24 yo woman from Denver, Colorado referred by her primary care physician to the office of Dr. Oscar A. Aguirre, a Master Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist in Parker, Colorado. She has a 10-year history of undesired cosmetic appearance of her vulva. Since puberty she has been bothered by her large and protruding labia minora which is also bothersome when wearing form-fitting clothing, exercise, and during intimacy. Pelvic examination performed with a chaperone present and the patient observing with a handheld mirror reveals bilateral labial hypertrophy with hyperpigmentation as well as a large ptotic clitoral hood with both excess and redundant lateral prepuce. All history and findings were discussed in detail with the patient, along with her surgical and nonsurgical options. She was eager to proceed with definitive surgical therapy. She scheduled to have Dr. Aguirre perform recommended in-office aesthetic vulvar surgery under local anesthesia. She had Laser Reduction Labiaplasty of the Labia Minora with Posterior Taper, Clitoral Hood Reduction, and Clitoropexy with PRP to surgical wounds. She returned to the office for her regularly scheduled postop appointments, very happy with excellent symmetry and very happy with her results.