40 yo mother of three from Western Colorado with a two year history of undesired cosmetic appearance of her vulva located the office of Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre through an internet search. She has been bothered by the aesthetic appearance of her labia due to her large, dark labia minora as well as large hood. Upon examination she was found to have bilateral labia hypertrophy with hyperpigmentation, excess clitoral hood skin and anal skin tags. All surgical and non-surgical options were discussed and she was eager to proceed with scheduling surgery. Dr. Aguirre performed, in an office surgical setting, Labiaplasty of the Labia Minora, Clitoral Hood Reduction with Clitoropexy and injection of PRP for improved healing as well as Excision of Anal Skin Tags.