27 yo woman from Fort Collins, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and Master Cosmetic Surgeon Dr. Oscar Aguirre of Parker, Colorado from a Google search. She has a greater than 10-year history of undesired cosmetic appearance of her vulva. Since a very young age she has been aware of very large labia minora protruding through her labia majora. Once she entered puberty, she became self-conscious regarding the size of her labia. Dr. Aguirre performed a thorough pelvic examination with a chaperone present and patient observing with a handheld mirror. Exam revealed very large vulvar structures consisting of labial hypertrophy with hyperpigmentation, redundant lateral prepuce, and excess perineal skin. All findings along with all surgical and non-surgical options were discussed in detail. She scheduled her procedures with Dr. Aguirre where he performed, in an in-office surgical setting, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction, Clitoropexy with PRP to surgical wounds, and Excision of Excess Perineal Skin. She returned to the office for her regularly scheduled postop appointments, very happy with nice symmetry and overall excellent results.