Labiaplasty and VaginoplastyPodcast

Upcoming Zoom Webinar on July 29, 2026, 6 PM CSTPersonal Message from Dr. Alinsod: I will be giving an update on CO2LiftV Carboxytherapy for both Surgical and Non-Surgical use and improving outcomes. I will share my secrets on how to use CO2LiftV to both help improve tissues for healing, help local anesthesia go deeper under the skin, and help improve surgical outcomes. Just block off 6 PM CST for July 29, 2026. Created for Medical Providers. Special invitation for the Lay Public to learn what you need to ask your Plastic and Genital Surgeon to support your healing.REGISTRATION LINK: Click HEREDescription: Patient care doesn’t end when the procedure is over. In this educational session, Dr. Alinsod will share how supporting tissue health beyond the office can help enhance the patient experience, encourage adherence to treatment plans, and extend the continuum of care through thoughtful at-home support.For Doctors and Medical Staff: Attendees will also receive an exclusive introduction to the new CO2Lift® V Provider Direct Program—a new way to seamlessly integrate professional homecare into your practice while creating new opportunities to support patients long after they leave the office.You’ll leave with practical clinical insights, new ideas for strengthening patient care, and a clear understanding of how CO2Lift® is making recovery easier and reducing complications. It is truly an amazing technology that is changing lives. Whether you are a medical provider or potential future patient, this webinar will provide actionable strategies you can begin implementing right away to improve outcomes and reduce complications. Zoom Registration: Click on Link or Photo BelowREGISTRATION LINK: Click HEREPast Newsletters and Carboxytherapy PresentationsMore detailed and scientific presentations released over the past years on my Cosmetic Gynecology Newsletter:* CO2Lift Pro & Surgery, June 30, 2026* Carboxytherapy for Post Op Care for Gynecologic Cancer Surgery, April 28, 2026* CO2LiftV with Jennifer Owen, MD, October 27, 2025* CO2LiftV’s New Role for Post Op Healing, April 15, 2025* How CO2LiftV is Helping Patients, From a Panel of Urogynecologists, Marach 19, 2025* CO2LiftV for Vaginal Restoration, March 14, 2023* How Vaginal Restoration with Carboxytherapy is Changing in 2023, January 25, 2023* Carboxytherapy for Gynecologic Conditions, May 2, 2022FOR THE SURGEONThe BEST place to learn Cosmetic Gynecology from your home and office. Anywhere.GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Click here for Silver Bullet Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!NOW AVAILABLE IN SPANISH: CLICK HERE FOR GYNFLIX ESPANOL!For Cosmetic Gynecology Short Videos (free for all) go to Video Shorts on Gynflix. This is made for the Lay Public. Dozens of high def, high quality videos of actual surgeries.For Cosmetic Gynecology Before and After Video Gallery go HERE. The patient’s Story from Start to Finish.Let’s Stay ConnectedI’m so grateful for the opportunity to serve you, whether you’re a patient, a colleague, or someone curious about what we do. Our new Arlington location is ready to welcome you with the same compassionate, personalized care you’ve come to expect. Explore our services, my background, and our mission at:* alinsodinstitute.com* About Dr. Red Alinsod* About Alinsod InstituteI’d love to hear from you—reach out with questions, feedback, or just to say hello. Together, we’re shaping a brighter, healthier future for women everywhere.Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on InstagramasVageniusMD.I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty and Vaginoplasty Newsletter:Follow me on my Adventures WorldwideMY LOCATIONAlinsod Institute — Red M. Alinsod, MD📞 945-900-7576www.alinsodinstitute.comwww.gynflix.comLabiaplasty and Vaginoplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comDesription: A CORE video on Combination labial surgery. Standard Alinsod Curvilinear Labiamajoraplasty is performed first. Clitoral Hood Reduction is included in the Majorplasty markings and excision as a Unified Approach. A modest Labia Minoraplasty is performed separately and a little bit of labia is kept. This is more a Barbie-Hybrid approach and not a complete removal of the Labia Minora. The Soniquence fine Hair Tip incisions are shown. The Alinsod Bipolar Forceps, also made and sold by Soniquence, is shown as a dissecting tool as well as a precision hemostatic device.Keywords: Local Anesthesia, Markings, Alinsod Bipolar Soniquence, Combination, Curvilinear Labia Majoraplasty, Labiaplasty, Barbie Look Labiaplasty, Clitoral Hood Reductions, Lateral Clitoral Hood Reduction, O-Shot, PRP, Alinsod SpeculumHere is the Full Length 2+ hour video of the entire case for Gynflix Subscribers: AIAVS Fellows Video 237, Live Narrated Majoraplasty, Barbie Labiaplasty, CHR, O-ShotClick on the picture below for more Combination PicturesLabiaplasty and Vaginoplasty Newsletter is integrated into Gynflix.com and is a reader-supported publication. To receive new posts and support my work, become a paid subscriber. Gynflix.com is $98 a month for Silver Subscription which includes this newsletter. $198 for Gold. $69 for Espanol.More detailed Step-By-Step pictures below.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comLast year I published these three Newsletters to teach how to fix botched surgeries:* Vaginal Band Release* Grooving for Labial Creation* History of the Alinsod Grooving Technique to Create Labia Minora from No LabiaToday, this new video is a combination and compilation of these approaches. What to do when a prior procedure results in painful sex because of …

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis is my presentation to the General Congress Audience at the 1st Female Aesthetic Genital Academy’s 1st International Functional Cosmetic Gynecology Congress in Istanbul, Turkey. It covers all the main decision making and technical issues of my Alinsod Curvilinear Labiaplasty technique. I show how one technique is able to achieve just about any “Loo…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI am so honored to be invited to present my Alinsod Labiaplasty Technique at my friend Ozgur Leylek’s 1st Congress! I am so proud of Ozgur for taking on this HUGE task. What an accomplishment for one of the pillars of Turkish Cosmetic Gynecology. He joins my Fellows Suleyman Eserdag, MD, and Eser Agar, MD, to expand the specialty in Turkey and beyond…

