49 yo mother of two from Lone Tree, Colorado self-referred to nationally renowned Urogynecologist and leading cosmetic surgeon, Dr. Oscar Aguirre for interests in Labiaplasty. She has a ten year history of undesired cosmetic appearance of her labia. Over the years she has noticed lengthening and darkening of her labia minora. She describes it as “looking like dead skin.” Upon further questioning, she has experienced vaginal looseness and thus decreased sexual pleasure. She also describes pelvic heaviness and difficulties with bowel movements over the past five to eight years. Dr. Aguirre performed a thorough pelvic examination and after discussing all surgical and non-surgical options, she decided to move forward with a staged procedure. In order to accommodate her schedule Dr. Aguirre first performed a medically needed Anterior/Posterior Vaginal Repair and Anal Tag Excision accompanied by aesthetic Vaginoplasty, in an out-patient hospital setting under anesthesia. Two weeks later Dr. Aguirre performed, in an in-office surgical setting, Laser Reduction Labiaplasty of Labia Minora, Clitoral Hood Reduction, Clitoropexy and PRP (Platelet Rich Plasma) to the surgical wounds. She returned to the office for regularly scheduled postop exams very pleased with her results.