55 yo mother of three from Conifer, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and master cosmetic surgeon Dr. Oscar Aguirre of Denver, Colorado, from an online search for vaginal tightening. She states that vaginal looseness has been a concern for fifteen years. Her partner has mentioned that “things could be tighter” and thus after a conversation with him, she has decided to seek treatment. At her examination Dr. Aguirre demonstrated with the patient observing with a handheld mirror her gaping introitus due to torn musculature contributing to vaginal looseness, as well as her labial hypertrophy of the labia minora and labia majora deflation with laxity contributing to an aged appearance. Dr. Aguirre explained that she was not a candidate for nonsurgical vaginal rejuvenation but she was in fact an excellent candidate for posterior compartment reconstruction with Vaginoplasty and Perineoplasty at the time of Labia Minora Reduction and Labia Majora Reduction as well. Dr. Aguirre performed the above recommended procedures in an outpatient setting. She returned to the office for her regularly scheduled postoperative appointments very happy with her results.