44 yo mother of two from Colorado Springs, Colorado referred to the office of Urogynecologist and master cosmetic surgeon Dr. Oscar Aguirre of Englewood, Colorado by her local OBGYN. She describes a 10 year history of vaginal issues, the onset of which occurred following her second vaginal delivery. She reports a lifelong history of difficulties with bowel movements. She also has developed difficulties having intercourse and is bothered by the aesthetic appearance of large labia. Upon examination she was also found to have anal skin tags. After discussing all surgical and nonsurgical options with both Dr. Aguirre and her husband, she decided that surgery would be her best option. In an outpatient surgical setting Dr. Aguirre performed a Rectocele Repair, Vaginoplasty, Laser Reduction Labiaplasty of the Labia Minora and Anal Tag Excision. She returned to the office for her regularly scheduled post-op appointments pleased with her results.