Case # 18879

47 yo mother of two from Colorado Springs, Colorado was self-referred to the office of Board Certified, Fellowship-Trained Urogynecologist and renowned Cosmetic Surgeon Dr. Oscar Aguirre of Denver, Colorado through an internet search on Vaginal Laxity. She has a five year history of decreased pleasure with sex. She also reports minor urinary incontinence, especially after voiding. She did have a laser vaginal resurfacing treatment two years prior and did notice a reduction of her urinary incontinence symptoms. She primarily wants to improve sexual function. During consultation with Dr. Aguirre she relayed that she is unhappy with the older-looking appearance of her vulva, especially deflated labia majora. Thorough pelvic exam by Dr. Aguirre reveals aging labia majora with deflation and skin laxity. There is an enlarged genital hiatus of 4.5 cm and a decreased size perineal body of 2.5 cm. She performs a good pelvic floor contraction. There is urethral hypermobility present and a stage II posterior compartment relaxation with excellent uterine and apical support. Her distal floor muscles do not tighten at the entrance. Her clitoris and G-Spot are somewhat dull. Patient examination was performed with a chaperone present and her observing with a handheld mirror. All surgical and non-surgical options were discussed in detail with patient. She was found to be an excellent candidate for a nonsurgical feminine rejuvenation, including Viveve treatment for introital laxity and an O-Shot to improve orgasm function. Both treatments will also reduce urinary incontinence symptoms. If she wishes improved sensation deeper in the vagina then she would benefit from laser vaginal resurfacing in the form of FemiLift. She would also benefit from a Vampire Puff procedure. She decided to move forward with the Viveve treatment, O-Shot and Vampire Puff of the Labia Majora. She returned to the office for her regularly scheduled postop appointments with excellent results.