31 yo mother of one from Aurora, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and renowned Cosmetic Surgeon Dr. Oscar Aguirre of Denver, Colorado through an internet search on Labia Reduction. She has a greater than 15-year history of undesired cosmetic appearance of her vulva. Since puberty she has been bothered by her large asymmetric labia minora, which has become more and more embarrassing to her. Pelvic examination that Dr. Aguirre performed with a chaperone present and patient observing with a handheld mirror revealed bilateral labial hypertrophy with hyperpigmentation and asymmetry. There is also a large ptotic prepuce and excess perineal skin as well as three large anal skin tags. Dr. Aguirre discussed all history and findings in detail with her as well as all surgical and nonsurgical options. She proceeded with definitive surgical therapy as per Dr. Aguirre’s recommendation. Dr. Aguirre performed an in-office, awake, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction and Clitoropexy as well as Excision of Excess Perineal Skin. She is interested in returning at a later time to address the Anal Skin Tags. She did return to the office for her regularly scheduled postop visits “very happy” with her results.