47 yo mother of one from Denver, Colorado was self-referred to Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre through an internet search on Labiaplasty. She has a greater than 15-year history of undesired cosmetic appearance of her vulva. She has been bothered by her large and dark labia minora, which worsened with her pregnancy 10 years ago. She has noticed an older-appearing vulva which has been very bothersome to her. During sex, she is very self-conscience of her excess labia. Dr. Aguirre preformed a thorough pelvic examination, while patient observed with a handheld mirror, which revealed bilateral labial hypertrophy with hyperpigmentation as well as a large prepuce secondary to bilateral lateral redundancy and excess tissue. After discussing all surgical and non-surgical options she preceded with scheduling an in-office, awake aesthetic vaginal procedure to improve the aesthetic appearance of her vulva. Dr. Aguirre performed Laser Reduction Labiaplasty of the Labia Minora, Excision of Redundant Prepuce Bilaterally and Clitoropexy with PRP to surgical site. She returned to the office postoperatively for her regularly scheduled appointments doing very well and pleased with her results.