This patient was very young – a high school senior, who was embarrassed with the look of her labia. She had asymmetric labia, in which the right labia was not only larger than the left, but the left labia only went half way down the length of the vaginal orifice. In this patient two procedures were used – first the excess prepuce was removed on both sides, we used the edge preserving technique on her right side, but on her left side we used a technique that extended the length of her labia so that it could match her other side and go the entire length of the vaginal orifice. She  had a fenestration procedure on the left, and an edge preserving procedure on the right, with removal of excess prepuce and reverse V  hoodoplasty resulting in natural looking labia’s on both sides.