49 yo woman from Arvada, Colorado located the office of Dr. Oscar Aguirre, a nationally renowned Urogynecologist and master cosmetic surgeon in Englewood, Colorado, through an internet search on Labiaplasty. She has a seven-year history of large labia minora which has progressed significantly over the past three years. She also states she has developed very tender skin tags near the clitoris on the left labia that are also bothersome and are creating great difficulty with exercising and wearing formfitting clothing. Upon examination, Dr. Aguirre found her to have moderate labial hypertrophy and hyperpigmentation including skin tags along the left and right labia minora. She was also noted to have redundant left lateral prepuce with otherwise appropriately proportioned central prepuce. All surgical and non-surgical options were discussed and she was excited to schedule aesthetic vulvar surgery. Dr. Aguirre performed Laser Reduction Labiaplasty of the Labia Minora and Excision of left redundant prepuce. She returned to the office four weeks postop, very pleased with the results and eager to be cleared to resume sexual activity.