Case # 23582

53 yo mother of five from Topeka, Kansas located the office of Board Certified, Fellowship-Trained Urogynecologist and master cosmetic surgeon Dr. Oscar Aguirre through an internet search on Vaginoplasty and Labiaplasty. She has a twenty year history of vaginal looseness, which she noticed following her fourth vaginal delivery. Since that time, she has been bothered by significant lack of pleasure and sensation with sex. Over the years she has also noticed enlarging and darkening labia minora. Dr. Aguirre performed a thorough pelvic exam which revealed an aging vulva with labial hypertrophy and hyperpigmentation as well as excess central prepuce with ptosis. She was also found to have a gaping introitus as well as large anal skin tags. She also discussed her bowel symptoms which are significant for difficulties with rectal evacuation which is consistent with symptomatic rectocele. These findings were discussed in detail with the patient as well as all surgical and nonsurgical options. She proceeded with scheduling the surgical procedure where Dr. Aguirre performed a medically needed Rectocele Repair accompanied by aesthetic Vaginoplasty, Labiaplasty of the Labia Minora, Clitoral Hood Reduction with Clitoropexy and Anal Tag Excision.