Case # 25599

28 yo mother of two from Ft. Collins, Colorado with a lifelong history of undesired cosmetic appearance of her vulva located the office of Board Certified, Fellowship-Trained Urogynecologist and Master Cosmetic Surgeon Dr. Oscar Aguirre of Parker, Colorado through an on-line search for Labiaplasty. Following her first vaginal delivery, she noticed worse changes of her labial appearance that worsened even more after her second delivery. Her most recent vaginal delivery was difficult and she has only recently stopped having pain with intercourse. She feels as though she is about to tear during penetration. She describes a thinning of her perineum. Dr. Aguirre performed a thorough pelvic examination which revealed excellent uterine support and mild vaginal relaxation. She performs a fair pelvic floor contraction. Distally, however, there are torn pelvic floor muscles consistent with laxity. Inspection of the vulva reveals bilateral labial hypertrophy with hyperpigmentation and redundant lateral prepuce with ptosis. There is also excess perineal skin with irregularities. There is a very large pubic mons. After discussing all surgical and nonsurgical options she scheduled to return to the office for recommended treatments. First, she returned for CoolSculpting of the Mons followed by definitive surgical therapy of the vulva. Dr. Aguirre performed, in an in-office surgical setting, Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction, Clitoropexy with PRP, and Excision of Excess Perineal Skin. She returned to the office for regularly scheduled postop appointments pleased with her results.