Ultra Femme is a non-evidence-based "Energy-Based Device" treatment that had mild to modest temporary effects on the skin of the area(s) of treatment. There is absolutely no evidence that it works long-term and, with a price tag of ~ $3000 for a series of 3 treatments that may provide modest exterior tightening for 6-8 months, you will be going to the doctor's office 5-6 times a year and paying $4000-$6000/year-- for what? That elusive "Vaginal Rejuvenation...? What the heck is that? My recommendation: have the labiaplasty first. Find a surgeon who is skilled at V-wedge labiaplasty, a surgical procedure that BOTH minimizes labial size and "lifts" and tightens the exterior. If internal laxity is also an issue, a "Vaginoplasty" (vaginal reconstruction) by a cosmetic gynecologist well-trained & experienced in this procedure is, in my opinion, your best bet. Yes, you will pay more initially, but your procedure is virtually "forever," and you don't continually need to return (the "gift that keeps on giving" for the practitioner, but a drain on both your pocketbook & your time. RealSelf's web reference below will help educate you. Do your "homework," don't be swayed by industry ads and non-scientific "White Papers." You will find, believe me, loads of practitioners not trained in either the proper LP technique to "lift & tighten" in addition to diminishing labial size, or to do a true muscle-approximating internal procedure, who instead take the easy way out with "machines" that sorta work short-term & keep you coming back... Short answer: do the proper surgical technique for your anatomy and functional/aesthetic wishes first, then see if the expense of a Laser or RF treatment is warranted as an adjunct later...Best wishes, Michael P Goodman, MD, FACOG, IF, AAACS. Sacramento, CA, USA