34 yo mother of two from Lone Tree, Colorado, with a 10 year history of undesired cosmetic appearance of her vulva, referred to renowned Urogynecologist and master cosmetic surgeon Dr. Oscar Aguirre by the aesthetic nurse in Dr. Aguirre’s office. During her initial consultation, she recalls developing larger and darker labia minora following her first pregnancy. She is self-conscious regarding her appearance as well as having discomfort with sex and wearing form fitting clothing. Upon examination, Dr. Aguirre found her to have bilateral labial hypertrophy with hyperpigmentation, excess perineal skin, redundant lateral prepuce with ptosis and labia majora deflation. After discussing all surgical and non-surgical options with her and her husband, she decided to move forward with surgery as recommended by Dr. Aguirre. He performed an in-office Labia Reduction Labiaplasty of the Labia Minora, Excision of Excess Perineal Skin and Clitoral Hood Reduction with Clitoropexy. Dr. Aguirre also performed Vampire Labia Majora Puff with injections of the patient’s own Platelet Rich Plasma (PRP) to the Labia Majora and PRP injections to the Clitoral Hood, for tissue regeneration and improved healing. Set #3 illustrates the improvement of her labia majora deflation after PRP injection. She returned to the office for regularly scheduled postop appointments, very pleased with her results.