20 yo female from Aurora, Colorado referred by her local OBGYN to the office of Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre of Englewood, Colorado for aesthetic vulvar surgery. Following a previous partial vulvectomy, she has become more aware of what she describes as large and dark labia as well as a large clitoral hood. Pelvic examination revealed symmetric bilateral labial hypertrophy with hyperpigmentation . The protruding tissue is primarily clitoral glans and the proximal portion of the labia minora. After discussing all surgical and nonsurgical options, Dr. Aguirre recommended an in-office labia minora reduction extending up toward the clitoral glans. Clitoral hood reduction is not necessary since this is of normal size and dimension. She decided to proceed with the procedure as recommended and returned to the office postoperatively, very pleased with the results.