Dryness, tightness, menopause, endometriosis, prolapse, childbirth injury, hysterectomy pain, mesh problems, skin disease, size mismatch, and treatment options explained in plain EnglishBy Red M. Alinsod, MDAlinsod Institute | Revique Medical & AestheticsArlington, TexasThis is a Pre-Release to this Labiaplasty and Vaginoplasty Newsletter. You get this one day earlier than everyone else. I will release this tomorrow on my Feminine Wellness Newsletter and Cosmetic Gynecology Newsletter in the next couple of days before I go on my Summer Vacation. Share this with your patients. It was written for the Lay Public in mind. Topics are trending and blowing up the Search Engines right now on “Painful Sex” and “Gaping Vagina.” I wrote this Lay version on my Feminine Wellness Newsletter on May 21, 2026. Share that with your patients also and strike while the iron is hot on these two search terms.PAINFUL SEXPainful sex is common. But it is not something a woman should be expected to silently endure. Too many just live with it.The medical term is dyspareunia, which means pain before, during, or after intercourse. Some women feel burning at the opening. Some feel tearing. Some describe “sandpaper.” Others feel deep stabbing pain, pelvic pressure, a “wall,” a tight band, or soreness that lasts for hours or days afterward. The American College of OBGYN notes that nearly 3 out of 4 women have pain with intercourse at some time in their lives.Common does not mean normal. Pain is not normal.Painful sex can come from the vulva, the vaginal opening, the vaginal canal, the pelvic floor muscles, the uterus, the bladder, the rectum, prior childbirth injuries, prior surgeries, mesh exposure, endometriosis, menopause, cancer therapy, or skin disease. Often, there is more than one cause. Detective work has to be done.My goal with this article is simple: to help you understand what may be happening, give you language for your symptoms, and show you that there are thoughtful medical, hormonal, regenerative, pelvic floor, and surgical options when the cause is properly identified. It is a pretty intensive Newsletter this month. Pick and choose what interests you and click on the links that lead to detailed explanations.Start here: Where does it hurt?The first question is not “What treatment do you want?”The first question is where is the pain?Pain at the openingPain at the vaginal opening often feels like burning, tearing, stretching, paper cuts, or “too tight.” This can happen with menopausal dryness, Genitourinary Syndrome of Menopause, lichen sclerosus, vestibulodynia, scar tissue, childbirth injury, prior labiaplasty, prior vaginoplasty, pelvic floor spasm, or a small/tight introitus. Take a look at these pictures for the many causes of Painful Sex at the opening:Pain inside the vaginal canalVaginal canal pain may feel like friction, dryness, narrowing, rubbing, rawness, or inability to stretch. This can happen after menopause, breastfeeding, hysterectomy, chemotherapy, pelvic radiation, hormone-blocking cancer therapy, scarring, or vaginal stenosis. Here are some causes of Painful Sex that is beyond that you can see on your own:Deep painDeep pain often feels like a collision. Patients say, “It feels like he is hitting something,” or “It only hurts in certain positions.” Deep pain can be related to endometriosis (lining of the uterus found outside the lining of the uterus), adenomyosis (endometriosis in the body of the uterus), fibroids (firm mass of muscle tissue found in the walls of the uterus), ovarian cysts, uterine prolapse, pelvic floor dysfunction, bladder pain, bowel pain, hysterectomy scarring, vaginal cuff tenderness, or cancer-treatment changes. Mayo Clinic lists deep thrusting pain as a dyspareunia pattern and includes endometriosis, uterine prolapse, adenomyosis, pelvic floor conditions, ovarian cysts, hysterectomy scarring, radiation, and chemotherapy among possible causes. Here are examples of pictures of the most common cause of Pelvic Pain: Endometriosis..Pressure, bulging, or “uncontrollable” sexA bulge, pressure, heaviness, looseness, blocked feeling, bowel trapping, or bladder urgency during sex may point toward pelvic organ prolapse: cystocele, rectocele, uterine prolapse, vaginal vault prolapse, or enterocele.* Transvaginal Uterine Suspension with Dermal Allograft SurgeryPartner painSometimes the partner feels hard “rocks” constipation stools. He can also feel poking, scratching, or sharpness. This can happen when mesh or permanent suture is exposed in the vagina. The FDA specifically advises patients with mesh to notify their provider if they have persistent vaginal bleeding or discharge, pelvic or groin pain, or pain with sex.Let’s systematically go over the main causes of Painful Sex once more in a bit more detail. This is not an exhaustive list but it does cover all the main culprits. I will organize and number them and also give you some of the therapies I use in my office to manage the problems:1. Menopausal dryness, tightness, and Genitourinary Syndrome of MenopauseOne of the most common and most under-treated causes of painful sex is Genitourinary Syndrome of Menopause, or GSM.GSM is the modern term for what used to be called vaginal atrophy or atrophic vaginitis. It is broader and more accurate because the problem affects more than the vagina. GSM can involve the vulva, labia, clitoris, vaginal opening, vaginal canal, urethra, bladder, and pelvic tissues.GSM can happen with:natural menopausesurgical menopause after ovary removalhysterectomy with hormonal changeschemotherapypelvic radiationbreast cancer endocrine therapyanti-estrogen medicationsbreastfeedingperimenopausemedications that reduce arousal or lubricationACOG explains that low estrogen can thin, dry, and inflame the vaginal walls, reducing lubrication, elasticity, and tissue comfort. Vaginal dryness can also happen after childbirth, breastfeeding, cancer treatment, or anti-estrogen medications.* The Aging Vagina and GSMWhat low estrogen does to the tissueEstrogen helps maintain vaginal and vulvar tissue thickness, moisture, blood flow, elasticity, pH balance, lubrication, and resistance to tearing. When estrogen stimulation drops, the tissue can become thin, dry, pale, tight, fragile, and inflamed.Women often describe:“sandpaper” sexburning at the openingtearing at the bottom of the vaginableeding after sexdryness that lubricant does not fixtightness that feels newpain with pelvic examsurinary urgency or recurrent UTIsloss of confidence and desire because sex now hurtsThis is not simply a lubrication problem. It is a tissue-health problem.2. “I use lubricant and it still hurts”Lubricant is helpful, but lubricant does not rebuild estrogen-deprived tissue.Lubricants reduce friction during sex. Moisturizers improve day-to-day tissue hydration. Both can be valuable. The 2025 AUA/SUFU/AUGS GSM guideline recommends vaginal moisturizers and lubricants to improve dryness and painful sex.But if the underlying issue is GSM, many patients need more than lubricant. Pull out the vaginal estrogens and Carboxytherapy and think about radiofrequency treatments such as ThermiVa or even the vaginal lasers. They both work well.The same guideline recommends offering local low-dose vaginal estrogen for GSM-related vulvovaginal dryness, discomfort, irritation, and dyspareunia. It also recommends offering vaginal DHEA as an option for GSM-related dryness and painful sex.Vaginal Estrogen OptionsVaginal estrogen can come as a cream, tablet, insert, or ring. ACOG explains that low-dose vaginal estrogen releases a small dose directly into the vaginal tissue to help restore thickness and elasticity and relieve dryness and irritation.Common forms include:Creams: flexible dosing and useful for vulvar and opening symptomsTablets or inserts: less messy and easy to useRings: steady release over time for patients who prefer less frequent dosingACOG states that topical estrogen for vaginal or vulvar dryness and pain with intercourse usually improves symptoms within a few weeks and acts locally on tissues.For cancer survivors, treatment should be individualized with the oncology team. The American Cancer Society notes that cancer therapy can cause vaginal dryness, thinning, narrowing, shortening, and painful sex, and that vaginal estrogen is sometimes used for dryness, narrowing, and atrophy after discussion with the cancer care team.Carboxytherapy OptionsThere is now a Carboxytherapy Gel treatment that gets results even faster than vaginal estrogens. It is made by Lumisque and called CO2LiftV or “The V.” In Latin America, Europe, Asia, carbon dioxide is injected under the skin to cause local tissue trauma and start the healing cascade to form new vessels, stimulate new collagen and elastin formation, and increase local moisture production. It hurts and is is not FDA approved in the USA. The Japanese came up with the same carbon dioxide treatment without the need for needles and with a mixture that created localized carbon dioxide that helped heal the skin. It was first used in the face as a mask then modified to work in feminine genital tissues. And it worked like Rocket Fuel in the speed of results obtained to create vaginal moisture and comfort. Not just for dry and thin skin but also for Lichen Sclerosus. The stuff works so well it is a CORE product for my Center of Excellence in Arlington, Texas. Go to www.lumisque.comfor info.Watch this Doctor Discussion on CO2LiftV: Doctor Discussion on The V3. Tightness is not always vaginismusMany women say, “I think I’m too tight.” That may be true, but the reason matters. Vaginismus is a type of sexual dysfunction. It happens when vaginal muscles cramp up or spasm involuntarily. We call them Levator Muscle Spasms. dYou can get aroused, get wet, but penetration is a No No and hurts too much. Even the touch of a QTip swab may incapacitate a patient! A woman may feel tight because of GSM dryness. She may have scar tissue from birth, episiotomy, perineal tearing, surgery, radiation, mesh, or a prior vaginal repair. She may have lichen sclerosus causing narrowing of the opening. She may have pelvic floor muscle guarding because sex has hurt for months or years. She may have vaginal stenosis after cancer therapy or surgery. An exam will help identify the problem. See a gynecologist and not a plastic surgeon or cosmetic surgeon or dermatologist. Family Practice specialists can be very helpful on the other hand. Cleveland Clinic describes vaginal stenosis as narrowing and shortening of the vagina from scar tissue, often after childbirth, surgery, or pelvic radiation, and notes that treatment may include vaginal dilators, estrogen medication, or vaginal moisturizers.The treatment for tightness depends on the cause. Dry tissue needs tissue restoration. Scar bands may need release. Pelvic floor spasm may need pelvic floor therapy. Lichen sclerosus needs skin-directed treatment. A shortened vaginal cuff after hysterectomy requires a different evaluation. Dilator work may be needed. Summary of what you can do for yourself: Vaginal estrogens, progressive dilator use, pelvic floor physical therapy, Carboxytherapy, Radiofrequency treatments such as ThermiVa. 4. Endometriosis, adenomyosis, and collision-type deep painDeep pain during sex often has a pelvic source.EndometriosisEndometriosis occurs when tissue similar to the uterine lining grows outside the uterus. Look back at the pictures I showed earlier. Notice it can involve the ovaries, fallopian tubes, pelvic lining, bowel, bladder, uterosacral ligaments, and tissue behind the vagina. Mayo Clinic lists pain during or after sex as a common symptom of endometriosis.Endometriosis can cause adhesions, scarring, and inflammation. During deep penetration, those tender or fixed areas may be hit or stretched, creating sharp “collision” pain that may last long after sex. The treatments for this are can be medication such as birth control pills, progesterone, and even medical menopause inducing shots to stop or reduce estrogen production that cause endometriosis to act up. Often times those medications fail and surgery to get rid of adhesions, chocolate spots, or remove organs such as the uterus, tube, and ovaries, may be needed. ACOG’s 2026 endometriosis diagnostic guideline focuses on improving evaluation and diagnosis for reproductive-aged adults and adolescents with symptoms suggestive of endometriosis. Your gynecologist can help with the diagnosis.AdenomyosisAdenomyosis happens when endometrial tissue grows into the muscle wall of the uterus. It can make the uterus enlarged, tender, heavy, crampy, and painful. Mayo Clinic lists heavy or long-lasting periods, severe cramping, chronic pelvic pain, painful sex, and lower abdominal pressure among adenomyosis symptoms.Patients may describe deep aching, cramping after sex, pelvic heaviness, or a bruised feeling when the uterus is contacted.The definitive treatment is to remove the uterus. A hysterectomy. It does not always work because those spots of endometrial tissue can implant in other places such as the bladder, the top of the vagina, the lining of the bowel and just about anywhere else. I have found them in the belly button, the inside of an ankle, on the outside of the labia, the inside of the labia, in the lungs, in the bones. Just about anywhere. 5. Pain after hysterectomy: vaginal cuff tenderness, scarring, and shortened vaginaAfter a total hysterectomy, the cervix is removed and the top of the vagina is closed. This closed top is called the vaginal cuff.Many women do well after hysterectomy. But some develop new pain with sex because of:vaginal cuff tenderness from unknown cause or short vaginal lengthgranulation tissue from the healing processscar tissue from the suturing can even entrap nervesnarrowing of the vaginal canalpelvic floor spasm triggered by traumatic surgery, vaginal delivery, examinationslack of estrogen stimulationovary removal and surgical menopause results in loss of estrogen producedendometriosis persistence in other locationsmesh or suture exposure when advanced reconstruction is donevaginal vault prolapse (fallen vagina) if the top is not properly anchoredMayo Clinic includes scarring from pelvic surgery, including hysterectomy, among causes of painful intercourse.A post-hysterectomy exam should look carefully at the cuff, the vaginal length, tissue mobility, estrogen status, pelvic floor muscles, and whether deep contact reproduces the patient’s pain.Things you can do by yourself to help: Vaginal Estrogens, Carboxytherapy, Radiofrequency treatments, Dilator work.6. Lichen sclerosus, lichen planus, and inflammatory vulvar diseaseNot all painful sex comes from inside the vagina. Sometimes the problem is the vulvar skin. This is a whole new other level of complex. Lichen sclerosusLichen sclerosus is an autoimmune chronic inflammatory skin condition that often affects the genital and anal areas. Mayo Clinic notes that lichen sclerosus can cause fragile skin, itching, burning, bleeding, open sores, painful sex, and scarring, and that postmenopausal women are at higher risk.Patients may notice:white patchesthin or shiny skinitchingburningpaper-cut tearsbleeding after sexpain at the openingclitoral hood scarringnarrowing of the introitusLichen sclerosus needs proper diagnosis and long-term follow-up. Treatment often includes high-potency topical steroids, vulvar skin care, estrogen support when GSM is present, and sometimes regenerative or surgical approaches for scarring and narrowing.* Lichen Sclerosus Part 1: The Silent Itch* Lichen Sclerosus Part 2: The Silent ItchLichen planus and lichenoid diseaseLichen planus can involve the vulva and vagina. Genital lichen planus looks like lacy white patches, sometimes with painful sores, and can cause scarring, severe pain, and painful sex.Other inflammatory causes include eczema, contact dermatitis, psoriasis, lichen simplex chronicus, recurrent yeast, bacterial vaginosis, allergic reactions, and vestibulodynia.The same treatments for Lichen Sclerosus often work with Lichen Planus. Go see your dermatologist first. If they cannot help you then we may be able to help with non-standard therapy such as radiofrequency, PRP, Exosomes, Hyaluronic Acid, and lasers. 7. Size mismatch: large penis, small vagina, short vagina, or painful depthSize mismatch is real, and patients deserve plain language.Pain may occur when a partner is long, wide, or both — especially if the patient has GSM, scarring, a short vaginal canal, a tender cuff, lichen sclerosus, pelvic floor spasm, vaginal stenosis, prolapse, or prior surgery.Possible solutions may include:restoring tissue moisture and elasticityusing high-quality lubricanttreating GSM with vaginal estrogen or DHEA when appropriatepelvic floor physical therapydilator therapyposition changes that limit depthpatient-controlled positionsdepth-limiting rings or devicestreating cuff tenderness, endometriosis, or prolapsesurgical correction when scar tissue or distorted anatomy is the causeA larger partner may simply reveal an underlying medical problem that a smaller partner did not trigger.Dilator WorkSurgical Band ReleaseThis is usually done in the surgery center but can be done in the office that is well equipped. This same method of band release can be applied to #8 below. Links to surgical Band Release in these two Newsletter Videos:* Perineal Band Release with Radiofrequency for Dyspareunia* Sutureless Band Release and the Management of the Tight Introitus8. Birth trauma, episiotomy scars, and perineal damageChildbirth can permanently change the perineum, vaginal opening, pelvic floor, and rectovaginal wall.The Royal College of Obstetricians and Gynaecologists states that up to 9 in 10 first-time mothers who have a vaginal birth experience some type of tear, graze, or episiotomy. Cleveland Clinic explains that vaginal tears range from first-degree tears to fourth-degree tears involving the anal sphincter and rectum, and notes that complications can include painful intercourse, fecal incontinence, ongoing pain, and soreness.Most tears heal well. Some do not.Post-birth causes of painful sex can include:painful episiotomy scarrigid perineal scarover-tight repairunder-repaired perineal bodygaping or loss of supportrectocelepainful scar bandsgranulation tissuefecal urgency or leakageloss of sensationpelvic floor spasmTreatments may include pelvic floor therapy, scar massage, topical estrogen, injections, perineoplasty, rectocele repair, revision of episiotomy scar, or reconstruction of the perineal body.The goal is not simply to make the vagina “tight.” The goal is to restore comfort, anatomy, support, and function.This is all done in the office under local anesthesia without IVs or intubation or spinals. 9. Pelvic organ prolapse: pressure, bulging, looseness, and painful sexTake a look at all the prolapse pictures I showed earlier. Pelvic organ prolapse happens when pelvic floor muscles and tissues no longer support the pelvic organs well. The FDA explains that prolapse can involve the vagina, cervix, uterus, bladder, urethra, and rectum, with the bladder being the most commonly involved organ.Common types include:Cystocele: bladder bulging into the front vaginal wallRectocele: rectum bulging into the back vaginal wallUterine prolapse: uterus dropping into the vaginaVaginal vault prolapse: top of the vagina dropping after hysterectomyEnterocele: small bowel bulging into the vaginal spaceMayo Clinic describes cystocele symptoms such as pelvic or vaginal pressure, a vaginal bulge, increased pressure with straining, urinary difficulty, incomplete bladder emptying, frequency, and leakage. Rectocele symptoms may include a vaginal bulge, trouble with bowel movements, rectal pressure, incomplete emptying, and sexual concerns such as looseness or embarrassment. Uterine prolapse can cause heaviness, tissue bulging, bladder emptying problems, bowel movement difficulty, pelvic pressure, and sexual concerns.During sex, prolapse may cause pressure, bulging, air trapping, bowel urgency, bladder urgency, pain, looseness, or a sense that sex is blocked or out of control.Treatment may include pelvic floor physical therapy, pessary fitting, vaginal estrogen, bowel management, bladder treatment, and surgery when symptoms are significant* What is the Bulge?10. Mesh, sutures, and prior surgery complicationsPrior surgery can help many women. But prior surgery can also cause pain when scarring, permanent sutures, vaginal shortening, adhesions, or mesh exposure develop.In 2019, the FDA ordered manufacturers to stop selling surgical mesh intended for transvaginal repair of pelvic organ prolapse because manufacturers had not demonstrated reasonable assurance of safety and effectiveness. The FDA also notes there are currently no FDA-approved surgical mesh products for transvaginal prolapse repair marketed in the United States.Mesh-related pain may involve:vaginal mesh exposurebleeding or dischargepartner discomfortscratchy or poking sensationpelvic paingroin paindyspareuniascar contractionnerve irritationrecurrent prolapseurinary or bowel symptomsSome patients need estrogen and observation. Some need trimming of a small exposure. Others need complex revision or removal. These are individualized, anatomy-driven decisions.These simple trims sometimes are inadequate to relive Painful Sex or Pelvic Pain. The entire mesh had to be removed by the finest pelvic surgeons in the land. It is a very tough dissection and excision and not for the faint of heart. 11. When prior labiaplasty or vaginoplasty causes painThis is a sensitive topic, but it needs to be discussed.Some patients develop painful sex after prior labiaplasty, clitoral hood reduction, vaginoplasty, perineoplasty, or “tightening” surgery. ACOG cautions that female genital cosmetic procedures can have complications including pain, bleeding, infection, scarring, adhesions, altered sensation, dyspareunia, and need for reoperation. Cleveland Clinic also lists labiaplasty complications such as wound breakdown, scarring, ongoing pain, pain with sex, or loss of sensitivity.Patients may search online for “botched labiaplasty” or “botched vaginoplasty.” In the office, I prefer to describe what actually happened anatomically:wound breakdownnotchingpainful scarover-resectionasymmetrykeloid or hypertrophic scartethered tissuepainful clitoral hood scarringover-tightened introitusinternal vaginal scar bandsshortened vaginal canaldistorted openingloss of tissue mobilityRevision surgery is highly specialized. It may involve scar release, layered closure, flap advancement, RF Feathering, mucosal advancement, perineoplasty, grafting, fat grafting, or careful reconstruction of the opening and canal. You have to find the highest volume revision specialist to avoid being botched. The goal is comfort, function, appearance, sensation, and mobility — not simply “making it look better.”Dr. Alinsod’s professional materials describe his long-standing work in aesthetic vulvovaginal surgery, pelvic reconstructive surgery, physician training, and development of surgical techniques, with more than 28 years of teaching and presentations worldwide.Examples of Labiaplasty Surgery resulting in Pain:* Feathering for Botched Labiaplasty Repair12. Vaginismus and pelvic floor guardingVaginismus is involuntary tightening or spasm of the pelvic floor muscles around the vagina. It can make penetration painful or impossible.Sometimes vaginismus is the main condition. Other times it develops secondarily because the body has learned that penetration hurts. A woman with GSM, endometriosis, lichen sclerosus, birth trauma, mesh pain, or vaginal scarring may begin to guard. The pelvic floor tightens in anticipation of pain, which creates more pain.Mayo Clinic lists vaginismus as a cause of painful penetration and notes that stress can tighten pelvic floor muscles, contributing to pain during intercourse.This is why telling a patient to “relax” is not enough. The muscles may be reacting automatically to a real pain generator.13. Pelvic floor physical therapy and dilator therapyPelvic floor physical therapy is often one of the most important parts of treating painful sex, especially when muscle guarding, vaginismus, pelvic floor dysfunction, postpartum injury, scar pain, or chronic pain cycles are present.Therapy may include:external and internal muscle assessmenttrigger point releasemyofascial releasescar mobilizationbreathing and nervous system down-trainingbiofeedbackpelvic floor coordinationhome exercisesgraded dilator therapyreturn-to-intercourse planningDilators: what they do and what they do not doDilators are not used to “force the vagina open.” They are used to gradually teach the tissues and pelvic floor muscles that gentle insertion can be safe.Memorial Sloan Kettering explains that vaginal dilators can help when the vagina becomes drier, less elastic, narrower, or shorter after menopause, cancer treatment, or surgery, and that patients usually start with the smallest dilator and increase size gradually. Cleveland Clinic describes dilators as a treatment option for pain with penetration and pelvic floor dysfunction, helping gradually improve flexibility and comfort.A safe dilator plan should be gentle, guided, and never forced. Pain is information. If dilators worsen symptoms, the plan needs to be adjusted. Here is a video example link on Vaginal Softening Exercises to show it is done in my office: Vaginal Softening Exercise14. Treatment options: matching the treatment to the causePainful sex does not have one universal treatment. The best treatment depends on the diagnosis.Foundational treatmentsProblem: Common treatments: GSM dryness/tightnessVaginal estrogen, vaginal DHEA, moisturizers, lubricants, vulvar carePelvic floor spasm/vaginismusPelvic floor PT, dilators, breathing, manual therapy, sometimes medications/injectionsLichen sclerosus/lichen planus diagnosis, topical steroids or immune therapy, vulvar care, estrogen if GSM overlaps.Endometriosis/adenomyosis: Imaging, medical management, surgical evaluation when appropriate.Birth trauma/scarringScar therapy, estrogen, pelvic floor PT, perineoplasty or revision if neededProlapsePelvic floor PT, pessary, estrogen, bowel/bladder management, prolapse repairMesh exposure/pain, Estrogen, observation, trimming, revision, removal, pelvic floor therapy.Prior labiaplasty/vaginoplasty pain: Scar release, reconstruction, revision surgery, pelvic floor therapySize/depth mismatch, tissue restoration, position changes, depth control, PT, treatment of anatomy/pain source.15. Hormonal and prescription options for GSM-related painful sexVaginal estrogenAs mentioned earlier, vaginal estrogen is often foundational. It can improve tissue thickness, elasticity, moisture, pH, and comfort. ACOG lists vaginal estrogen creams, rings, and tablets as options that deliver lower estrogen than systemic hormone therapy and have fewer risks.Vaginal DHEAVaginal DHEA, also called prasterone, is a prescription intravaginal option for GSM-related dyspareunia. The 2025 AUA/SUFU/AUGS guideline recommends offering vaginal DHEA for GSM-related dryness and painful sex.It should not be called “hormone-free,” because it works through local hormone conversion inside tissues. A better phrase is a non-estrogen intravaginal prescription option.OspemifeneOspemifene is an oral selective estrogen receptor modulator that may be used in selected patients for GSM-related dryness or dyspareunia. The 2025 AUA/SUFU/AUGS guideline says clinicians may offer ospemifene for these symptoms.Vaginal testosteroneVaginal testosterone is sometimes discussed for low arousal, low sensitivity, vestibular pain, or GSM-related symptoms, but it is generally off-label and evidence is still developing. The 2025 AUA/SUFU/AUGS guideline notes insufficient evidence to support clinical recommendations for vaginal or systemic testosterone for GSM symptoms.In a Substack article, I would present testosterone as individualized and investigational/off-label, not as a proven standard GSM therapy.And don’t forget about Carboxytherapy! It is non-hormonal, non-prescription and available at our office. 16. Energy-based treatments, biologics, and regenerative adjunctsThis section is important, and it must be written with balance.Patients hear about “vaginal rejuvenation,” radiofrequency, lasers, plasma, PRP, and carboxytherapy online. Some patients have had good experiences. Others have been disappointed or harmed. The best approach is honest counseling.ACOG states that the FDA has not approved laser or other energy-based treatments for vaginal cosmetic surgery, menopausal symptoms, urinary incontinence, or sexual problems, and warns that serious problems can include burns, scarring, pain with sex, and long-lasting pain. With that being said, ACOG is a decade behind the times and closes its eyes to progress made. The energy based devices such as radiofreuquency and lasers are exceptionally safe in the well trained hands. And they work. Go watch the video on this dedicated Newsletter for more details:The 2025 AUA/SUFU/AUGS GSM guideline states that evidence does not support CO₂ laser, Er:YAG laser, or radiofrequency for GSM-related dryness, discomfort, dysuria, quality of life, satisfaction, or dyspareunia outcomes; it also says CO₂ laser may be considered only in shared decision-making when patients are not candidates for or prefer alternatives to FDA-approved treatments, with disclosure that therapy is experimental outside clinical trials.That does not mean these tools have no role in any patient. It means they should be framed as adjuncts, not replacements for diagnosis, tissue evaluation, GSM treatment, pelvic floor therapy, or surgery when anatomy is the problem.* The Synergy of Energy Plus BiologicsThermiVa radiofrequencyThermiVa is a radiofrequency technology associated with vulvovaginal tissue heating and tightening. The Alinsod Institute states that ThermiVa was invented by Red Alinsod, MD, and developed in collaboration with ThermiAesthetics. Link for info:* Feminine Restoration 2024: State-Of-The-Art Introduction to FemXHA* ThermiVa from Start to Finish* What is ThermiVa Radiofrequency Treatment?Jett Plasma / plasmaporationThe Alinsod Institute describes Jett Plasma as a direct-current technology used in vulvovaginal therapy, with proposed mechanisms involving heat, membrane depolarization, and reversible electroporation. Link for info:* Plasmaporation for Gynecology ISCG 2025Fractional CO₂ and Erbium lasersExamples include MonaLisa Touch-type CO₂ platforms and Erbium systems such as Sciton diVa. These should be discussed with clear consent about evidence, FDA status, risks, alternatives, and expected outcomes.PRP and biologicsPlatelet-rich plasma and related biologic approaches are used by some clinicians for tissue quality, sensitivity, lubrication, and healing support. These should also be presented as adjunctive and individualized. Link for info: * Feminine Restoration 2024: State-Of-The-Art Introduction to FemXHA* Clitoxin for Improved Female Sexual Response17. Surgical treatment: when anatomy is the problemSurgery is not the answer for every patient. But when anatomy is the pain generator, surgery may be the most direct solution.Surgical options may include:perineoplastyrevision of episiotomy scarvaginal scar band releasevaginal cuff revisionrectocele repaircystocele repairuterine prolapse repairvaginal vault prolapse repairmesh exposure revision or removallabiaplasty revisionvaginoplasty revisionvulvar scar releaselysis of adhesionsendometriosis surgerybirth trauma reconstructionA successful surgical plan must respect function, sensation, tissue health, estrogen status, pelvic support, and the patient’s goals.* It’s Too Tight!18. Why integrated care mattersPainful sex rarely belongs to only one specialty.A menopausal patient may also have lichen sclerosus.A prolapse patient may also have GSM.A hysterectomy patient may have cuff pain and pelvic floor spasm.A cancer survivor may have stenosis, dryness, and fear of penetration.A postpartum patient may have scar pain, rectocele, and muscle guarding.A mesh patient may have exposure, estrogen-deprived tissue, and nerve pain.A prior labiaplasty patient may have scar tethering plus vestibular pain.This is why an integrated approach matters.At the Alinsod Institute and Revique Medical & Aesthetics in Arlington, Texas, Dr. Red Alinsod, Amy Haddad, RNP, and Dian White, MA, provide a model that brings surgical and non-surgical options together. The Alinsod Institute describes Dr. Alinsod’s work in urogynecology, pelvic reconstructive surgery, aesthetic vulvovaginal surgery, physician education, Gynflix, and innovation in vulvovaginal techniques. Gynflix is as an online training platform for physicians and surgeons in reconstructive pelvic surgery and aesthetic vulvovaginal surgery. The 1st and only one of its kind in the world. 20 years in the making.Revique Medical & Aesthetics lists services including hormone replacement, peptide therapy, advanced lab testing, women’s intimate health, ThermiVa, Emsella, O-Shot, Clitoxin, and related wellness services.The goal is not to sell one procedure. The goal is to identify the real cause and match the treatment to the tissue, anatomy, muscles, hormones, and patient goals. The goal is teamwork, excellence, and Platinum Service. Pelvic Pain Review written by my friend John Paulson:19: Interstitial Cystitis / Bladder Pain Syndrome: The Great Imitator of Pelvic PainAnother major cause of painful sex that is often missed is Interstitial Cystitis, also called Bladder Pain Syndrome, or IC/BPS. I am going go spend a bit more time on this because it is so frequently missed and overlooked. The average patient sees about 7 doctors before this diagnosis is even brought up. IC is a chronic pain condition involving the bladder and surrounding pelvic tissues. It can cause bladder pressure, bladder pain, pelvic pain, urinary urgency, urinary frequency, and pain with sex. Mayo Clinic describes IC as a chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain, with pain ranging from mild discomfort to severe pain. It also notes that symptoms can flare with menstruation, stress, sitting for a long time, exercise, and sexual activity.I often call IC “The Great Imitator” because it can look and feel like so many other pelvic pain conditions.It can feel like endometriosis.It can feel like adenomyosis.It can feel like a recurrent urinary tract infection.It can feel like pelvic floor spasm.It can feel like vaginal cuff pain after hysterectomy.It can feel like deep dyspareunia or collision pain.It can even trigger burning, urgency, and pelvic pressure that patients may assume is coming from the vagina, uterus, ovaries, or bowel.This is why IC must be part of a thorough painful-sex evaluation, especially when a patient has chronic pelvic pain, urinary urgency, bladder pressure, pain that worsens with bladder filling, or pain that persists despite treatment for endometriosis.IC and endometriosis: the “evil twins”Interstitial cystitis and endometriosis frequently overlap. Some studies in chronic pelvic pain populations have reported very high coexistence rates. One review reported that among patients with endometriosis, 86% were also diagnosed with IC, and among patients with IC, 72% were also diagnosed with endometriosis.I would word this carefully for patients: “In some chronic pelvic pain studies, IC has been found in nearly 90% of women with endometriosis.” That is powerful and accurate, but it avoids implying that 90% applies to every endometriosis patient in every setting. Broader reviews show wide variation in coexistence rates, with one 2024 meta-analysis reporting coexistence of endometriosis and IC/BPS in chronic pelvic pain populations ranging from 15.5% to 78.3%.The practical point is this: if a woman has endometriosis and painful sex, bladder pain syndrome should be on the checklist. Treating endometriosis alone may not resolve pain if IC is also present.What IC feels likePatients with IC may describe:bladder pressurepelvic pressureburning pelvic painpain with bladder fillingrelief after urinationurinary urgencyurinary frequencywaking at night to urinatepain during or after sexpain with pelvic examspain that flares before or during the periodpain after certain foods or drinkssymptoms that feel like a UTI but urine cultures are negativeNIDDK explains that IC pain often worsens as the bladder fills and improves after urination. Patients may also feel pain in the groin and pelvic floor muscles, and symptoms may include pelvic pressure, tenderness, urinary urgency, and urinary frequency. Mayo Clinic similarly notes that IC symptoms can resemble a chronic urinary tract infection, but there is usually no infection.This “UTI feeling without infection” is one of the biggest clues.Why IC causes painful sexSex can irritate the bladder, urethra, pelvic floor muscles, and anterior vaginal wall. For some women, penetration places direct pressure on the bladder base. For others, the pelvic floor muscles tighten in response to bladder pain, creating a secondary vaginismus-like guarding pattern.This can produce:burning during penetrationdeep anterior vaginal painbladder pressure during sexurgency during or after sexpain after orgasmpelvic cramping after sexa flare that lasts hours or daysNIDDK notes that chronic pelvic pain and vulvodynia can be associated with pain during sex, and that sex may increase bladder pain flares in some patients with IC. This is one reason IC can be confused with endometriosis, pelvic floor dysfunction, GSM, vulvodynia, hysterectomy cuff pain, or prolapse-related pressure.What causes IC?The exact cause is not fully known. It is likely not one single disease in every patient, but a syndrome with multiple pathways.Possible contributors include:a damaged or “leaky” protective bladder liningbladder wall inflammationoveractive pain nervespelvic floor muscle dysfunctionimmune or allergic factorsmast-cell activationprior infections that trigger lingering pain sensitivitycentral sensitization, where the nervous system becomes more reactiveoverlap with other chronic pain conditions such as IBS, fibromyalgia, vulvodynia, migraine, and chronic fatigueMayo Clinic states that the exact cause is unknown, but possible contributors include a defect in the protective bladder lining that may allow irritating substances in urine to affect the bladder wall, as well as possible autoimmune, hereditary, infection-related, or allergy-related factors. NIDDK also notes that IC is more likely to occur with other chronic pain conditions, gastrointestinal disorders, allergies, autoimmune diseases, depression, and anxiety.How IC is diagnosedThere is no single simple test that proves every case of IC. The diagnosis is usually made by listening carefully to the symptoms, examining the pelvis and pelvic floor, ruling out infection, and looking for other conditions that can mimic or coexist with IC.Evaluation may include:urinalysis and urine culturepelvic examassessment of pelvic floor tenderness and spasmscreening for endometriosis, adenomyosis, vulvodynia, GSM, and prolapsebladder symptom questionnairescystoscopy in selected patientsevaluation for Hunner lesions in more severe or classic bladder-centered casesThe important point is that repeated antibiotics for “UTIs” without positive cultures may delay the real diagnosis. If the cultures are negative and the symptoms keep returning, IC/BPS deserves consideration.Treatment for IC/BPSTreatment is individualized. There is no one-size-fits-all cure, but many patients improve when the correct pain generators are addressed.Lifestyle and trigger managementMany patients learn that certain foods or drinks flare their bladder. Common triggers include caffeine, carbonated drinks, citrus, tomatoes, alcohol, spicy foods, artificial sweeteners, and high-acid foods. Mayo Clinic lists the “four Cs” as common bladder irritants: carbonated beverages, caffeine, citrus products, and high-vitamin-C foods.A bladder diary or food diary can help identify patterns without making the patient feel afraid of food.Bladder trainingBladder training can help reduce urgency and frequency by gradually increasing the time between voids. NIDDK notes that bladder training may help the bladder hold more urine, reduce pain and urgency, and decrease bathroom trips.Pelvic floor physical therapyPelvic floor physical therapy is often essential. Many IC patients have tight, reactive, painful pelvic floor muscles. These muscles may need relaxation, lengthening, trigger-point release, myofascial work, breathing techniques, and down-training.This is not the same as Kegels. In fact, NIDDK specifically advises that patients with IC symptoms should avoid pelvic floor strengthening exercises such as Kegels unless working with a physical therapist.Oral medicationsDepending on the patient, medications may include:anti-inflammatory pain relieversbladder pain medicationstricyclic antidepressants such as amitriptyline to help calm pain signaling and relax the bladderantihistamines in selected patients with allergic or mast-cell featurespentosan polysulfate sodium, also known as Elmiron, in selected casesMayo Clinic lists tricyclic antidepressants, antihistamines, and pentosan polysulfate sodium among medication options for IC. It also notes that pentosan polysulfate may take months to help and has been associated with macular eye disease in some patients, requiring eye monitoring.Bladder instillationsSome patients benefit from bladder instillations, where medication is placed directly into the bladder through a small catheter. Mayo Clinic describes DMSO bladder instillation and other instillation mixtures that may include lidocaine, sodium bicarbonate, heparin, or pentosan.Neuromodulation and proceduresFor persistent symptoms, options may include TENS, sacral nerve stimulation, bladder hydrodistention, Botox injections into the bladder wall, and treatment of Hunner lesions when present. NIDDK lists neuromodulators, bladder instillation, bladder stretching or hydrodistention, Botox, and electrocauterization of Hunner lesions among treatment approaches.Surgery is rarely needed for IC and is generally reserved for severe, refractory cases because major bladder surgery does not always cure the pain.Why IC belongs in a painful-sex articleIC is one of the most important missed diagnoses in women with painful sex and chronic pelvic pain.A woman may come in thinking she has recurrent UTIs.Another may think her endometriosis has returned.Another may believe her hysterectomy cuff is the only problem.Another may have GSM dryness and bladder pain at the same time.Another may have pelvic floor spasm that started because the bladder was painful.The key is to look for all contributors, not just the most obvious one.When IC is present, treating the bladder, pelvic floor, hormones, vulvar tissue, endometriosis, prolapse, or scar pain together can make the difference between partial relief and meaningful recovery.20. When should you schedule an evaluation?Consider evaluation if you have:pain with sex that keeps returningburning, tearing, or bleeding after sexdryness that lubricant does not fixnew tightness after menopause, hysterectomy, childbirth, or cancer therapydeep pelvic pain with penetrationpain after hysterectomypain after labiaplasty or vaginoplastyvulvar itching, white patches, fissures, or scarringa vaginal bulge, pressure, or heavinessdifficulty emptying bladder or bowelpain or partner discomfort after mesh surgerysex that has become impossible or frightening because of painYou do not need to know the diagnosis before you call. That is what the evaluation is for.A personal notePainful sex is not just about sex.It affects relationships, confidence, mood, sleep, identity, and how a woman feels in her own body. Many women apologize when they finally bring it up.Please do not apologize. It surely is more common than you think. Your pain is real. Your story matters. And in many cases, there are answers.At the Alinsod Institute and Revique Medical & Aesthetics in Arlington, Texas, our goal is to listen carefully, examine respectfully, explain clearly, and build a plan that fits your body and your life.I hope this Newsletter helps your understanding of Painful Sex. Do something about it. Don’t live with it. Don’t ignore it. It does not get better with time. Watch how these procedures are doneFor Patients and Physicians who want to understand the surgical artistry and technical details, I encourage you to visit www.gynflix.com.Gynflix includes a section called Video Shorts, which is designed for both patients and doctors and features educational videos about procedures, outcomes, and post-operative care. (Gynflix)The Shorts section includes many videos related to vaginoplasty, perineoplasty, posterior compartment repair, combined procedures, and radiofrequency treatments. (Gynflix)Here is an example of the videos found on Video Shorts section of Gynlix.com:FOR THE SURGEONI built an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Click here for Silver Bullet Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!NOW AVAILABLE IN SPANISH: CLICK HERE FOR GYNFLIX ESPANOL!For Cosmetic Gynecology Short Videos (free for all) go to Video Shorts on Gynflix. This is made for the Lay Public. Dozens of high def, high quality videos.Let’s Stay ConnectedI’m so grateful for the opportunity to serve you, whether you’re a patient, a colleague, or someone curious about what we do. Our new Arlington location is ready to welcome you with the same compassionate, personalized care you’ve come to expect. Explore our services, my background, and our mission at:* alinsodinstitute.com* About Dr. Red Alinsod* About Alinsod InstituteI’d love to hear from you—reach out with questions, feedback, or just to say hello. Together, we’re shaping a brighter, healthier future for women everywhere.Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD.I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty and Vaginoplasty Newsletter:Follow me on my Adventures WorldwideMY LOCATIONAlinsod Institute — Red M. Alinsod, MD📍 Same location📞 945-900-7576🌐 www.alinsodinstitute.comwww.gynflix.comLabiaplasty and Vaginoplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis video is self explanatory. She has a Stage 3 Cystocele, Stage 2 Rectocele, Stage 2 Uterine Prolapse, and Severe Stress Incontinence. She also complains of vaginal laxity and lack of friction during sex. She does not want a hysterectomy so I will suspend her uterus with the aid of the VNew Dermal Allograft I designed. This case is done in the Su…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comNo big bulges on this case and just a gaping introitus and vaginal laxity. She wants her labia majora to be tighter and has no concerns about volume. She likes the athletic and sleek look. This video is part of Gynflix Module S9 that covers Combination Labial and Vaginal Surgeries. It is free for Gynflix Gold Subscribers: If you want Module S8 Combination Labial Surgeries you can go click HERE: Combination Labial Surgery. This is also free for Gynflix Gold Subscribers.Surgical Steps

