44 yo female from Littleton, Colorado with four-year history of urinary incontinence and vaginal looseness came to Urogynecologist and cosmetic surgeon, Dr. Oscar Aguirre to address these issues as well as aesthetic vulvar concerns of large and dark labia minora. She is four-year post term vaginal delivery which was associated with significant obstetrical injury requiring repair. In addressing the urinary incontinence, Dr. Aguirre placed a RetroArc Suburethral Sling. At the same time he addressed the vaginal looseness and aesthetic concerns by performing a Vaginoplasty and Labiaplasty of the Labia Minora with Clitoral Hood Reduction. These procedures were completed as a co-surgery with a local Otolaryngologist who corrected a deviated nasal septum at the same time.