44 yo mother of three from Littleton, Colorado searched the internet for labiaplasty and vaginal rejuvenation which led to nationally renowned Urogynecologist and master cosmetic surgeon, Oscar Aguirre. She has a near twenty year history of undesired cosmetic appearance of her vulva. She is bothered by the dark and large labia minora, the appearance of an old vagina, and gaping introitus. After further questioning she describes having decreased sensation during intercourse following her three vaginal deliveries. Dr. Aguirre recommended and performed, in an office surgical setting, Labiaplasty of the labia minora, Clitoral Hood Reduction with Clitoropexy, Vaginoplasty, Perineoplasty, and an anal tag excision. She returned to the office for her regularly scheduled postop appointments very pleased with the surgery.