Case # 25541

27 yo mother of two from Denver, Colorado with a three year history of undesired cosmetic appearance of her vulva was self-referred to renowned Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist Dr. Oscar Aguirre of Parker, Colorado due to an internet search. She describes experiencing good sex and is primarily bothered by the appearance of her posterior vagina and perianal region. She denies painful intercourse and describes good pleasure with sex. Dr. Aguirre performed a thorough pelvic examination which revealed bilateral labial hypertrophy with hyperpigmentation as well as redundant lateral prepuce, which are not her primary concern. She is more bothered by excess perineal skin and a polypoid-type growth on her perineum as well as two anal skin tags. These findings were demonstrated to her with a handheld mirror, confirming her interest in addressing only the posterior aspect of her vulva. He discusses the need to taper the posterior labia so as to create a better aesthetic result upon excising the perineal skin. After discussing all surgical and non-surgical options in detail, she was interested in scheduling definitive surgical therapy as soon as possible. Dr. Aguirre performed in an in-office surgical setting, aesthetic vulvar surgery consisting of Excision of Excess Perineal Skin and Polypoid Introital Tag, and Excision of Anal Skin Tags. She returned to the office for her regularly scheduled postop visits, healing nicely and very pleased with her results, specifically the nice taper and symmetry.