37 yo mother of one from Castle Rock, Colorado called the office of nationally renowned Urogynecologist and master cosmetic surgeon, Dr. Oscar Aguirre regarding labial changes making sitting and clothing uncomfortable, as well as for vaginal pain symptoms following the delivery of her child. During consultation with Dr. Aguirre, she describes vaginal pain during intercourse, as a tearing-type sensation with initial penetration as well as deeper penetration. She is also bothered by the aesthetic appearance of her vulva describing the labia as dark and large which pull inward during sex. Upon examination, Dr. Aguirre found bilateral redundant lateral prepuce, labia hypertrophy with hyperpigmentation and asymmetry, in addition to excess perineal skin. After patient consented to surgery, Dr. Aguirre performed in-office Labia Minora Reduction (Labiaplasty), Clitoral Hood Reduction with Clitoropexy, Excision of Excess Perineal Skin, and Anal Tag Removal. She returned to the office with excellent results.