43 yo mother of two from Ogallala, Nebraska found nationally renowned Urogynecologist and master cosmetic surgeon, Dr. Oscar Aguirre through an internet search for Vaginoplasty. Since her operative-assisted vaginal delivery in 1992, she’s had decreased vaginal sensation with sex. She has a life-long history of undesired cosmetic appearance of her vulva. During examination she was counseled extensively regarding her surgical and nonsurgical options of which, she desired to proceed with definitive surgical therapy. Dr. Aguirre performed, in an outpatient surgical center, Vaginoplasty, Labiaplasty of the Labia Minora, Clitoral Hood Reduction with Clitoropexy and Excision of Anal Tags. She returned to the office for regular postop visits pleased with her results and wanting to move forward with other cosmetic procedures in the near future.