50 yo mother of two from Dillon, Colorado with a greater than 10 year history of urinary incontinence as well as decreased sensation with sex. She was referred by a local GYN to Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre of Englewood, Colorado. During consultation with Dr. Aguirre, she expressed concerns with “things not feeling normal with sex.” She feels spacious and states there is significant noise during sex as well as her husband falls out. She is also bothered by the aesthetic appearance of her labia. Following examination Dr. Aguirre discussed all surgical and non-surgical options. She decided to proceed with definitive surgical therapy. Dr. Aguirre performed, an outpatient Vaginoplasty and Anal Tag Excision to address the vaginal looseness and the presence of an Anal Tag at the same time as a Rectocele Repair and Mid Urethral I-Stop Sling to address posterior vaginal relaxation and incontinence issues. Patient plans to return to address her labia concerns at a later date.