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI focus on getting rid of the posterior bulges. In this case a large rectocele and an enterocoele sneaking in and can be easily missed. If you do not close up that sac you will increase your failure rate. You may cure a rectocele made of large bowel/rectum only to have another bulge grow and blow but but this time filled with small bowel. You need to close both sacs. Here are the steps for my Posterior Compartment Repair using the Levatorplasty method that is integrated into the vaginoplasty tightening. I also include the short section on getting rid of an enterocoele and securing the closure of the potential space that an enterocoele can slide into. This also includes the Perineoplasty to eliminate the gaping vagina.Labiaplasty and Vaginoplasty Newsletter is a reader-supported publication. Subscribe to be a paid subscriber and receive all content. Join www.gynflix.com and receive my newsletters at no additional cost.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comTime to notch up the difficulty level. What do you do when the patient needs both labial surgery of various kinds because she has minora and majora issues? Plus she has a rectocele, vaginal laxity, as well as a gaping introitus? How do you make it all look beautiful and symmetric? She wants a Barbie Look Labiaplasty and an eventual Clamshell Look wit…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis patient had a prior labiaplasty and does not like the way the edge just look. She wants them smoother. She also wants to look more virginal and have the opening of her vagina more like a letter “V” instead of a letter “U.” How do you do that at the same time you're doing a revision and feathering procedure? Here's a good case to learn from. Do t…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comNow it's time to dive in and learn how to do a Perineoplasty from start to finish. And what to do when it breaks down a week later. Do you leave it alone, do you fix it right away, when is a good time to do the repair? If you do enough of these cases, breakdowns will happen. I used to get breakdowns in the 4 to 7% range when I was using Vicryl suture bo…

