38 yo mother of three from Centennial, Colorado located the office of nationally renowned Urogynecologist and master cosmetic surgeon Dr. Oscar Aguirre from Denver, Colorado through an internet search. She states she has a greater than six year history of undesired cosmetic appearance of her Labia Majora. She is status post laparoscopic supracervical hysterectomy with anterior and posterior colporrhaphy and perineorrhaphy eight years prior. She has done extremely well over the years and now wants to address Labia Majora Laxity which is causing her significant difficulties with intimacy. She has also noticed progressive symptoms of difficulties with bowel movements as well as the return of some vaginal looseness. Pelvic examination revealed moderate Labia Majora Laxity and Deflation. Distally there is separation of her levator musculatures as well as a perineocele present contributing to her obstructive defecation symptoms. Dr. Aguirre counseled her extensively regarding all surgical and non-surgical options and she decided to proceed with definitive surgical therapy. Dr. Aguirre performed a posterior Vaginoplasty and Labia Majora Reduction in an out-patient surgery center. She returned to the office for her regularly scheduled postoperative visits doing very well.