46 yo mother of three from Aurora, Colorado was self-referred to the office of Board Certified, Fellowship-Trained Urogynecologist and renowned Cosmetic Surgeon Dr. Oscar Aguirre of Denver, Colorado. She has a 13-year history of persistent hemorrhoids, which she has treated twice before surgically without concern for the aesthetic outcome. She continues to be bothered by the aesthetic appearance of her anus due to multiple anal tags. Dr. Aguirre performed a rectal examination which confirmed the absence of any hemorrhoids consistent with recent hemorrhoidectomy. There are multiple anal skin tags. Dr. Aguirre performed in-office Anal Skin Tag Excision. She followed up in the office for her regularly scheduled postop appointments with excellent results.