistic insights and mode of action.","volume":"45","author":"Van Loghem","year":"2025","journal-title":"Aesthet Surg J"},{"key":"2026062605065620500_ojag101-B15","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002160","article-title":"Consensus recommendations for the use of hyperdiluted calcium hydroxyapatite (radiesse) as a face and body biostimulatory agent","volume":"7","author":"Almeida","year":"2019","journal-title":"Plastic and Reconstr Surg Glob Open"},{"key":"2026062605065620500_ojag101-B16","doi-asserted-by":"publisher","first-page":"1973","DOI":"10.1111\/jocd.16216","article-title":"Dilutional rheology of radiesse: implications for regeneration and vascular safety.","volume":"23","author":"McCarthy","year":"2024","journal-title":"J Cosmet Dermatol"},{"key":"2026062605065620500_ojag101-B17","doi-asserted-by":"publisher","first-page":"295","DOI":"10.2147\/CCID.S50546","article-title":"Dermal fillers in aesthetics: an overview of adverse events and treatment approaches.","volume":"6","author":"Pavicic","year":"2013","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"2026062605065620500_ojag101-B18","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1093\/asj\/sjae031","article-title":"A structured approach for treating calcium hydroxylapatite focal 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