We’re excited to share an important milestone for the Gynflix community. English Version:🎉 Introducing Gynflix Español: Two Year in the Making!Advanced Cosmetic Gynecology Education — Now Available in Spanish. And so affordable!At Gynflix, our mission has always been to provide high-quality, clinically relevant, and low cost education for physicians practicing cosmetic and aesthetic gynecology. Today, we are proud to expand that mission with the official launch of Gynflix Español — a Spanish-language learning experience designed for Spanish-speaking healthcare professionals worldwide.This new module removes language barriers while maintaining the same depth, clarity, and surgical excellence Gynflix is known for. With exceptional value pricing and convenience and Top Notch support also in Spanish.✨ What Gynflix Español Offers* Spanish-language surgical and non-surgical video content* Expert instruction focused on real-world clinical application* Flexible, on-demand learning — anytime, anywhere* Personalized Zoom discussions with Dr. Red Alinsod* Member newsletters and dedicated technical supportWhether you are refining existing skills or expanding your practice offerings, Gynflix Español allows you to learn confidently and efficiently — in your preferred language.📌 Membership Options for Gynflix Español* $69/month* $759/yearYour subscription includes access to all current Spanish-language content, with additional videos added over time. Over 100 full length videos I have used in my teaching programs for the past 20+ years are now yours to learn from in Spanish. No place else to find such depth of content with all my secrets. Nothing is held back. 👉 Start Learning TodayVisit https://gynflix.com/gynflix-espanol/ to subscribe and begin exploring GynFlix Español.Thank you for being part of our growing global community of dedicated medical professionals. We’re honored to support your continued education and commitment to exceptional patient care.Warm regards,The Gynflix TeamEnglish: Suzette Peterson, +1 (909) 374-1000, [email protected] Spanish: Marizol Carranza: +1 (949) 573-5804, [email protected]ón en español:Ahora disponible: Gynflix Español — Educación avanzada en ginecología cosméticaAhora disponible: Gynflix Español — Educación avanzada en ginecología cosmética. Y bastante asequible.Nos complace compartir un hito importante para la comunidad de Gynflix.🎉 Presentamos Gynflix EspañolEducación Avanzada en Ginecología Cosmética — Ahora Disponible en EspañolEn GynFlix, nuestra misión siempre ha sido ofrecer educación de alta calidad y clínicamente relevante para médicos que ejercen la ginecología cosmética y estética. Hoy, nos enorgullece ampliar esa misión con el lanzamiento oficial de Gynflix Español, una experiencia de aprendizaje en español diseñada para profesionales de la salud de habla hispana en todo el mundo.Este nuevo módulo elimina las barreras del idioma, manteniendo la misma profundidad, claridad y excelencia quirúrgica por las que Gynflix es reconocido.✨ ¿Qué ofrece Gynflix Español?* Contenido en video quirúrgico y no quirúrgico en español* Instrucción experta enfocada en la aplicación clínica real* Aprendizaje flexible y bajo demanda — en cualquier momento y lugar* Conversaciones personalizadas por Zoom con el Dr. Red Alinsod* Boletines informativos para miembros y soporte técnico dedicadoYa sea que esté perfeccionando habilidades existentes o ampliando los servicios de su práctica, Gynflix Español le permite aprender con confianza y eficiencia — en su idioma preferido.📌 Opciones de membresía: Gynflix Español* $69/mes* $759/añoSu suscripción incluye acceso a todo el contenido actual en español, con nuevos videos que se agregarán continuamente. Más de 100 vídeos completos que he usado en mis programas docentes durante los últimos 20+ años ahora están a tu disposición para aprender en español. No hay otro lugar donde encontrar tanta profundidad de contenido con todos mis secretos. Nada se retiene.👉 Comience a aprender hoyVisite https://gynflix.com/gynflix-espanol/ para suscribirse y comenzar a explorar GynFlix Español.Gracias por formar parte de nuestra creciente comunidad global de profesionales médicos comprometidos. Nos honra apoyar su educación continua y su dedicación a brindar una atención excepcional a sus pacientes.Cordialmente,El equipo de GynflixEnglish: Suzette Peterson, +1 (909) 374-1000, [email protected] Espanol: Marizol Carranza: +1 (949) 573-5804, [email protected] INSTITUTE and REVIQUE IN ARLINGTON, TEXASThe Warm Glow is real. You will be pampered. We have moved in!We are having our Grand Opening on March 26, 2026 from 4-7 PM!It has taken many months of planning and many more months of building out our beautiful new office here in the Veridian of Arlington, Texas. We will have family and friends and Arlington’s leaders for our ribbon cutting the day before. On Thursday, March 26, a little more than a month away, we will open our doors to you our patients and our friends and show off our new home and what we offer. Read the announcement below and click on it to sign up and attend. Or just show up! If you show up in person you may win one of my raffled treatments! Can’t beat FREE!🩺 Our New Partnership in ArlingtonThis part brings me deep pride.Just a few months ago, I opened my independent solo surgical practice here in Arlington. After decades in California, years of teaching around the world, and training thousands, it feels good to bring my craft into a private, intimate setting where I can focus on the highest-quality surgical work.Now, Amy Haddad, RNP, opens Revique in the same medical complex.Two practices.Two experts.One integrated vision for women’s health.Together, we offer:✔ surgical + nonsurgical excellence✔ personalized and private care✔ evidence-based regenerative therapies✔ advanced aesthetic and anti-aging medicine✔ a team with 50+ years combined experience✔ a bond built over nearly a decadeThis is a union you will not find anywhere else. Teamwork at its best.⭐ North Texas Is Now the Center of the Universe for Cosmetic GynecologyI have taught surgeons from just about every continent.I have seen the evolution of this specialty from the inside. I am part of the history.And I can say with total confidence:North Texas is now the epicenter of modern Feminine Wellness.With Amy leading nonsurgical care at Reviqueand my surgical services through the Alinsod Institute,Texas patients no longer need to travel across the country for world-class expertise.It is here.It is local.And it is unmatched.We welcome the world and the other 49 states.📍 Location & ContactRevique Medical & Aesthetics — Amy Haddad, MSN, APRN, FNP-C📍 4040 N Collins St, Suite 134, Arlington, TX 76005📞 817-533-0988📧 [email protected]🌐 www.reviquemedical.comAlinsod Institute — Red M. Alinsod, MD📍 Same location📞 945-900-7576🌐 www.alinsodinstitute.com🌐 www.gynflix.comA Personal Closing NoteMy career has been blessed with great teachers, great students, and great colleagues.Amy is all three.She has earned every accomplishment through relentless dedication and genuine care for her patients.I am honored to work alongside her once again.I am proud to welcome her into her own private practice.And I truly believe she will set a new standard of excellence for women in North Texas.Revique Medical & Aesthetics is OPEN!!!Appointments are now being accepted.— Red M. Alinsod, MDLearn more about Amy Haddad, RNP: Click on pictureLearn more about Red Alinsod, MD: Click on pictureSocial Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on InstagramasVageniusMD.I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty and Vaginoplasty Newsletter:ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576 Contact: Dian WhiteDr. Red Alinsod: [email protected] Contacts:English: Suzette Peterson, +1 (909) 374-1000, [email protected] Spanish: Marizol Carranza: +1 (949) 573-5804, [email protected] This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThe goal of this surgery is to make the vaginal opening look virginal. From a letter “U” to a letter “V” with the labial right and labial left meet in the midline bottom of the letter “V.” I often do this surgery at the time of labiaplasty when there is a gaping vaginal opening. Here are examples:

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comLet's be honest. The majority of Gynecologist and Plastic surgeons and Cosmetic Surgeons who say they're performing vaginal tightening surgery, vaginal rejuvenation surgery, vaginoplasty, are really performing a modification of an episiotomy repair or superficial perineoplasty. Not too many people are trained for full depth vaginoplasty that brings the …

