High-Frequency Ultrasound Assessment of Female Genital Rejuvenation

To describe the role of high-frequency ultrasound (HFUS) in the anatomical evaluation and monitoring of female genital rejuvenation procedures and to illustrate characteristic sonographic patterns associated with commonly used aesthetic treatments.

This retrospective observational study reviewed anonymized clinical and ultrasound records from eight female patients who underwent genital rejuvenation in a private dermatologic ultrasound center. HFUS examinations were performed using 20-33 MHz linear probes in standardized B-mode, with color Doppler added when indicated. Representative cases were selected to demonstrate normal anatomy, age-related changes, postprocedural findings, and complications.

HFUS provided high-resolution visualization of the epidermis, dermis, subcutaneous tissue, and fascial planes of the external genitalia. Younger patients showed compact fat lobules and well-defined fascial layers, whereas older patients exhibited dermal thinning and a subepidermal low-echogenicity band. Postprocedural HFUS identified distinct patterns for each treatment modality, including anechoic lobulated deposits after hyaluronic acid, hyperechoic punctate "snowfall" reflections after calcium hydroxyapatite, linear hyperechoic structures after absorbable threads, and focal hyperechoic panniculitis following lipolytic mesotherapy. HFUS also aided in detecting and characterizing treatment-related changes and potential complications.

HFUS appears to be a useful adjunct for minimally invasive female genital rejuvenation, enabling detailed anatomical assessment, visualization of injected materials, and monitoring of treatment-related changes. These preliminary findings support the integration of HFUS into aesthetic practice and highlight the need for further studies to standardize its application in this growing field.