31 yo female from Denver, Colorado referred by her local OBGYN to the office of Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre for evaluation of recurrent vulvar sebaceous cysts. During her initial consultation with Dr. Aguirre, she described a lifelong history of bothersome large labia contributing to discomfort with form fitting clothing, exercise, and intercourse. She expressed unhappiness with the size, asymmetry, and color of her labia. She has to be vigilant with changing out of exercise clothes to decrease the recurrence of cysts. This, along with regular Sitz baths have helped reduce their frequency. Pelvic examination performed with a chaperone present and patient observing with a hand-held mirror reveals bilateral labial hypertrophy with hyperpigmentation and asymmetry, right side greater than left. Upon closer inspection Dr. Aguirre was unable to identify any infectious cysts. She was found to have redundant lateral prepuce bilaterally, right side greater than left, excess perineal skin, as well as a large anal skin tag. After thorough discussion of surgical and non-surgical options, she decided to proceed with surgery which would also likely result in marked reduction of her cysts and improve comfort during exercise and intimacy. Dr. Aguirre performed in an office surgical setting, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction, Excision of Excess Perineal Skin, PRP (Platelet Rich Plasma) Injection to Incision Sites, and Excision of Anal Skin Tag. She returned to the office for regularly scheduled postop visits, well healed with excellent results.