This case covers a span of several years and illustrates what can happen when there is estrogen loss and menopausal changes in the vulvovaginal areas. In summary, the patient underwent both labiaplasty and vaginoplasty and did very well until years later when GSM resulted in a tight introitis, dry vagina, and dyspareunia. This video shows how to perform a band release in the office under local anesthesia. This is a Core video.