28 yo mother of two from Grand Junction, Colorado located the office of renowned Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist Dr. Oscar Aguirre of Denver, Colorado through an internet Google search on Labiaplasty. She has a 20 year history of undesired cosmetic appearance of her vulva. Since grade school she has been bothered by the uneven appearance of her labia which she first noticed when she was becoming more self-aware. She felt that during self-play, she created a lengthening and separation of her labia from the hood. Since the deliveries of her children, she has been bothered by a hemorrhoid for 5 years resulting in excess skin and hygiene issues. She consulted with Dr. Aguirre about her uneven labia minora and extra skin as well as old hemorrhoid skin. Dr. Aguirre performed a thorough pelvic examination which revealed left labial hypertrophy with left redundant lateral prepuce. The right side is perfect. There is an anal skin tag present as well. All surgical and nonsurgical options were discussed in detail. Dr. Aguirre had recommended, as an option, in-office aesthetic vulvar surgery in the form of Laser Reduction Labiaplasty of the Left Labia Minora, Clitoral Hood Reduction with PRP (Platelet Rich Plasma) to Surgical Site, and Excision of Anal Skin Tag. She was eager to proceed with definitive surgical therapy as recommended. She scheduled surgery for the coming weeks and returned postoperatively for her regularly scheduled visits very happy with the symmetrical results and stating her vulva “looks good”.