32 yo female from Castle Rock, Colorado consulted board certified, fellowship-trained Urogynecologist and master cosmetic surgeon, Dr. Oscar Aguirre because of a twelve year history of being “unhappy with the appearance, feel and look of the vagina” and since her third vaginal delivery had noticed very large labia on the left side with significant asymmetry and darkness. Over the years she had developed decreased sensation and pleasure with sex. To address the lack of vaginal sensation, Dr. Aguirre performed a Vaginoplasty and Perineoplasty. At her request, ten months later she was ready to move forward with addressing the appearance of her labia, at which time Dr. Aguirre performed bilateral Labiaplasty of the Labia Minora and an Excision of Anal Tags.