24 yo virginal woman from Pueblo, Colorado located the office of Master Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist Dr. Oscar Aguirre of Parker, Colorado through on-line research on Labiaplasty. She has a more than three year history of worsening discomfort from her large labia, which she has had since puberty. She has great discomfort with wearing formfitting clothing and while exercising, but now has become self-conscious regarding the protrusion of her labia minora beyond her labia majora. She is seeking aesthetic vulvar surgery. 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 as well as redundant lateral prepuce, and excess perineal skin extending into an anal tag. Dr. Aguirre discussed with patient and her mother all surgical and nonsurgical options. She was found to be an excellent candidate for in-office aesthetic vulvar surgery which she was eager to get scheduled. 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 Incision Sites, and Excision of Excess Perineal Skin. She returned to the office for her regularly scheduled postop appointments very happy with her results.