ABOUT DR. RED ALINSODFounder, The Alinsod Institute for Aesthetic Vulvovaginal SurgeryFounder, Gynflix – Global e-Learning for Cosmetic GynecologyCosmetic Gynecologist • Urogynecologist • Surgeon • InnovatorPersonal Note: My good friend Marco Pelosi III released this hilarious AI Video of me on Instagram yesterday and it cracked me up!!! ISCG 2026is around the corner (March 12, 13, 14 2026) in Fort Lauderdale, Florida, and I will be there to talk about surgery surgery surgery. If you are doing Cosmetic Gynecology YOU HAVE TO GO!!! Meet the world leaders and learn from the Best of the Best. Click here for more info: ISCG 2026. One of The World’s Most Influential Cosmetic Gynecologist — Now in Arlington, TexasFor more than 30 years, Dr. Red M. Alinsod has shaped, guided, and redefined the field of cosmetic gynecology. He is not simply a practitioner—he is the surgeon and teacher who invented many of the core techniques, technologies, and in-office surgical methods used by specialists worldwide today. Women seeking labiaplasty, vaginoplasty, or complex reconstructive repair routinely travel from across the U.S. and abroad to be treated by the physician who created the methods now considered global standardsHis work blends surgical precision, restorative artistry, and a gynecologist’s deep understanding of vulvovaginal anatomy and function. This rare combination has made him a trusted authority for patients, surgeons, and medical societies around the world.Dr. Alinsod now brings this lifetime of innovation and excellence to Arlington, Texas, offering women access to one of the most experienced and respected cosmetic gynecologic surgeons on the planet.A Pioneer Who Reimagined Modern Labiaplasty and VaginoplastyDr. Alinsod is internationally recognized as the originator of modern aesthetic vulvovaginal surgery, including signature procedures such as:Surgical Innovations* Barbie Look® Labiaplasty* Hybrid Look® Labiaplasty* Medial Curvilinear Labia Majoraplasty* Central, Lateral & Vertical Clitoral Hood Reductions* Clitoral Reduction with Medial Hoodoplasty* In-Office Awake No-IV Labiaplasty & Vaginoplasty (his original protocol)* Pudendo-Levator Block & Micro-Tumescent Labial Block for comfortable awake surgery* Grooving Technique for natural labial contouring* Radiofrequency Feathering for revision surgery* RF Grooving for postoperative contour restoration* LightScalpel & RF Anal Skin Tag Excision TechniquesThese advances are now taught internationally—and began directly with Dr. Alinsod’s creativity, research, and hands-on development.Patents, Devices & TechnologiesDr. Alinsod is the inventor or co-inventor of numerous patented medical devices and technologies, including:* ThermiVa® and temperature-controlled RF for feminine rejuvenation* Lone Star APS Vaginal Retractor* Alinsod Surgical Table & Instrument System* Alinsod Scissors, Speculum, and Surgical Tools* Predictive Permeation Technology* O2Vasc, a topical system for enhanced genital blood flow* Implants & devices for pelvic floor reconstructionHis inventions revolutionized how cosmetic and functional gynecologic surgery is performed in clinics worldwide.Founder of the Field’s Most Respected Training ProgramsDr. Alinsod created the Alinsod Institute for Aesthetic Vulvovaginal Surgery, the first international program to integrate cosmetic, functional, and pelvic reconstructive principles. For more than 20 years, he has trained many of today’s top cosmetic gynecologists—surgeons who now lead societies, lecture internationally, and teach their own courses.He is also the founder of:* CAVS – Congress on Aesthetic Vulvovaginal Surgery, the field’s oldest and most respected congress* Gynflix, the world’s first comprehensive cosmetic gynecology e-learning platform* Honorary founder of multiple Aesthetic Gynecology Societies worldwideHis reach extends across all continents, shaping standards, guidelines, and techniques used by the global medical community.A Recognized Leader in Revision Surgery & Restorative Feminine RepairDr. Alinsod is deeply committed to women who suffer from botched or poorly performed labiaplasty or vaginoplasty—a growing concern as more non-specialists attempt these procedures with minimal training.His signature innovations—Radiofrequency Feathering, RF Grooving, and new labia minora reconstruction methods—allow him to correct scarring, asymmetry, tissue loss, over-resection, and deformities once believed to be unfixable. His published reconstructive work includes new techniques for repairing injuries from female genital cutting as well as complex surgical errors.Patients choose him for repairs because:* Few surgeons worldwide have his reconstructive mastery* He invents the techniques that others use* He restores both appearance and function* He focuses on compassionate care, privacy, and emotional recoveryAir Force Major, Surgeon, and PatriotDr. Alinsod’s medical career began with a proud 12-year service in the United States Air Force, rising to the rank of Major while serving as Chief of Gynecologic Services at Nellis Air Force Base and George Air Force Base.The discipline, integrity, and calm professionalism he developed during his military service continue to define his surgical philosophy today.A Surgeon of Creativity, Precision, and HeartThough he is acclaimed for his inventions and surgical innovations, Dr. Alinsod is equally known for his warmth, kindness, and ability to make patients feel deeply understood and respected. His background in photography sharpens his aesthetic eye; his decades in gynecology ensure complete anatomical mastery; and his commitment to minimally invasive, comfortable, in-office surgery reflects his dedication to patient safety and well-being.Women choose Dr. Alinsod not only for his expertise—but because they feel safe, informed, and cared for in his hands.Why Choose a Gynecologist Over a General Plastic Surgeon?Cosmetic gynecology requires specialized anatomical knowledge far beyond what most plastic surgeons receive. Many perform only 1–2 labiaplasty cases per year. Even fewer have experience in vaginoplasty or clitoral hood surgery.Dr. Alinsod offers:* Thousands of procedures performed* Decades of specialization* Techniques and devices he personally pioneered* The most advanced reconstructive capabilities available* A gentle, awake, no-IV surgical experience* Natural, elegant, functionally sound outcomes* The trust of surgeons who come from around the world to learn from himWhen it comes to the most intimate parts of a woman’s body, experience matters—and no one has shaped this field more than Dr. Alinsod.Now Welcoming Patients in Arlington, TexasDr. Alinsod invites you to experience the highest standards of aesthetic, functional, and reconstructive gynecology in a private, elegant, and patient-centered environment. Whether you seek cosmetic improvement, functional enhancement, or expert repair after previous surgery, you will be treated with dignity, precision, and the full depth of a lifetime dedicated to women’s health.Dr. Alinsod in his own word: A Podcast from May 3, 2024CV and BioBio Cv Inventions Awards Pubs Nov 2024 V244.2MB ∙ PDF fileDownloadAlinsod AdventuresClick picture below for more pictures of Dr. Alinsod teaching worldwideLet’s Stay ConnectedI’m so grateful for the opportunity to serve you, whether you’re a patient, a colleague, or someone curious about what we do. Our new Arlington location is ready to welcome you with the same compassionate, personalized care you’ve come to expect. Explore our services, my background, and our mission at:* alinsodinstitute.com* About Dr. Red Alinsod* About Alinsod Institute* Gynflix.comI’d love to hear from you—reach out with questions, feedback, or just to say hello. Together, we’re shaping a brighter, healthier future for women everywhere.For more Cosmetic Gynecology Short Videos (free for all) go to Video Shorts on Gynflix. This is made for the Lay Public. Dozens of high def, high quality videos.GYNFLIX COMMUNITY HAS LAUNCHED! For the SurgeonI built an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Click here for Silver Bullet Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD.I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comBefore we start on this new topic of the Vagino/Perineo Set Up go watch and review “The Informed Consent for Labiaplasty Surgery” published on April 4, 2024. This consent can be applied to Vaginoplasty surgery. Also review “Labiaplasty Set Up and Draping” published January 17, 2024. These all go together well. Today I want to show you the basic tools and a low cost but efficient set up that allows safe vaginoplasty in your office. The list of equipment below is what I shared with my grads when they visited me in Laguna Beach when I had live one-on-one training a few years back. Some things have changed. I no longer use the Ellman Surgitron and have switched over to Soniquence. They are a small company that takes care of you and they seem to always have enough supply. They now service all of the Ellman and Soniquence lines including Pelleve. Ellman was abandoned by Cynosure and the company just about folded only to be purchased by Soniquence. I buy all my stuff from Monarch Medical Products in Georgia. Andre and Tina Keeve will guide your purchase of equipment. They have all my Alinsod instruments for labial and vaginal surgery. They know what I like. Update: I no longer use sterile towels to drape for surgery. I use standard GYN LAVH drapes with buttock drapes that have a pocket. We did not want the hassles of having to do laundry. More efficiency for my staff of one!Enjoy the Videos. Thank you for subscribing. More secrets to come.Red Alinsod, MD ([email protected], www.gynflix.com, www.alinsodinstitute.com)I have the Equipment List and Informed Consent below for subscribers.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comLet’s make sure you have all your paperwork ready to do Vaginoplasty surgery. It is really important you educate yourself and your staff and your patients on what you expect of them, what to expect during recovery, and how to make sure they do all the right things to heal as fast and as perfect as possible. With this Post Op Vaginoplasty/Pelvic Reconstruction Instruction Form the patient reads, initials, and signs the document so that there are few to no “You did not tell me” moments. Excellent medicolegal protection.Watch this 13 minute video carefully and absorb it, copy it, modify to your needs. Place a signed copy in your chart, give the patient a signed copy. Place it on your website for patients to access.Join Gynflix Gold Fellow Group if you want the PDF version of the Post Op Vaginoplasty/Pelvic Reconstruction Instructions that you can use with your own logo. Simple and premade for your practice. A most valuable asset. I placed a downloadable PDF copy below for those who are paying subscribers.Notice a few important things on the Post Op Instruction Sheet:* The patient initials the left column so that she know what is specific for her and to show that she read the line item.* The patient signs the bottom to confirm she has read it all and has a copy.* Place a copy in your records and give the patient a copy also.* I initial these on the bottom right (not shown here) to confirm that she was personally given the instructions. If it was not me then my nurse or MA will initial the bottom right.* Notice that our Emergency Contact telephone numbers and emails are clearly present at the bottom of the document.Once the patient is 6 weeks Post Op and well healed they will need to massage the vaginal opening for a week or two with her fingers and/or with vaginal dilators/vibrators. I have a video and downloadable PDF below on “Vaginal Softening Exercises.” Downloadable Version you can modify: Post Op Instructions and Vaginal Softening InstructionsLabiaplasty and Vaginoplasty Newsletter is a reader-supported publication. To access all content become a paid subscriber.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comHappy New Year! I have five years of Gynflix Zoom Webinars of High Level discussions of specific topics and cases. My dear friends Amr Seifeldin, MD, from Cairo, Egypt, Joao Brito Jaenisch, MD, from Porto Alegre, Brazil, Michael Reed, MD, from Davis, California are partners in crime in teaching our students worldwide. Join in on this one time special…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis was just released on Gynflix (Live Narrated Majoraplasty, Barbie Labiaplasty, CHR, O-Shot HD). This is my Christmas gift to you my loyal Labiaplasty Newsletter subscribers. I narrate the video fully and explain the step by step details of my Unified Approach to labial surgery and highlighting the new Soniquence Bipolar Forceps I designed and is n…

I released this video on my Feminine Wellness Newsletter on September 10, 2025. I also released a prior version on July 2, 2025 called “Radiosurgery for the Cosmetic Gynecologist: A Bried Tour Through Time.” I want to share the new updated version to you, my Cosmetic Gynecology Newsletter members, to announce that this Labiaplasty Newsletter will get a massive Face Lift and Content Upgrade and will now be called “Labiaplasty and Vaginoplasty Newsletter” starting January 2026. A perfect newsletter for the surgically inclined that will include all surgical topics relating to Cosmetic Gynecology (addition of perineoplasty, vaginoplasty, pelvic reconstruction, slings, complex dual surgeries). A perfect kissing cousin for my Gynflix.com online e-Learning platform. More news coming with the beginning of Vaginoplasty contents in January 2026. Radiosurgery 101 for 2026: The Soniquence DifferenceOne of the most frequent questions I get is “Dr. Alinsod how do you do your labiaplasty surgeries? Do you use lasers or radiofrequency, scissors or knives?” I have this discussion quite a bit with surgeons from around the world. I cover this on my practice website (www.alinsodinstitute.com) and have lots of photos and videos. I’ve never really covered it for the Lay Public so I created this video that shows what radio frequency can do for Cosmetic Gynecology and why I use it for the right person. I gear this for non-medical people who wondered how this surgery is done in my office, awake, with no IV, under local anesthesia.I first covered Radiosurgery 101 for the Cosmetic Surgeon on May 30, 2022. Go see that 15 min video if you have not already done so. An update and full length version on what radiosurgery can do for labiaplasties, botched surgeries, clitoral hood surgeries, anal skin tags was released on July 2, 2025 on my Cosmetic Gynecology Newsletter called Radiosurgery for the Cosmetic Gynecologist: A Brief Tour Through Time. Today’s newest video is an update with an extra section at the end that instroduces my just released Soniquence A1 Bipolar forceps. Enjoy the learning. Let me know what you think as a lay person seeing this. Does it help explain how labiaplasties are done with radio waves?Red Alinsod, MD ([email protected])www.alinsodinstitute.comwww.gynflix.comIntroducing my new Arlington, Texas, PracticeDear Friends, Patients, and Colleagues,I’m thrilled to share some exciting news with you! After years of serving our patients at the Alinsod Institute in Dallas, we’ve relocated to a beautiful new home in Arlington, Texas. This move is all about making your experience with us even better, and I can’t wait to welcome you to our new space. You can find us at www.alinsodinstitute.com, and I’m eager to share why this change is so special. I am also proud to announce that Amy Haddad, RNP, of Revique Medical & Aesthetics, will lead and provide new services such as weight management, Peptide Therapy, BioIdentical Hormones, O-Shot/P-Shot and Vampire Wing Lift and injectable services. She will lead in Non-Surgical treatments like ThermiVa, Jett Plasmaporation, Lasers, Emsella, and others energy devices. Why Arlington?We chose Arlington for its unbeatable convenience. Nestled just minutes from Dallas Fort Worth International Airport (DFW), our new location makes it a breeze for patients flying in from across the country or even internationally. With an array of hotels nearby, your visit—whether for a consultation, procedure, or follow-up—will be as seamless as possible. Arlington places us right in the heart of America, and I like to think of it as the Center of Cosmetic Gynecology for the United States. It’s the perfect spot to continue our mission of transforming lives through innovative care.A Legacy of Care and InnovationFor the past 30 years, I’ve dedicated my practice to helping women feel confident, comfortable, and empowered. My focus has been on labiaplasty, vaginoplasty, vaginal rejuvenation, and pelvic reconstructive surgery, with a special emphasis on Revision Surgeries for those seeking to correct less-than-ideal outcomes from prior procedures. It’s been a privilege to develop techniques like the Barbie Look Labiaplasty, Hybrid Look Labiaplasty, Curvilinear Labia Majoraplasty, and in-office, no-IV labiaplasty and vaginoplasty—approaches that prioritize comfort and natural results. I’m also humbled to have invented tools that make these procedures safer and more precise, including the Lone Star APS Vaginal Retractor, Alinsod Surgical Stand, and specialized scissors, clamps, and forceps. My work with ThermiVa, a groundbreaking radiofrequency treatment for feminine restoration, and Predictive Permeation for gynecologic conditions has opened new doors for non-surgical solutions. It’s all about giving you options that fit your needs and lifestyle.Beyond the operating room, I’m proud to serve as the Founder, Editor, and Director of Gynflix.com, the premier online e-learning platform for cosmetic gynecology. For 20 years, I’ve had the honor of training dozens of Alinsod Fellowsworldwide, sharing techniques that blend artistry and science to elevate patient care.Dr. Alinsod’s CV: CV and BioComprehensive Women’s WellnessAt the Alinsod Institute, we go beyond aesthetics. We specialize in addressing fallen bladder, overactive bladder, and leaky bladder issues, tackling challenges like incontinence, urgency, and frequency with personalized solutions. Menopause brings its own set of concerns—vaginal dryness, painful intercourse, hormonal imbalances, recurrent infections, and changes in sexual function—and we’re here to help. All with an eye towards beauty and aesthetics. Our modern, innovative therapies, often with near-zero downtime, are designed to improve your quality of life and restore your confidence. Aging and gravity may be inevitable, but their impact doesn’t have to be.Leading the Way with PlasmaporationWe’re proud to be the Plasmaporation Center for the United States, harnessing Direct Current Plasma for tissue engineering and vulvovaginal skin tightening. This cutting-edge technology offers remarkable results with minimal invasiveness. Curious to learn more? Check out our detailed overview here: Jett Plasma for Electroporation.Let’s Stay ConnectedI’m so grateful for the opportunity to serve you, whether you’re a patient, a colleague, or someone curious about what we do. Our new Arlington location is ready to welcome you with the same compassionate, personalized care you’ve come to expect. Explore our services, my background, and our mission at:* alinsodinstitute.com* About Dr. Red Alinsod* About Alinsod Institute* Gynflix.comI’d love to hear from you—reach out with questions, feedback, or just to say hello. Together, we’re shaping a brighter, healthier future for women everywhere.For more Cosmetic Gynecology Short Videos (free for all) go to Video Shorts on Gynflix. This is made for the Lay Public. Dozens of high def, high quality videos.GYNFLIX COMMUNITY HAS LAUNCHED! For the SurgeonI built an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Click here for Silver Bullet Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD.I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] Newsletter is a reader-supported publication. To receive new posts and support my work, become a paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis is the DEFINITIVE full expanded version of my lecture and talk and video on Hymenoplasty Surgery. It is about 1 hour and 15 minutes long. It covers background, history, social issues, techniques published, and my very own method taught for two decades to my Fellows worldwide. A very detailed video of the Alinsod Pillar Technique. This is a fun topic so enjoy it. For those who want a deeper dive, join www.gynflix.com. Here are the other Hymenoplasty Videos and lectures I have on Gynflix. Click on the photo below:Alinsod Pillar Technique for Hymenoplasty

