Response to Letter: A Novel Approach to Female Genital Mutilation Reconstruction with Fat Grafting and Adipose Stem Cell Therapies: A Minimally Invasive Solution with a Potential Impact on Millions of Women Worldwide.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

FGM is an issue of increasing concern also in countries where it is not traditionally practiced. It is associated with multiple health consequences and significant economic costs for the public health systems. FGM-related vulvar hypertrophic scars are the most common long-term effects associated with this practice. Regenerative therapies based on the use of adipose-derived stem cells are considered the standard of care for ameliorating scarring and fibrosis. This study aimed to explore the potential of fat grafting in the treatment of post-FGM scars. Thirteen FGM survivors with vulvar scars underwent fat grafting and were assessed using the Vulvar Architecture Severity Scale (VASS), Female Genital Self-Image Scale (FGSIS), Female Sexual Function Index (FSFI), and Hospital Anxiety and Depression Scale (HADS). At an average follow-up of 12.23 months (±3.03), clinical results (VASS) showed a significant improvement in all vulvar aesthetic units treated with FG (p<0.001). Patients reported improvements in genital-related self-image (FGSIS) (p=0.001), sexual function (FSFI) (p=0.019), and psychological well-being (HADS) (p=0.002). Fat grafting ameliorates vulvar scar tissue and improves volumetric contouring of vulvar aesthetic units, with a positive effect on patients' quality of life. This minimally invasive intervention has far-reaching implications, providing a cost-effective so

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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