Fractional CO2 laser can be used to shrink and tighten the mucosa of the external labia. By attaching an adapter, it can also tighten the internal vagina. It heals in 3-5 days depending on how aggressive a treatment you need. Externally, topical anesthetic and a chiller is used for comfort. Internally, typically does not need any anesthetic and takes about 10 seconds. Sessions are repeated monthly x 3, and then annually for maintenance.