Hello Lauram71,Laser Reduction Labiaplasty is a technique invented by Dr. David Matlock. It represents a very reproducible way of performing labia reductions for most women. The laser is used to cut the labia tissue in a precise manner, however it may create a thermal injury (burn) and cause sloughing of the skin, deformities, and postop pain. The "CO2 Labiaplasty" is industry's way of capturing some of the cosmetic vaginal surgery market where they sell an expensive laser and tell their inexperienced "surgeons" that they too can get the results that specialized cosmetic vaginal surgeons have for many years. It's a gimmick.What is most important is the skill and experience of your surgeon, not so much the actual "tool". Having trained under Dr. Matlock I first used a laser to perform Labiaplasty procedures. It only took a few patients to realize that the laser was too hot and was causing healing difficulties and moderate postop pain. I have since changed to a different "tool" to make my incisions, but still use the same specific technique that enables an aesthetically pleasing and youthful result. By making this switch I am able to perform these surgeries with the patients awake in my surgical center, under local anesthesia and no sedation. Patients recover pain free, except for the discomfort that comes from the swelling surrounding the sutures which are removed between postop day 4-7, depending on their progress. This enables them to travel back home with minimal discomfort and excellent aesthetic results. Be sure to look for an experienced surgeon and look through their photo gallery to assess their expertise. What is key is the surgeon you choose, not the tool.Best of luck,Oscar A. Aguirre, MDUrogynecologist & Cosmetic Vaginal Surgeon