Longer labia has been bothering her for a while, especially since three kids and vaginal birth. It’s painful for her during intercourse and uncomfortable in clothes. Said with her last child, she tore both ways. Plan for vertical excision bilateral majora. Plan for ellipse incision on right minora, wedge excision on left, Minimal clitoral hood excision on Left, More extensive clitoral hood on right extending upwards to remove the excess. Left posterior minora ellipse excision as well. Under local in office.