31 yo mother of 1 from California with a long history of undesired cosmetic appearance of her vulva located the office of Board Certified, Fellowship-Trained Urogynecologist and renowned Cosmetic Surgeon Dr. Oscar Aguirre of Denver, Colorado, from an internet search on RealSelf. She first contacted the office desiring Labiaplasty with Dr. Aguirre after looking through photos on the Aguirre Specialty Care website and seeing the natural looking results that she too wants to attain. Since first reaching out she has also noticed difficulties with sexual gratification. She is worried that her vagina is too loose since her partner cannot climax inside her and he falls out easily during sex. Her initial consultation with Dr. Aguirre was over the phone. Photos that the patient sent to our office were reviewed by Dr. Aguirre. They revealed bilateral labial hypertrophy and redundant lateral prepuce bilaterally. There was absence of any prolapse on frontal view with the labia separated and Valsalva. Dr. Aguirre found her to be an excellent candidate for aesthetic vulvar surgery and Vaginoplasty. After discussing all surgical and non-surgical options as well as instructions when traveling from out of state, patient decided to proceed with scheduling surgery. Upon arriving into town, Dr. Aguirre performed a thorough pelvic examination confirming initial findings. Dr. Aguirre performed, in an out-patient surgery center, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood reduction and Vaginoplasty. She returned to the office for her regularly scheduled postop appointment very happy with the results.