47 yo mother of three from Highlands Ranch, Colorado with a greater than ten year history of vaginal looseness located the office of Dr. Oscar Aguirre, a nationally renowned Urogynecologist and master cosmetic surgeon in Englewood, Colorado, through an internet search on vaginal rejuvenation. While consulting with Dr. Aguirre she states that she has noticed progressive changes contributing to difficulties with sexual pleasure because of vaginal looseness. She is also bothered by the aesthetic appearance of her vulva. Upon examination Dr. Aguirre found her to have vaginal relaxation contributing to female sexual dysfunction, in particular looseness and difficulty with orgasm, labial hypertrophy and anal skin tags. There was also confirmation of an inguinal hernia which the patient had suspected. After thorough consultation, patient scheduled surgery to be completed around the same time as her Inguinal Herniorrhaphy. Dr. Aguirre performed, in an out-patient surgical setting under general anesthesia, Anterior and Posterior Vaginoplasty with Perineoplasty, Labiaplasty of the Labia Minora, Clitoral Hood Reduction with Clitoropexy and Excision of Anal Tags. She return to the office with excellent results.