32 yo mother of four from Highlands Ranch, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and Master Cosmetic Surgeon Dr. Oscar Aguirre of Parker, Colorado through an online search on Labiaplasty. She presented to the office having been bothered by the size of her labia since she was very young. She describes herself as being hyper-sensory and is bothered by formfitting clothing. She wants to have a labia reduction. Dr. Aguirre performed a thorough pelvic examination with a chaperone present and patient observing with a handheld mirror. Inspection of her vulva revealed bilateral labial hypertrophy with hyperpigmentation and redundant lateral prepuce, bilaterally. She was also found to have pursestring stricture at the introitus due to perineal web. Beyond this there is a stage II rectocele and significant pelvic floor muscle trauma and tears and gaping introitus beyond the stricture. All surgical and nonsurgical options with discussed with the patient. Dr. Aguirre’s recommendations were Rectocele Repair, Vaginoplasty, and Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction with PRP to Surgical wounds. Patient discussed all findings with her husband and decided to address her aesthetic concerns with her vulva. Dr. Aguirre performed in an in-office surgical setting, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction with PRP (Platelet Rich Plasma) to the surgical wounds. She returned to the office for her regularly scheduled postop appointments healing nicely with no issues or concerns. She will think about proceeding, at a later time, with other recommended procedures.