24 yo woman from Denver, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre from an online search. She has a five year history of a persistent vaginal tag following urethral diverticulectomy. This is bothersome to her with placement of a tampon and may impede her confidence with intimacy. She desires surgical excision. Dr. Aguirre performed a thorough pelvic examination which revealed hymenal remnants that are hypertrophied between 9 and 12 o’clock. There is also a mid-line skin tag consistent with prior diverticulectomy. She returned to the office where Dr. Aguirre performed an in-office aesthetic vaginal and vulvar surgery consisting of the excision of hypertrophied hymenal remnants and excision of hypertrophied vaginal tissue. She returned to the office for a regularly scheduled four week postop exam, very happy with her results.