38 yo female from Commerce City, Colorado, with a lifelong history of aesthetic concerns regarding her vulva, sought the office of nationally renowned Urogynecologist and master cosmetic surgeon Dr. Oscar Aguirre. She presents for an in-office awake aesthetic vaginal procedure to improve her bilateral labial hypertrophy with hyperpigmentation as well as redundant lateral prepuce bilaterally. After discussing all surgical and non-surgical options, the in-office surgical procedure was scheduled at the request of the patient. Dr. Aguirre performed Laser reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction and Clitoropexy with PRP (Platelet Rich Plasma) as well as an O-Shot. At her 4.5 wk postop visit, she returned very pleased with excellent results.