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis was first released on September 19, 2025, on my Feminine Wellness Newsletter created for the Lay Public and then September 30, 2025 on my Cosmetic Gynecology Newsletter made for the Medical Professional. Some of you do not subscribe to those two newsletters so I want to share it with you now. This is the material I share with patients on consults to try and guide them into the right labiaplasty choices for their anatomy. Some of you have seen and heard me talk about this around the world for the past 20 years. I hope you enjoy this and I hope it helps your practice. You should get your staff to watch this so they can use it to prepare for their patient consults. First of all, click the link and go watch my April 17, 2024 video “The Barbie Look Labiaplasty for the Lay Public” to get a well rounded education on my labiaplasty techniques I have taught worldwide since 2005. It is for you and your staff to learn from. It is by far the BEST Labiaplasty Education video for the general and lay public as well as the Medical Professional who works in Cosmetic Gynecology. It is 32 minutes long, detailed, and excellent. That newsletter has all the PowerPoint slides shown and explained.This Newsletter dives into who the best candidates are for my Barbie and Hybrid Look Labiaplasty. Barbie Look is NOT for everyone.”Exploring Labiaplasty Techniques: The Perfect Fit for Your Anatomy and DesiresWelcome to this special edition of my Labiaplasty Newsletter, where I dive into the world of labiaplasty choices. I invented the Barbie Look and Hybrid Look Labiaplasty in Laguna Beach, California, in 2005, and have taught my methods globally, with emphasis on precision radiofrequency surgery for minimal scarring and optimal results. The language I use is as if I were speaking to the patient. In this issue, we’ll break down how to choose the right labiaplasty technique based on your unique anatomy (like the size, shape, and pigmentation of your labia minora and majora) and personal desires (whether you want a dramatic change, natural preservation, or something in between). We’ll start with the Big Picture: Linear Excision versus Wedge Excision. Then, we’ll zoom in on linear excision options, including my signature looks—Barbie, Hybrid, and Simple Trim—to help you decide what’s best for you. Remember, this is educational content; always consult a Cosmetic Gynecology Specific Board-Certified Specialist for personalized advice.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI have a special section on Gynflix called ALINSOD LIVE. It has been active since 2021. Born out of necessity when the Pandemic hit us all. A way to stay up to date with the world of Cosmetic Gynecology from your bedroom and office. Many of you who are Gynflix Subscribers have watched these recorded Zooms. Well this is the most recent from last Fri…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comOn April 29, 2025, I published History of the Alinsod Grooving Technique to Create Labia Minora from No Labia. Be sure to watch that video before this one. It is a great history and summary of my development of creating labia from no labia without the need for flaps. It is how to manage genetic absence of labia minora, unexpected shrinkage of labial …

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThere will be times in your career when your labiaplasty surgery and suturing at the perineum can result in dyspareunia. It happens with vaginoplasty and perineoplasty surgeries that combine labiaplasty with all the sutures ending up right at the introitus. Scars can form and painful intercourse can happen. This video shows that type of patient. When al…

First Some Housecleaning:I updated my billing system. Your old subscriptions have been terminated. You won’t be getting billed anymore. If you are indeed interested to continue getting this awesome Labiaplasty Newsletter you need to re-register. All of you. Otherwise you will cease to receive my content. I only want serious labiaplasty surgeons. This is a paid content newsletter and there are no more freebies. I did that for over a year and hope you have enjoyed my rich content and teaching. Appreciate your loyalty. Subscribe now quickly. You will not regret it. I have dozens of new and amazing videos to be released. If you paid for the year or you have Founder status then don’t worry about it. Got you covered. This is the last free video on Labiaplasty Newsletter. Ever. Go subscribe and be a paying member at only $48 a month. It is so worth it. I am eliminating dormant and seldom used accounts. If you decide not to subscribe there will be no hard feelings at all. Do follow me on Instagram and at least see what I am up to as I give sneaks peeks regularly: Instagram: VageniusMDIf you have not already done so go watch my April 15, 2024 video on “Gynecologic Photograpy for Dummies and Digital Asset Management.” It is a great place to start to learn the core basics of digital recording. Now on to the next level. Videography. Gynecologic Videography for Dummies and Digital Asset ManagementThis is where the REAL GOLD is. Your videos. When a patient is searching for a labiaplasty surgeon, they don't just flip through photos—they dive into videos to see your skills in action! I'll make you shine on screen, so buckle up and learn. Don't skim this one.In the eyes of the consumer, you're only as good a surgeon as your videos can demonstrate. Static images are great, but videos bring your expertise to life, showing the precision, the process, and the transformative results. So invest a 17 minutes with me and level up your gynecologic videography skills. Check out my video library on www.gynflix.com. This could be the most impactful "procedure" you'll master this year. Gynflix Gold Fellows snag exclusive access to all my digital assets first. I originally delivered a version of this talk at my Congress of Aesthetic Vulvovaginal Surgery back in 2006, and most recently at the European Society of Aesthetic Gynecology (ESAG) Congress in Edinburgh in summer 2019, just before the pandemic hit. I've revamped it with passion to include the latest in the field: iPhone videography for quick, high-quality captures, 4K and 360-degree video options, and a primer on editing tools like Adobe Premiere and Final Cut Pro or even free apps like CapCut. I'll walk you through a narrated live video session from setup to final edit, showing exactly how I film my procedures and patient stories.Red Alinsod, MD ([email protected], www.gynflix.com, www.alinsodinstitute.com)Call to ActionGynflix Gold Fellows Member Registration:This unique and valuable service provides access to all future surgical and non-surgical videos and AIAVS Video materials. There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on aesthetic gynecology. This is not a CME program.Transform your practice by mastering these life-changing procedures. Subscribe to Gynflix, learn of worldwide preceptorships, or contact me at [email protected] or call 945-900-7576 to discuss training opportunities with my Fellows worldwide. Let’s empower our patients together.Sincerely,Red M. Alinsod, M.D., FACOG, FACSDirector, Alinsod Institute for Aesthetic Vulvovaginal SurgeryGYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Subscriptions: GYNFLIX PRICINGSILVER BULLET SUBSCRIPTIONS: $98/month. Access all regular subscription videos, SHORTS Videos, Fellows Videos, Free Cosmetic Gynecology and Feminine Wellness Newsletters, scheduled access to Dr. Alinsod personally.GOLD FELLOWS MEMBERSHIP: $198/month. This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology. Get all my practice forms. All Newsletters are free. The Modules are FREE with Diplomas upon completion.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you have any questions.Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:ARLINGTON OFFICEAlinsod Institute Arlington, TexasPhone: 945-900-7576Dr. Red Alinsod: [email protected] Newsletter is a reader-supported publication. To receive new posts and support my work, be a paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI first saw this patient in 2016, almost ten years ago. She had labial asymmetry and wanted a labiaplasty to leave very little labia. A Barbie Look Labiaplasty. She also had vaginal laxity and a gaping vaginal introitus that needed repair.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comAll my Alinsod Felows for the past 20 years have watched me perform and teach the Q-Tip Exercise. I recorded these two videos to cover important points and techniques on how to avoid the post op problem of tissue agglutination post Feathering, Grooving, Hood Release, Exposure of Buried Clitoris.Here is another video to reinforce the concept of the Q-Ti…

Almost all my posts on this Labiaplasty Newsletter have to do with Labiaplasty surgery. Next week is the annual gathering in Las Vegas for The Aesthetic Show. So many non-surgical options can support a surgical practice. Today I want to introduce you to a potential adjunct to a labiaplasty practice. Hair Restoration. Give it a listen and see if it can work in your particular practice. Other adjuncts to my labiaplasty practice has been Bioidentical Hormones, Radiofrequency and Laser treatments. And as of 2025, the amazing Plasmaporation technology. Here is the agenda for TAS on Friday, June 27, at the Wynn Resort. Notice the focus on Non-Surgical treatments:THIS ZOOM WEBINARIn this recent GetHairMD webinar, Dr. Ezzat provides an in-depth look at the clinical data and scientific evidence behind GetHairMD's comprehensive hair loss solutions. I am a provider of these services in the DFW area of Texas.What makes this presentation particularly valuable is Dr. Ezzat's firsthand experience with these treatments and his detailed explanation of how they work synergistically as combination therapy to deliver exceptional results for patients experiencing hair loss.GetHairMD hosts monthly webinars that offer valuable insights into the latest advances in hair restoration. You can stay informed about upcoming sessions by following them on their website and social media channels.Their evolving suite of solutions represents one of the most innovative approaches to hair loss treatment available today, with new breakthrough technologies being added regularly. As a member of the Clinical Advisory Board, I take pride in helping to evaluate and ensure that every product and treatment in their portfolio meets the highest standards for the physicians in our network.The commitment to evidence-based, clinically-proven solutions is what sets GetHairMD apart in the hair restoration field. Red Alinsod, MDWHAT’S UP NEXTOn Wednesday evening, 6 PM CT, July 9, 2025, the next webinar from GetHairMD will be on this: Cost is one of the biggest reasons patients delay or decline treatment. In this webinar, you’ll learn how top practices are using financing to reduce friction and increase booked procedures—without discounting.Sierra Wolf from PatientFi shares key data and insights on how financing impacts patient behavior, while Dr. Grant Stevens brings a surgeon’s perspective on how it plays out in real aesthetic practices.In this webinar, you’ll learn:* How financing options help convert hesitant patients* The real numbers: case studies, stats, and impact on revenue* How to talk about financing without sounding salesy* What tools and workflows make it easy for your team* Why offering financing can differentiate your practiceSierra Wolf from PatientFi shares key data and insights on how financing impacts patient behavior, while Dr. Grant Stevens brings a surgeon’s perspective on how it plays out in real aesthetic practices.Webinar Details:* Time: July 9th at 6pm CST* Duration: 45 minutes with Q&AIf you want to increase bookings without cutting your prices, this session is for you.Go HERE and join the webinar on Wednesday, July 9: Title: How to Close 40% More Aesthetic Treatments with Patient FinancingDate and Time: July 9th at 6pm CTHere is your specific link to next week’s program: GetHairMD WebinarGYNFLIX COMMUNITY HAS LAUNCHED!I built an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Click here for Silver Bullet Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comDear Fellow Surgeons,Welcome to Part 3 of my series on how to manage the Buried Clitoris. For two years this patient had a progressive closure of her clitoral hood over the clitoris resulting in reduced sensitivity. It was barely noticed. There was minimal to no itching or discomfort. Watch this 30 minute video and listen to my in depth commentary. This Labiaplasty Newsletter is $48 a month. It is free to subscribers of Gynflix.KEY POINTS* Lichen Sclerosus is a very common cause * Office procedure using precision RF pinpoint tip* Palpate for location of the clitoral bulb* Careful RF incision then blunt dissection* Have fine Metzenbaum Scissors, fine Tonsils and fine Right Angle dissectors* Dissect mostly laterally to isolate the clitoral bulb and body and avoid vessels sitting on top of the clitoris.* Must decide on no suturing or suturing of clitoral hood edge to the base of the clitoral body/bulb.* If no suturing: Q-Tip Exercises daily to keep clitoris free and uncovered. This method may result in agglutination over the clitoral bulb if not aggressively performed daily.* If suturing: suture the clitoral hood edge below the clitoral body/bulb. Use 5-0 Monocryl. This will better prevent agglutination over the clitoral bulb. Will still need to do Q-Tip Exercises.* Q-Tip Exercise daily to prevent agglutination over the clitoris (Video Next Week)* Use PRP or Amniotic fluid (or both) to reduce inflammation and aid in healing* Recurrence is common and maintenance with Energy (RF or Laser) and Biologics (PRP or Amniotic fluid injections, Exosome Creams) will prolong disease free intervals. STEPS: Watch the Video for detailsLabiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, become a paid subscriber.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis Labiaplasty Newsletter is $48 a month. It is free to subscribers of Gynflix.Lichen Sclerosus: Understanding Incidence, Cancer Risk, Follow-Up, and Treatment OptionsPart 2 of 4: Biopsy and Ruling Out CarcinomaDear Fellow Surgeons,Welcome to my Part 2 Newsletter dedicated to lichen sclerosus (LS), a chronic inflammatory dermatosis primarily affecting…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis Labiaplasty Newsletter is $48 a month. It is free to subscribers of Gynflix.Understanding and Treating the Buried ClitorisPart 1 of 4: Surgical Techniques for Buried Clitoris ReleaseDear Fellow Surgeons,As pioneers in aesthetic and reconstructive gynecology, we continually strive to enhance our patients’ quality of life through precise, innovative…

