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.