Dr O performs an awake labiaplasty and hood reduction under local anesthesia, also excising a recurring small bump on the patient’s left outer labia previously biopsied as benign excess sebum and likely an ingrown hair/epidermal inclusion or sebaceous cyst. They discuss the tradeoff between removing the bump and leaving a scar, then proceed with numbing injections, pinch tests, tissue removal, cautery, and stitching, noting the left side tends to be more sensitive and explaining how lidocaine blocks nerve impulses. During the procedure they talk about the patient’s work as a 911 dispatcher, on-the-job training, triage, humor in stressful jobs, existential questions, religion, aliens, and robotics. The patient plans five days off and discreet icing at work; post-op photos and a brief video are taken, and the patient expresses relief about reduced friction and discomfort.