48 yo mother of three was self-referred to Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre after seeing an advertisement in the Women’s Edition magazine. She has a 30 year history of undesired appearance of her vulva. She has always been unhappy with the length and color of her labia, and with her avid cycling this has become more problematic. Since her vaginal deliveries she has noticed a decreased sensation with sex and increasing difficulties with orgasm. In more recent years she has experienced vaginal dryness and decreased libido. She has rare vaginal orgasms and clitoral orgasms require more work. She is also bothered by loss of urine with strenuous activity and possibly during intercourse. Dr. Aguirre performed a thorough pelvic examination and discussed with her all surgical and nonsurgical options. Her primary concern is addressing her aesthetic concerns, and thus she was ready to schedule her procedure. Dr. Aguirre performed, in an in-office surgical setting, Laser Reduction Labiaplasty of Labia Minora, Clitoral Hood Reduction with Clitoropexy and Excision of Excess Perineal Skin. She was also treated non-surgically with vaginal rejuvenation consisting of laser vaginal resurfacing with FemiLift, radiofrequency introital tightening with Geneveve, and the O-Shot. Upon returning to the office for her regularly scheduled post-operative and post-treatment appointments, she was found to have excellent results. She denies any urinary incontinence and states that sex is much better with stronger orgasms. She is very pleased with her outcome.