Dr. Patricia Gutiérrez-Ontalvilla · MD PhD cum laude · Plastic, Aesthetic and Reconstructive Surgeon · Nixarian Institute, Valencia · National Secretary ISAPS Spain
Quick response
Fat-derived stem cell treatment (Liquenia-SVF protocol) for vulvar lichen sclerosus and vulvar lichen planus is performed in the operating room under general anesthesia, lasts approximately 1 hour and 15 minutes, and is painless during the procedure. Recovery is fast: discharge on the same day, an estimated 1-week medical leave for office work, sports after one month, and sexual relations gradually starting from 1.5–2 months.
If you have made it this far, you have probably spent months—or years—living with the itching, burning, and fear that accompanies vulvar lichen sclerosus or vulvar lichen planus. You have read about the Liquenia-SVF protocol and are asking yourself the question that almost all patients ask us before taking the step:
Does it hurt? What exactly are they going to do to me? How long will it take me to recover?
It is completely logical that you should ask yourself this. You are coming from a disease that in itself hurts, limits, and wears you down. The treatment should do exactly the opposite: take care of you, not add more suffering.
This guide answers all of that, with real data from more than 21 years of clinical experience in plastic surgery and 10 in vulvar regenerative surgery.
What worries my patients most before surgery
In consultation, almost all women tell me the same thing:
- “I’m afraid of the pain”
- “I don’t want to go through something traumatic”
- “I don’t know if I’ll be able to lead a normal life afterwards”
Each of those phrases hides something much deeper: years of late diagnoses, treatments that didn’t work, and a disease that no one ever fully explained to you.
That is why, before talking about the procedure, I need you to know something important: with more than 21 years of accumulated clinical experience, I have created the Liquenia-SVF protocol precisely so that the patient arrives at the operating room with all the information and leaves with maximum safety.
Is it done with local anesthesia, sedation, or in the operating room?
The Liquenia-SVF protocol is always performed in the operating room, under general anesthesia. This is not a minor detail: it is a deliberate clinical decision.
The patient must not suffer either physically or emotionally during the treatment. That is not a luxury: it is part of the result.
Why general anesthesia and not local or sedation?
- The vulvar area is extraordinarily sensitive. Working on it with the patient awake—even with local anesthesia—would generate unnecessary discomfort and pain and would compromise technical precision.
- Microliposuction requires a controlled surgical environment. A slight movement of the patient or involuntary muscle contraction can compromise the safety of the Liquenia-SVF procedure.
- General anesthesia allows the SVF to be infiltrated with the precision that the protocol demands: in the layers where the fibrotic damage of lichen sclerosus and vulvar lichen planus occurs.
- The patient is monitored at all times by the anesthesiology team. Maximum medical safety.
How long does the intervention last?
The surgery lasts approximately 1 hour and 15 minutes.
The procedure includes obtaining the patient’s own adipose tissue, processing it to obtain nanofat and SVF, and applying it to the vulvar area. If there is clitoral phimosis and/or pterygium with narrowing of the vaginal opening, everything is operated on in the same surgical act.
Discharge is on the same day. The patient returns home with their companion—mandatory, as you cannot drive after general anesthesia—with prescribed analgesia and clear postoperative instructions.
Does the postoperative period hurt?
No—or more precisely: it is not a painful postoperative period.
It is common to notice mild discomfort and a sensation of inflammation or tightness in the first few hours. It is perfectly controlled with conventional analgesia:
- Ibuprofen
- Paracetamol
Most patients describe it as much more manageable than they expected. The first week is surprising, and that positive surprise is part of the change.
The circuit prior to surgery: nothing is improvised
One of the reasons why the intervention proceeds without setbacks is that the prior process is perfectly protocolized. On the day of surgery, there are no surprises because everything has been prepared in advance.
| Step | What it consists of |
|---|---|
| 1. Diagnostic visit | Complete clinical evaluation of the vulvar area |
| 2. Pre-anesthetic assessment | Online and in-person. No surprises on the day of surgery |
| 3. Complete preoperative workup | Complete blood analysis, ECG |
| 4. Informed consent | Delivered, read, and signed more than 24 hours before surgery |
| 5. Fasting | 6–8 hours before the intervention |
| 6. Companion | Mandatory. You cannot drive after general anesthesia |
The informed consent is delivered at least 1 week in advance so that you can read it calmly, without pressure, and resolve any doubts. The goal is for you to arrive at the operating room calm, with all the information and without uncertainties.
Recovery time: what you need to know
Recovery is, in general, more manageable than patients expect. Here is the real timeline:
| Timeframe | Permitted activity | Clinical note |
|---|---|---|
| Next day | Daily shower | Specific soap (Dermnix) + healing cream |
| 1 week | Office work | Stand up for a few min. every hour |
| 1–2 weeks | Gentle physical activity | Walking, gentle stretching |
| 1 month | Sports | Progressive, according to tolerance |
| 1.5–2 months | Sexual relations | Gradual start |
Medical leave: not all leaves are the same
The general orientation is 1 week for office or sedentary work. But every patient is different: a person who works in front of a computer does not have the same physical demands as a fitness instructor or a physiotherapist.
If your work activity involves intense physical effort, standing for prolonged periods, or movements involving the pelvic area, the leave will necessarily be longer—aligned with the restriction on sports until one month. This is assessed individually in consultation.
