27 yo female from Aurora, Colorado with a greater than 10 year history of undesired cosmetic appearance of her vulva located the office of renowned Urogynecologist and master cosmetic surgeon, specializing in Intimate Aesthetics, Dr. Oscar Aguirre of Denver, Colorado after an internet search on Labiaplasty. She recalls as a teenager having asked her gynecologist questions about her large labia, and she was advised to postpone this until a later age. She now presents with progressive increase in size and discomfort of her labia. She has pulling and dragging with sex, especially of her right side. She desires improved aesthetic appearance of her vulva as well as improved sexual function as she has noticed decreased vaginal sensation and difficulties with orgasm as of late. Dr. Aguirre performed a thorough examination which revealed bilateral labial hypertrophy with hyperpigmentation as well as redundant lateral prepuce bilaterally with ptosis. She was found to have labia majora deflation as well. She was strongly discouraged from surgical vaginal tightening (vaginoplasty) since she was an excellent candidate for nonsurgical introital tightening with radiofrequency using Geneveve with O-Shot. With regards to the aesthetic aspect of her vulva, she is an excellent candidate for in-office Laser Reduction Labiaplasty of Labia Minora, Clitoral Hood Reduction with Clitoropexy and Vampire Labial Majora Puff procedure. She followed up in the office for her regularly scheduled postop appointments with excellent results.