Case # 25301

40 yo woman from Denver, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and renowned Cosmetic Surgeon Dr. Oscar Aguirre of Denver, Colorado through a referral from a “friend of a friend”. She has a 25 year history of bothersome vulvar tissues. Since the age of 15 she has been bothered by her large asymmetric labia minora, and with aging, has noticed worsening features of her labia majora. She is unhappy with loss of volume and wrinkledness of her labia majora. She describes discomfort with wearing form-fitting clothing and pulling and dragging with intercourse. She is also unhappy with the aesthetic appearance. Pelvic examination performed with a chaperone present revealed bilateral labial hypertrophy with hyperpigmentation and asymmetry, left side greater than right. There is also a large prepuce on both sides. There is excess perineal skin and an anal skin tag. Inspection of the labia majora is significant for deflation and laxity, very amenable to a labia majora reduction. Dr. Aguirre counselled her on all surgical and non-surgical options and after discussing all questions, she decided to move forward with definitive surgical therapy in the form of an in-office aesthetic vulvar surgery as soon as possible. Dr. Aguirre performed Laser Reduction Labiaplasty of Labia Minora, Labia Majora Reduction, and Clitoral Hood Reduction with PRP to surgical incision sites, Excision of Excess Perineal Skin and Excision of Anal Skin Tag. She returned for her regularly scheduled postop appointments very eager to return to skiing and her normal activity.