A combination surgery is performed to narrow the vaginal canal and improve the vulvar appearance. The Lone Star Retractor is used to allow visualization for the office vaginoplasty and perineoplasty. The labia majoraplasty is performed in the standard manner with inclusion of some lateral clitoral hood for improved symmetry. The unique step in this video is the performance of the labia minoraplasty without the need for suturing. Radiofrequency is used for the excision and Feathering technique.