57 yo woman from Littleton, Colorado with a nearly 10-year history of undesired cosmetic appearance of her vulva located the office of nationally renowned cosmetic surgeon and board certified, fellowship-trained Urogynecologist Dr. Oscar Aguirre of Parker, Colorado, through an internet search for Labiaplasty in the Denver Area. She has been bothered by labial asymmetry since 2010, left side greater than right, and has noticed overall laxity of her tissues as well. She presented for an aesthetic vulvar consultation. Pelvic examination, by Dr. Aguirre, is significant for an aging vulva. There is good fullness of her labia majora; however there is laxity of the skin. There is Labial asymmetry, with left side greater than right as well as redundant lateral prepuce with ptosis. There is also a large anal skin tag. All history and findings were discussed in detail with her along with her treatment options. She was found to be an excellent candidate for Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction with Clitoropexy with PRP (Platelet Rich Plasma) to Surgical Wounds, Labia Majora Reduction, and Anal Skin Tag Excision. She proceeded with scheduling the recommended surgery with Dr. Aguirre. She returned for her regularly scheduled postop visits, very pleased with her results.