Red Alinsod, MDAlinsod Institute for Aesthetic Vulvovaginal SurgeryDallas, TXBACKGROUND:In 2005 I developed the Barbie Look Labiaplasty, a radical and aggressive form of labiaplasty that removed almost all to all of the labia minora to achieve maximal comfort for athletes, reduce the outlining of the labia when wearing swimsuits and leotard, and as a cosmetic preference to obtain a “clamshell” look wanted by women in Southern California. This was an athletic, smooth, and sleek look that was the most “tucked in” you could get. It was impossible to achieve this look with the standard plastic surgery wedge labiaplasties. It has been a beloved surgery for the carefully selected patients who want this minimalist “Look” it. No more adjusting and tugging. My Olympic level athletes found it to be an outstanding choice.HISTORY:Soon after my Barbie Look Labiaplasty technique became well known through my teaching programs, the media, presentations in Congresses, it was copied worldwide and attempted by untrained surgeons. Poor and awful outcomes were rapidly occurring, and I was referred many patients for repair. Patients came to me with no labia minora at all when they did not seek out or ask for the Barbie Look Labiaplasty. Their surgeon chose the wrong procedure of a Barbie Look for patients who wanted labia left. Many surgeons who had done zero to only a few labiaplasties ended up not knowing of the massive retraction of tissues in the upper third of the labia minora with resultant retraction of labial edges to end up flat and with NO labia at all. These surgeons did not know what to do and I was often consulted. I was also sought out as an expert witness for malpractice cases.I had a small handful of patients in the first decade of my practice doing the Barbie Look Labiaplasty who changed their minds months to years later and wanted to have a little bit of labia minora showing and not be completely flat. The pictures below is one of those patients. My original solution was simple and worked well if they wanted just a little bit of labia minora below the level of the labia majora. If they wanted more of the labia above the level of the labia majora I would have to make labia majora incisions up to 2cm above where the labial crease would have been. I called this my Grooving Technique because I created a groove between where the labia minora and labia majora had met, the interlabial fold, undermined medialy, and created a labia from no labia. It was actually creating an optical illusion of a new labia when in reality it was creating a groove and sometimes suturing the lateral majora edge to the lowest portion of minora edge that was just “grooved.”I shared this secret with Amr Seifeldin when he visited my office on October 6, 2015, 2017, 2019. I did not publish my technique and only shared it with my Alinsod Fellows who would travel to Laguna Beach over the past 18 years to participate in my Preceptorships. Amr expanded on my methods for the patient who wanted a more significant labia minora reconstruction without the use of flaps and has taught this to his Fellows. His Center in Cairo, Egypt, has been a tremendous resource for patients in the area wanting both Female Genital Mutilation Repair, Cosmetic Gynecology Surgeries, and advanced Revision Labial Surgeries such as my Grooving Technique. The landmark article by Reham Awwad, Amr Seifeldin, Natalie Sorial, and myself is attached at the end of this newsletter.PATIENT SELECTION AND GROOVING TECHNIQUE SUMMARY:1. For the patient who wants to create the illusion of a labia minora where there was none up to the level of the labia majora and just past it.2. Local anesthesia3. Use radiosurgery to create a “Groove” between the labia minora and labia majora, where the crease used to be, the former intralabial fold.4. Start with the fine pinpoint “Hair Tip” of the Ellman or Soniquence RF to outline and incise from the top of the labia minora to the introitis.5. Use this “Hair Tip” to smoothen any labial and hood areas to create a smooth from from the clitoral hood to the frenulum or its remnants, to the labia minora.6. Use the small ball tip to continue the Grooving deeper while maintaining hemostasis to create a flab of labia minora medially. With adequate numbing cream, a QTip is used twice daily to keep the edges from fusing together. This is performed for 4-6 weeks. No suturing needed.7. For more significant labial creation, suturing is need to attach the lateral majora edge of the incision to the lowest portion of the medial minora edge to keep the appearance of a new labia minora.8. Inject PRP into the surgical site and use Estrogen Cream or Exosome Cream to aid in healing for the next 6 to 8 weeks.I have videos on how this surgery is performed on Gynflix intended for surgeon training:The Long Version is 2:18:41 long: Vaginoplasty 101, CHR Grooving and Feathering Revision, and O-ShotThe Short Version is 1:24:50 long: Feathering and Grooving Revision, CHR, and O-Shot for Botched LabiaplastyThe Full Length version of this video will be released on www.gynflix.com shortly in May 2025. Just SEARCH the term “Grooving” on the website and it will pop up.Click for more Botched Labiaplasty Repair Photo Sets for you to view: RevisionsPhotography: 20151st Row: Before Barbie Labiaplasty, Vertical CHD, and Labia Majoraplasty2nd Row: Immediately After Surgery3rd Row: Before Grooving4th Row: Immediately After Grooving5th Row: Four Months Post Op6th Row: Six Months Post OpTop Row: Before GroovingMiddle Row: Immediately After GroovingBottom Row: Six Months Post OpFull Surgical History: Before all Surgeries and After Grooving Revision in 2015LABIA MINORA RECONSTRUCTION USING A LABIA MAJORA FLAPClick HERE for my September 2024 Newsletter on this publication.GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Subscriptions: GYNFLIX PRICINGSILVER BULLET SUBSCRIPTIONS: $98/month. Access all regular subscription videos, SHORTS Videos, Fellows Videos, Free Cosmetic Gynecology and Feminine Wellness Newsletters, scheduled access to Dr. Alinsod personally.GOLD FELLOWS MEMBERSHIP: $198/month. This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology. Get all my practice forms. All Newsletters are free. The Modules are FREE with Diplomas upon completion.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you have any questions.Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Dr. Red Alinsod: [email protected] Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

The Updates are Live!We have revamped Gynflix 2.0. Easier, faster, more intuitive, more content, super affordable. Here are the reasons you should subscribe to www.gynflix.com.* Full-length teaching videos in 4K and HD* Monthly updates and NEW videos* Top Watched Videos* Highlighted Videos* “Video Shorts” Collection of 3-5 min abbreviated videos for the Lay Public* “Cheat Sheet” collection of videos to review right before your case starts* ALINSOD LIVE: Quarterly Zooms with Fellows (2021, 2022, 2023, 2024, 2025)* SEARCH Capabilities are exceptional* INDEX/GUIDE TO AIAVS VIDEOS: Descriptions and Keywords and Direct Links* Photo Gallery: Best In Class Before and After Photo Collection * Modules: Specifically dedicated to a narrow topic. Surgical and Non-Surgical* CMA and Charles Runels, MD, personalized connection and training* Industry Resources: Alinsod supported and Approved devices and resources* Access Alinsod: Private One-On-One FaceTime/Zoom/Phone calls* FORMS: Access to Alinsod forms for office use upon Request* NEWSLETTERS:* Cosmetic Gynecology Newsletter: For Medical Professionals* Labiaplasty Newsletter: For Surgeon* Feminine Wellness Newsletter: For the Lay Public* SOCIAL MEDIA: VaginiusMD on IGOn January 2025 I launched Gynflix Community on X (formerly Twitter). Go join it. It is new and fresh. I will build an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:GYNFLIX Cosmetic Gynecology e-LearningFor Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comGynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.Subscriptions: GYNFLIX PRICINGSILVER BULLET SUBSCRIPTIONS: $98/month. Access all regular subscription videos, SHORTS Videos, Fellows Videos, Free Cosmetic Gynecology and Feminine Wellness Newsletters, scheduled access to Dr. Alinsod personally.GOLD FELLOWS MEMBERSHIP: $198/month. This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology. Get all my practice forms. All Newsletters are free. The Modules are FREE with Diplomas upon completion.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you have any questions.Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Dr. Red Alinsod: [email protected] Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Thanks for reading Labiaplasty Newsletter! This post is public so feel free to share it. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI frequently do combination surgeries of a labia minora and a majoraplasty at the same time I am doing a vaginoplasty and perineoplasty. When I have a combination surgery, I call it the Unified Approach. When I remove a labia minora and a labia majora and a clitoral hood together as one specimen that is truly a Unified Approach. This video shows how I c…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI have built a career on botched labiaplasty repairs since 2005. Radiofrequency has been my tool of choice, specifically the Soniquence RF from New York. This is a CORE lecture which I presented at the International Society of Cosmetic gynecology just a couple of weeks ago. I first shared this at the Congress several years ago and it had turned out to be quite a popular requested lecture. PowerPoint Slides

Technology sure moves rapidly! Today I will cover Jett Medical Plasmaporation. The Next Generation of last year’s Predictive Permeation. I am presenting this novel new technology at ISCG 2025 in Fort Lauderdale, Florida, later this week. This is how I am able to get comfort for In Office Labiaplasty and Vaginoplasty surgeries:* 30% BLT Numbing Cream placed 1 hour before the patient comes to the office* Upon arrival at the office, push the 30% Numbing Cream deeper under the skin using Plasmaporation technology that use DC Current creating plasma to open up the water channels of the skin. * Use a 30 Gauge needle to inject 0.25% Marcaine with Epi plus Bicarbonate under the skin at strategic places. Review last year’s Newsletter on my Predictive Permeation (aka Dermoelectroporation, Electroporation, Collagenizer). Click below:How Plasmaporation Works and What It Can Do:I will cover this in more detail after my ISCG Presentation. I will discuss the devices approved in the US versus Europe and the world. I will discuss the technology more and what it can accomplish.Go to my Cosmetic Gynecology Newsletter and view my PLASMAPORATION presentations in greater detail. Also view my opinion on what devices to consider when starting up a Cosmetic Gynecology practice. Click below:* Part 1: Jett Medical Obtains FDA Clearance* Part 2: Jett Medical II Plasmaporation for Topical Anesthesia and Tissue Engineering* Tip Toeing into Cosmetic Gynecology Part 1PROTOCOLS FOR JETT MEDICAL TREATMENTSFor more information contact Distributor: Dan Wray: [email protected] COMMUNITYOn January 2025 I launched Gynflix Community on X (formerly Twitter). Go join it and become part of the discussions. I will build an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:For More Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comSubscription Pricing: is $98/month for Silver Bullet and $198/month for Gold Fellows.Gynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!If you have any Gynflix questions call Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Help me grow my Instagram presence.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis video shows me using the Ellman Surgitron device for Feathering. Many surgeons own this device around the world. I spoke and taught for Ellman from 2005 till about 2014. Unfortunately, Ellman met its demise when Cynosure discontinued the division. Lutronix purchased Cynosure and has no plans to resurrect Ellman. No more service and no more parts for the Ellman Surgitron/Pelleve units. For the past 4 year I have exclusively used Soniquence as my RF device of choice for labiaplasty surgery. It was founded by Alan Ellman. Yes, the man behind Ellman International. Alan Ellman and Bill Bernstein have done a tremendous job in providing the best RF surgical platform in the world. Watch my new RF Labiaplasty video below demonstrating what Soniquence can do.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comMake sure to watch Part 1 and Part 2 before watching this Part 3. I give very detailed description of the entire process in this full length video. You will learn tons on how to manage the Botched Labiaplasty by watching Parts 1, 2, and 3. Email me at [email protected] or text me at 945-900-7510 if you have questions about Feathering. For the past 4 y…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comWhat to do when the labial edges are irregular? What if the final results are lumpy and protruding? What if the sutures are tied too tight and scalloping occurs? What is the timing for labiaplasty revision? This newsletter highlights the basic surgical concept of Feathering. Feathering is the use of an energy device, most often radiofrequency, to smoothen and shrink irregular tissue edges. Newsletter releases coming up:Part 2: The CORE of Feathering Resurfacing Revision will be released on March 10, 2025Part 3: The Full Length Feathering Resurfacing Revision will be release on March 24, 2025 after the Annual International Society of Cosmetogynecology Congress. Two short videos in this current Labiaplasty Newsletter will illustrate the basics. I use Soniquence RF for my Feathering procedures. SONIQUENCE:Gynflix and the Alinsod Institute are full-time supporters of Soniquence RF. They are Premier sponsors of our Resource section on Gynflix. https://www.soniquence.com/Bill Bernstein, VP: [email protected]

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comHere is a primer on what I want you to learn the next couple of months. Combination Surgery Using the Unified Approach. Then we will tackle Labiaplasty Revision Surgery.Unified Approach:* Excision of the labia minora and labia majora plus the lateral clitoral hood in carefully chosen patients. Can also be done in conjunction with a vaginoplasty and/or …

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comNot much commentary needed on this video. It is one hour and forty minutes of the entire process of a labiaplasty surgery in my office on a typical day. Next year we start off with Revision Surgery to make you experts on what to do when things don’t go perfect as you planned. Or if you want to be that Center of Excellence everyone refers Botched Labi…

Gynflix provides the Took Kit of learning for the Cosmetic Gynecologists.In a rush? Need a quickie review of how to do an “A” Incision to avoid Dog Ears? Need to refresh on where to inject for a Pudendo-Levator Block? I created a Cheat Sheetfor you. I spent a year condensing and refining my full-length videos into more manageable bite sized pieces for you to look at right before you go into the operating room. Organized it into sections that help you find exactly what you need. The Cheat Sheet is only for Gold Fellows but if you sign up by Dec 31, 2024, it will be available to new Silver Bullet subscribers for all of 2025. Cannot loose on this Christmas Deal. The only way to get this special access is to email Suzette Peterson at [email protected] and type in “Cheat Sheet Deal” on the Subject line. Here are the main categories:* Labia Minoraplasty* Labia Majoraplasty* Unified Approach* Clitoral Hood Reduction* Clitoral Reduction* Botched Labiaplasty Revision* Vaginoplasty* Vampire Wing Lift/Majora Augmentation* Perineoplasty* Radio Frequency Treatments* Hymenoplasty* Luksenburg Incontinence Procedure* Anal Skin TagsPrepping for a surgery? Would you like a quick review to make sure you are up-to-date on procedures and tips from Dr. Alinsod? Check out the cheat sheet!Now available only on www.gynflix.com for Gold Fellows Subscription.GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos and AIAVS Video materials. There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.CHEAT SHEET CONTENT December 2024:Labia Minoraplasty* Labiaplasty Set Up and Draping Doctor View* Labiaplasty Set Up and Draping Patient View* Labia Minoraplasty Anesthesia and Marking HD* A Incision Review 2023* Rim Labiaplasty: The Basics* Hybrid Labiaplasty with Clitoral Hood Reduction, ThermiVa, O-Shot, and Vampire Wing LIft* Barbie Labiaplasty with Clitoral Hood Reduction, and A Incision Steps* Sutureless Feathering Labiaplasty Revision with VCHR and Contouring* Incisionless Labiaplasty with Feathering Resurfacing RevisionLabia Majoraplasty* Labia Majoraplasty Anesthesia and Marking* Labia Majoraplasty with Fat Pad Reduction, VCHR, LMF, O-Shot – ShortUnified Approach* Unified Approach to Vaginoplasty and Barbie Labiaplasty* Unified Approach to Vaginoplasty, Labia Minora and Majoraplasty, Clitoral Hood Reduction* Unified Approach with LightScalpel Laser for Vaginoplasty, Labiaplasty, Anal Skin TagsClitoral Hood Reduction* Clitoral Hood Reduction Techniques* Lateral Clitoral Hood Reduction* Vertical Clitoral Hood Reduction* Clitoral Hood Release for Buried Clitoris* Revision of Buried Clitoris and Frenulum Release, PRP with Amniotic Fluid* Release of Buried Clitoris and Frenulum, PRP and Amniotic Fluid Injection* Management of the Protuberant Clitoris* Clitoral Hood Reduction: Lateral and Vertical ApproachesClitoral Reduction* Management of the Protruberant Clitoris 2024* Management of the Protuberant Clitoris* Revision of Buried Clitoris and Frenulum Release, PRP with Amniotic Fluid* Release of Buried Clitoris and Frenulum, PRP and Amniotic Fluid Injection* Clitoral Reduction and Medial Clitoral Hood Reduction 2024Botched Labiaplasty Revision* Feathering Revision of Labial Edges* LN Management of Labial Scalloping & Scars w/ Feathering & Shaving* Sutureless Feathering Labiaplasty Revision with VCHR and Contouring* Incisionless Labiaplasty with Feathering Resurfacing RevisionVaginoplasty* Vaginoplasty and Perineoplasty Review* TOT, Anterior Repair with Dermis, and Transvaginal Uterine Suspension* Augmented Pelvic Floor Repair with Dermis* Vaginal Softening Exercises* Transvaginal Uterine Suspension: Pelvic Reconstruction with Dermal AugmentationVampire Wing Lift/Majora Augmentation* ThermiVa, O-Shot Clitoxin, Vampire Wing Lift with FemXHA* ThermiVa with Vampire Wing LiftPerineoplasty* Small Perineoplasty* Perineal Band Release* Band ReleaseRadio Frequency Treatments* Live Narrated Thermi-O* ThermiVa with Vampire Wing Lift* ThermiVa, O-Shot Clitoxin, Vampire Wing Lift with FemXHAHymenoplasty* Hymenoplasty PIllar TechniqueLuksenberg Incontinence Procedure* The Luksenburg System for SUIAnal Skin Tags* Anal Skin Tag Excision with Bipolar RF* Anal Skin Tag Excision Compendium* Live Narrated Excision of Anal Skin Tag with LightScalpel LaserEach section provides a wealth of review materials. Plus you have access to discuss these videos with me via scheduled Calendly. Phone or Zoom.GYNFLIX COMMUNITY IS LAUNCHING IN 2025On January 2025 I will launch Gynflix Community on X (formerly Twitter). This is my first announcement. There are no posts yet. Go join it. I will build an online community of expert Cosmetic Gynecologists from around the world who you will be able to communicate with and pick their brains. Click on the logo picture for the link:Merry Christmas!Red Alinsod, MD ([email protected])For More Detailed Videos Click on the Index Photo Below:For more Cosmetic Gynecology Training join Gynflix.comClick here for Silver Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.Gynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Help me grow my Instagram presence.Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comWill end the year with a review this week of Clitoral Hood Reduction techniques and next week will be The Process: Labiaplasty From Start to Finish. I have had a blast sharing with you the way I do surgery in my office and hope you have improved your labiaplasty surgical skill for your patients. Labiaplasty Newsletter 2025 will focus first on Labiapla…

