43 yo mother of two from Northern Colorado located the office of renowned Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist Dr. Oscar Aguirre of Denver, Colorado through a direct referral from her local OBGYN. She has a lifelong history of an undesired cosmetic appearance of her vulva. Since puberty, she has noticed that her labia are larger than she would like, and as an adult, she has been progressively bothered by discomfort, especially with wearing form-fitting clothing and cycling. For approximately 10 years, she has been involved in triathlons, and this has become very difficult. Dr. Aguirre performed a thorough pelvic examination with a chaperone present and patient observing with a handheld mirror. Examination revealed bilateral labial hypertrophy with hyperpigmentation and redundant lateral prepuce with ptosis of moderate to large degree. There is also excess perineal skin and 2 anal skin tags. All history and findings were discussed in detail with her, along with Dr. Aguirre’s recommendation for an in-office aesthetic vulvar surgery. She was very interested in proceeding with the recommended Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction, and Clitoropexy with PRP (Platelet Rich Plasma) to Surgical Site and Excision of Excess Perineal Skin as well as Anal Skin Tags. She scheduled to have Dr. Aguirre perform the surgery in the fall when she was less active. She returned to the office for her regularly scheduled postop visits pleased with her excellent and very natural looking results.