This patient also complained of a wide/ smooth vagina, and a gaping appearance of the vaginal opening with large labia and wrinkling of her labia majora as well as excess prepuce. The procedure performed was a vaginal reconstruction with a perineoplasty, in which the perineum muscles and structure were put back together appropriately. All of which gave the slit like appearance to her vaginal opening, and also reducing the wrinkling and giving a normal labia majora appearance even though the labia majora was not operated upon. She had an edge preserving procedure of the labia minora with removal of the excess prepuce and pleat like tissue and a reverse V hoodoplasty, returning her natural normal youthful appearance.