55 yo mother of 3 from Steamboat Springs, Colorado located Urogynecologist and cosmetic surgeon, Dr. Oscar Aguirre through an internet search for Liposuction and Labiaplasty. She presented to the office with undesired appearance of her inner and outer thighs, wanting to move forward with Liposuction to decrease volume. Dr. Aguirre performed in-office SmartLipo Liposculpture of bilateral inner and outer thighs. She returned to the office for her first postop visit but as well as a thorough consultation regarding the undesired cosmetic appearance of her vulva. She is bothered by discomfort while horseback riding, from her large labia. She has also noticed an old appearing vulva with flaccid looking labia majora and long dark and asymmetric labia minora. After discussing in detail all surgical and nonsurgical options, she moved forward with scheduling the procedure to be performed in an in-office surgical setting. Dr. Aguirre performed a Laser Reduction Labiaplasty of the Labia Minora, Labia Majora Reduction, Clitoral Hood Reduction with Clitoropexy and Anal Tag Excision. The vaginal postop photos are taken at both six weeks and six years following her surgery. The after Liposuction photos were taken four months postop.