49 yo mother of two from Ft. Collins, Colorado self-referred to renowned Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist Dr. Oscar Aguirre of Parker, Colorado through a search on the internet. She has a lifelong history of undesired cosmetic appearance of her vulva. Since she was young, she has been bothered by her long left labia minora. She feels this has worsened with aging. Upon examination she was found to have unilateral labial hypertrophy with hyperpigmentation and asymmetry, left side greater than right. There is also redundant left lateral prepuce and an anal skin tag. Dr. Aguirre discussed in detail with her all surgical and nonsurgical options. She decided to proceed with definitive surgical therapy. She returned to the office where Dr. Aguirre performed in-office aesthetic vulva surgery consisting of Laser Reduction Labiaplasty of the left Labia Minora and Clitoral Hood Reduction with Anal Skin Tag Excision. She returned to the office for her regularly scheduled postop visits, healing nicely and very happy with the results.