41 yo mother of one from Sedalia, Colorado located the office of Dr. Oscar Aguirre, a nationally renowned Urogynecologist and master cosmetic surgeon in Englewood, Colorado, through an internet search on Vaginoplasty and Laser Skin Resurfacing. She has a long history of vaginal looseness since a difficult vaginal delivery years ago. She had significant obstetrical trauma to her perineum, which was repaired but only lasted a few months before breaking down. For the past two years she has also been bothered with difficulties achieving orgasm. Upon examination she was found to have a gaping introitus, which is aesthetically bothersome to her, as well as vaginal relaxation contributing to vaginal looseness. She is also bothered by redundant left lateral prepuce with ptosis of the prepuce as well as significant labia majora laxity and deflation. After discussing all surgical and non-surgical options she moved forward with scheduling surgery to be done at the out-patient surgery center. Dr. Aguirre performed a Vaginoplasty and Perineoplasty due to her gaping introitus and primary complaint of vaginal looseness with poor perineal support. She will return to the office at three months post-op to proceed with an O-Shot to address difficulty with achieving orgasm.