Case # 25637

53 yo mother of four from Denver, Colorado self-referred to renowned Cosmetic Surgeon and Board Certified, Fellowship-Trained Urogynecologist Dr. Oscar Aguirre of Denver, Colorado for vaginal rejuvenation. She has a 30 year history of undesired cosmetic appearance of her vulva as well as bothersome vaginal looseness.  She has had significant vaginal changes contributing to sexual dysfunction since giving birth to her first child. She is experiencing significant vaginal laxity which she feels has worsened over the past year. She also describes urinary incontinence which has been managed relatively well with laser treatments and O-Shot. She is bothered by her long labia minora and aged appearance and feels that her labia majora have deflated. Dr. Aguirre performed a thorough pelvic examination with a chaperone present and patient observing with a handheld mirror. He addressed her issues of concern which revealed an aged appearance. There is clitoromegaly from her testosterone, but also bilateral labial hypertrophy with hyperpigmentation, redundant lateral prepuce with ptosis, and labia majora deflation and laxity. Dr. Aguirre recommended Laser Reduction Labiaplasty of the Labia Minora, Clitoral Hood Reduction and Clitoropexy and Labia Majora Reduction which she wanted scheduled for the next soonest available time. Patient returned for recommended procedure which Dr. Aguirre performed in an in-office surgical setting. She returned to the office for her regularly scheduled postop appointments with excellent results.