💡 Clinical tip: If you must remain seated during the first week, stand up for a few minutes every hour. This small gesture favors lymphatic and venous drainage of the operated area and contributes to a more comfortable and faster recovery.
Sports
From one month after the intervention. This includes swimming, cycling, running, and any activity with impact or pressure on the pelvic area. Progression is always gradual and according to individual tolerance.
In lichen sclerosus, repeated microtrauma can aggravate the disease (Koebner phenomenon). That is why this timeframe is not arbitrary: it is part of the treatment.
Sexual relations
Gradually from 1.5–2 months. No rush. No pain. Always listening to your body.
This margin allows the treated tissues to complete their initial phase of regeneration without subjecting the area to friction or pressure. Any activity that generates tension or rubbing on the vulva must be postponed until the medical team indicates otherwise.
Care after treatment: part of the result, not just comfort
The postoperative period does not end in the operating room. It starts there. And the care you perform in the first few days directly influences the quality of your recovery.
- Daily intimate hygiene: Daily shower from the day after the intervention. Clean water is your ally.
- Specific soap: Use exclusively soap formulated for the vulvar area. At the Nixarian Institute, we recommend Dermnix soap, formulated for sensitive skin and mucous membranes.
- No conventional pads: Avoid conventional pads. If you need protection, opt only for postpartum-type cotton pads, which are breathable and free of perfume and plastic.
- Underwear: Choose cotton or natural fiber underwear that allows for breathability. Avoid tight synthetic clothing during the first few weeks.
This care is not just for comfort. It is part of the treatment. Because well-cared-for vulvar skin heals better and reduces relapses.
“I was very afraid of general anesthesia. But the pre-anesthetic visit completely reassured me. On the day of the intervention, I fell asleep without anxiety and woke up without pain. The following week I was already working from home. What surprised me most was how well I handled the postoperative period.”
Are you a candidate for the Liquenia-SVF protocol?
Resolve your doubts without obligation. Contact the Nixarian Institute team directly.
What is important—and honest
The Liquenia-SVF protocol is not a miracle treatment. It does not replace medical follow-up. And it is not the same for all patients.
But in well-selected patients, with the correct diagnosis and the complete protocol:
- It can significantly improve the symptoms of lichen sclerosus and vulvar lichen planus.
- It can improve quality of life, including sexual function and emotional well-being.
- It can change the patient’s relationship with their own body.
This paradigm shift—from treating symptoms to regenerating tissue—is backed by clinical evidence published in the Aesthetic Surgery Journal (Oxford, 2025, DOI: 10.1093/asj/sjaf148) and by the ISAPS clinical practice guide (2025), in which Dr. Gutiérrez-Ontalvilla participates as lead author.
Frequently asked questions about the Liquenia-SVF protocol: anesthesia, operating room, and recovery
Will I feel pain during the stem cell procedure for lichen sclerosus?
No. The intervention is performed under general anesthesia: you are completely asleep during the entire procedure, with no perception of pain. The anesthesiology team monitors your status at all times. Upon waking, discomfort is mild—inflammation or tightness—and is controlled with conventional analgesia such as ibuprofen or paracetamol.
How long does it take to recover from stem cell treatment for lichen sclerosus?
Return to office work occurs around 1 week. Sports are resumed at one month and sexual relations gradually from 1.5–2 months. Clinical improvement of symptoms is perceived progressively in the weeks and months following treatment.
How long does the Liquenia-SVF protocol operation last?
The surgery lasts approximately 1 hour and 15 minutes. The total time in the hospital, including prior preparation and recovery from anesthesia, is about 6–8 hours. Discharge is on the same day of the intervention.
When can I do sports after stem cell treatment for lichen sclerosus?
From one month after the intervention. Progression is always gradual and according to tolerance. Low-impact activities such as walking can be started earlier, in the first 1–2 weeks, according to medical indication.
When can I have sexual relations after stem cell treatment for lichen sclerosus?
It is recommended to reintroduce them gradually from 1.5–2 months. Any activity that generates friction or pressure on the vulva must be postponed until the medical team indicates otherwise.
Do I need a companion on the day of the Liquenia-SVF protocol surgery?
Yes, it is mandatory. After general anesthesia, you cannot drive or manage the transfer home alone. It is essential to be accompanied by a trusted person who can take you home and be with you during the first few hours of the postoperative period until the effect of the anesthesia wears off completely.
Does stem cell treatment also work for vulvar lichen planus?
Yes. The Liquenia-SVF protocol is indicated for both vulvar lichen sclerosus and vulvar lichen planus. Both conditions share the mechanism of chronic tissue damage that SVF addresses through local cellular regeneration.
When will I start to notice improvement after stem cell treatment for lichen sclerosus?
The response varies according to each case. Many patients report progressive improvement in the first 6–8 weeks after the intervention, with consolidation and stabilization of results during the months following treatment.
About the author
Dr. Patricia Gutiérrez-Ontalvilla — Specialist in Plastic, Aesthetic and Reconstructive Surgery (MD PhD cum laude, University of Valencia). National Secretary of Spain at ISAPS, ISAPS mentor, international researcher, and President of the Nixarian Foundation. She practices at the Nixarian Institute (Valencia). More than 21 years of accumulated clinical experience in plastic surgery and 10 in vulvar regenerative surgery.
