25 yo woman from Denver, Colorado with a 10 year history of undesired cosmetic appearance of her vulva located the office of Board Certified, Fellowship-Trained Urogynecologist and Master Cosmetic Surgeon Dr. Oscar Aguirre of Parker, Colorado through an on-line search for Labiaplasty. Since going through puberty, she has been bothered by the size of her labia. Since becoming sexually active, she has been bothered by the discomfort she has with sex as well as being self-conscious regarding her appearance. Recently she has noticed increasing urinary tract infections and soreness and swelling of her vulvar tissues. Pelvic examination that Dr. Aguirre performed with a chaperone present and patient observing with a handheld mirror revealed bilateral labial hypertrophy with hyperpigmentation as well as redundant lateral prepuce with ptosis bilaterally. Dr. Aguirre discussed with patient all surgical and nonsurgical options. She was eager to proceed with scheduling definitive surgical therapy. Dr. Aguirre performed in an in-office surgical setting, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction and Clitoropexy. She returned to the office for her regularly scheduled postop appointments happy with her results.