49 yo mother of three from Denver, Colorado with a greater than 10 year history of undesired cosmetic appearance of her vulva, was referred to Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre, by another cosmetic surgeon in the area. She is unhappy with the size of her labia, which protrude outwardly. She is interested in proceeding with aesthetic vulvar surgery in addition to improving her orgasm capabilities. She describes herself as being very sexual but despite this, has rarely had an orgasm with any of her sexual partners. After consulting with the patient about her aesthetic concerns as well as her desire to enhance sexual function with reaching orgasm during intercourse, Dr. Aguirre found her to be an excellent candidate for the O-Shot® as well as Laser Vaginal Tightening in the form of FemiLift®. Simultaneously she would undergo in-office laser reduction Labiaplasty of the Labia Minora as well as Clitoral Hood Reduction with Clitoropexy and Anal Tag Excision. She was eager to move forward and scheduled the procedures as recommended.