She presented with excess labia minora and desired to have surgical correction. The excess labia caused discomfort while wearing bathing suits and yoga pants, which resulted in chafing, itching and swelling. The alter wedge technique was performed for maximum patient comfort and easy post-operative care. While no external sutures were necessary, all sutures were placed internally. Exparel anesthetic injection was used for post-operative pain relief for 72 hours. Additionally, pain was controlled with prescription topical anesthetic cream. The patient was elated with the results and had no post-operative pain. She gave Dr. Fernau a 10/10 satisfaction rating.