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThe Medial Clitoral Hood Reduction is an excellent technique for times when the patient’s clitoral hood is covered and you want to expose the clitoris more. It is also very useful when performing a clitoral reduction and now have to manage the relative excess of clitoral hood over the now reduced sized clitoris. This is what I show in this video which has recently been released on Gynflix.Purpose:* Reduce the coverage of the clitoris* Clitoral Unhooding* Improve clitoral access* Reduce the prominence of the clitoral complex* Accompany a Clitoral ReductionWatch this video and the Step-By-Step detailed method of marking, excision, and suturing if needed. It is a finesse technique.More Examples of Surgery on Gynflix: Click on the pictureThe technique is simple and safe. I have a complete set of pictures below that you can examine as you watch the video on a separate screen. The best way to learn. The full set of Before and After photos as are shown below.A Message from Red and Rafal Kuzlik, MD, Warsaw, PolandRed Alinsod, MD ([email protected])The Steps for Medial Clitoral Hood Reduction SurgeryThe photos below cover the short version video above focusing only on the Medial Clitoral Hood Reduction. The Full Length version on Gynflix.com (28 min)Description of “Medial Clitoral Hood Reduction”Clitoral reduction with medial clitoral hood reduction, Barbie Look Labiaplasty, Perineoplasty, with LightScalpel CO2 Laser.Keywords: Clitoral Reduction, Medial Clitoral Hood Reduction, Clitoral Hood Reduction, Frenulectomy, Radiofrequency, Soniquence, Bipolar

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comI developed this unique Vertical Clitoral Hood Reduction technique about 18 years ago and taught it to my Fellows and now releasing it to my Gynflix platform. Gynflix has multiple full versions of this type of surgery. This is the short version at 13 minutes. The Full Length version includes the actual Clitoral Reduction Surgery and will be released on Gynflix on November 1. It is an hour and 20 minutes long and quite awesome. Purpose:* Reduce vertical length of the clitoral hood* Reduce width of the clitoral hood* Reduce the appearance of a large clitoris* Accompany a Clitoral Reduction * Obtain a moderate Pull-In and tightening of the Labia Majora in its upper most region* In this case, to remove “Railroad Scars” from a prior Labia MajoraplastyWatch this video and the Step-By-Step detailed method of marking, excision, and suturing. Learn how the letter “A” is used as a guide in amount of tissue to remove. More Examples of Surgery on GynflixExamples of Results: All of these surgeries are on Gynflix.com. Click on pictures.The technique is fairly simple and quite safe. I have a complete set of pictures below that you can examine as you watch the video on a separate screen. The best way to learn. The full set of Before and After photos as are shown below.Red Alinsod, MD ([email protected])The Steps for Vertical Clitoral Hood Reduction SurgeryThe photos below cover the short version video above focusing only on the Vertical Clitoral Hood Reduction. The Full Length version is to be released on Nov 1, 2024, today, on Gynflix.comFull Length Description of “Live Narrated Clitoral Reduction, Frenulectomy, Vertical Clitoral Hood ReductionThis patient had a prior Labia Majoraplasty in the traditional “Football” shaped excision of bilateral Labia Majora resulting in a Railroad Track scar.  She also has been on long term Testosterone resulting in a prominent Clitoris that did not reduce in size after stopping the steroids.  She requested a reduction in the size and length of the clitoris and to reduce the scars.  Keywords:Cliteromegaly, Clitoral Reduction, Vertical Clitoral Hood Reduction, Clitoral Hood Reduction, Frenulectomy, Radiofrequency, Soniquence, Bipolar See all the steps below.

This is a free preview of a paid episode. To hear more, visit labiaplasty.substack.comThis technique will be the large majority of the Clitoral Hood Reductions (CHR) you will be doing. Learn this well. When you perform a labiaplasty it leaves a larger top heavy look in many patients with the Clitoral Hood appearance looking larger in relative terms now that the labia minora have been reduced. To achieve balance and symmetry I offer Clitoral Hood Reduction in most of my patients and this CHR is the most common to fit most patients. It is adjustable, can be very dramatic, can be minimal and refined, and can be used to expose a buried clitoris to a modest degree if needed. The video has great detail on how to place marks and where to incise/excise and how to suture. This patient already has local anesthesia on board so not much time is spent on that. This video is filled with brilliant Pearls of Wisdom. A definite Must See!Watch the video and look at the photos below for details. I will cover #2 and #3 in November Newsletters. For those who want it all and want it now: All videos on Clitoral Hood Reduction are now available to Gynflix subscribers. Clitoral Hood Reduction: Lateral (NOW)* Clitoral Hood Reduction: Vertical (NOVEMBER 1, 2024)* Clitoral Hood Reduction: Medial (NOVEMBER 15, 2024)The BEST way to learn from this Newsletter is to open the video in a separate window and follow along with the photos below to be able to examine and understand every step. I narrate the steps in intricate detail and give my personal commentary along the way. Enjoy this priceless learning.Red Alinsod, MD ([email protected])The Steps for Lateral Clitoral Hood Reduction Surgery

I released “How Vaginal Restoration with Carboxytherapy is Changing in 2023” on my Cosmetic Gynecology Newsletter on January 25, 2023. Today’s video is the longer academic version using the original slides provided by my friend Gustavo Leibashoff, MD. This is what I use in my live teaching courses and it is available to you now. I recorded this for my Alinsod Fellows when I was back in Laguna Beach a couple of years ago and its content is a CORE knowledge for my Grads. I share this to you today so that you have an option outside of hormones to get the best skin possible before any labial surgery. Or even before any vaginal surgery. It is about 39 minutes long. I am sending this free to every Labiaplasty Newsletter subscriber. Enjoy.Red Alinsod, MD ([email protected])CO2LiftV by LumisqueI released these PowerPoint Slide Set on April 25, 2022 in my Cosmetic Gynecology Newsletter. Without the video: Carboxytherapy for Gynecologic Conditions. Here is what I wrote:I went to Brazil about a decade ago to speak in Rio at the first ever Cosmetic Gynecology Congress for Latin America. Went back in 2017 to show off ThermiVa to the Latin physicians. During my visit there I was most fascinated with the injected carbon dioxide under the skin called carboxytherapy. 30 gauge needles were used under the skin of the lower lids, face, stretch marks. It was getting injected under the skin of the labia and perineum. It looked like a painful and awful procedure. I looked into it when I returned to America and found out that there was a practice in Beverly Hills and in Manhattan that had obtain the equipment to do these carboxytherapy procedures. I tried to get a machine and found out it was not FDA cleared or approved. It is still not approved in the United States. So I lost interest. Then I get an email from my friend Gustavo Leibaschoff, M.D., an OBGYN from Argentina, living in Dallas, and President of the World Society of Cosmetic Gynecology. He had a new treatment using carbon dioxide but without needles! So obviously that sparked my interest! We got together and he told me about his new baby. CO2LiftV Gel.Traveling the world with Gustavo and preaching the word of Carboxytherapy.I think this is an important topic because of the rapid grown of the Feminine Wellness field and huge interest in feminine restoration.The development of Carboxytherapy became quite important because of the huge number of women entering menopause. The genital symptoms of dryness, burning, and pain drove this development.The first paper on carboxytherapy came from Argentina decades ago.Carbon dioxide gas was injected under the skin superficially and in deep tissues to get its intended effect.French cardiologist injected it improve blood flow in arms and legs.This resulted in higher localized oxygen levels! It helped with healing.The microcirculation improved, the vessels became dilated. The Bohr effect was working. Increasing the CO2 reduced O2’s affinity for hemoglobin. This resulted in the pH decreasing or becoming more acidic. Oxygen was released, new vessel formation started. Collagen was stimulated.The amazing this is that the effects also occurred far away from the place of injection! The vascular flow increased and vessels opened up brought more oxygen to tissues.Here are the studies listed showing carboxytherapy’s effects:So here is a summary of the physiologic effects of CO2:It was safe and non-toxic. However, it hurt, feel heavy, could cause bruising, and crepitation. Imagine using this on the vulva for lichen. It would help but it hurt!So for 25 years its use in aesthetics grew in many parts of the world such as Latin America. Since it stimulated fibroblasts new and fresh collagen would be made. Tighter and fresher skin! Wonderful for the face, saggy eyelids, lines and wrinkles. It was like a poor man’s filler.More and more papers came out showing effectiveness for dermatologic conditions.Here is how Collagen Synthesis occurred. It was really the creation of Procollagen that made the difference.So injected carboxytherapy gained acceptance for wound care and healing around the world. Except the U.S. The procedure still hurt and injections were painful. The injections of carbon dioxide under the skin would cause a separation of the skin from the underlying tissue. It was actually a physical trauma that initiated the healing cascade. Carbon dioxide bubbles were being made under the skin and you were trying to create crepitis for a short while.Then the Big Event happened. Yoshitada Sakai of Japan published a paper about a gel that caused the same Bohr Effect without having to inject anything. No needles! No more pain from the dozens of shots needed to get a clinical effect.A company was created called Lumisque who branded the gel “CO2Lift.” The gel was now used for cosmetics and not just for burn patients and wound care patients. CO2Lift was great for the face and skin and created a fresh and vibrant look. It helped reduce wrinkles and even out the skin tone.The product was gentle and non-irritating.Gustavo wrote a paper with Luis Coll and Wendy Roberts and showed the increase in microcirculation using the gel.Gustavo showed that the injected CO2 and the gel CO2 gave very similar results.The horizontal and vertical capillaries were increased! More blood flow!Not only more blood flow but also more density in the vascularity.The vessel diameter even widened!The study conclusion:So now you wonder if this works in the genital area? A gel for GYNs perhaps! Read on to see my experience of the past few years. Go to Lumisque and get more info.The next logical step was to see if the effects on the skin of the face could be duplicated with the skin and mucosa of the vulva and vagina. CO2LiftV was born. Made specially for genital use. Studies were done in Columbia.Gustavo and his team were able to show a thickening of vulvar skin on histopath.H&E Stain showed improved maturation, thicker epithelium, increased Glycogen.They created a protocol for daily use for 5-10 days straight that definitely showed an increase in the Glycogen stores indicting active metabolic activity. The vulvovaginal tissues were waking up!Posterior wall biopsies of the vagina showed a dramatic increase in pro collagen at day 21. The pinkish red stuff you see on the right picture.The Vaginal Health Index shot up from 11 to 18. The FSFI scores improved in all domains in separate study done in Mexico.Here are some of the photos the group recorded. You can see tightening effects on the majora as new tight collagen was created. This is without any RF or laser treatment.These are what the study found:Another study in the US and Venezuela by Gustavo found similar results.Gustavo’s World Society of Cosmetic Gynecology did another study and found similar results. You can contact Gustavo Leibaschoff at [email protected] to obtain a copy of his research.Here is the conclusion of the study.So Lana Kerr, CEO and Founder of Lumisque created CO2LiftV for release in America with this kit shown below. 5 small packets and 5 large packets and 5 syringes.The small packet had Glucololactone and the large packet had magnesium carbonate. You mixed them in a small shot glass or paper cup. You suck it up in a syringe. You place it inside the vagina with the syringe and any leftover you place on the external vulva. Simple. Leave alone for 45 minutes and shower or bath. 5 to 10 straight nights and it acts like jet fuel to create vascularity which brings in oxygen which brings in collagen from the awoken fibroblasts. Even elastin is improved and the genital tissues get moist and get the stretch back. This can be used alone and also used in conjunction with vaginal estrogens. Maintenance is done 1-2x per month with a single syringe as needed. Again, it is like a jump start, jet fuel to rapidly improve the tissues. I have used it now for a couple of years and have been totally impressed. I use it to maintain my ThermiVa results! A great post RF or Laser adjunct to maintain the investment your patients have just made.Here is the list for who you may consider treating with Carboxytherapy.Pretty impressive stuff. An option for those who want a rapid response, who are not wanting to use vaginal estrogens, who do not want to use lasers or RF. Or as an adjunct to lasers and RF and vaginal estrogens. So safe and soothing. Another product that started in the face and ended up in the vagina like PRP, Lasers, RF.As a disclosure and disclaimer, I am a consultant for Lumisque.Personal Message About GynflixFor More Detailed Videos Check Out My Index:For more Cosmetic Gynecology Training join Gynflix.comClick here for Silver Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.Gynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 70,000 subscribers to this Cosmetic Gynecology Newsletter and I am hopeful you help me get that many on IG!Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe

The next few weeks will focus on revision surgery and repair of botched labiaplasties. If you are not a subscriber to Labiaplasty Newsletter or to Gynflix.com now is the time to join. The expanded full length versions of all my videos are there. A entire Module on Revision Surgery is available to Gold Fellows members. You will not find these valuable techniques elsewhere. Red Alinsod, MD ([email protected])Video OverviewThis patient had a labiaplasty performed years earlier. She thinks a wedge labiaplasty was done which broke down leaving her with a misshaped right labia minora. She wanted this to be more symmetric with her left side and she wanted her clitoral hood to be more petite and now so wide. I did a Feathering and Sutureless labiaplasty on her and made both labias about the same size without the need for any cutting on them. As for her clitoral hood, we decided on a Vertical Clitoral Hood Reduction technique I invented almost 15 years ago. She was so happy with the results and she continues to be my patient over a decade later. This video is made in HD quality from when I used a Sony video recorder that used magnetic tape. Gynflix.com has newer versions in 4K. Just go to SEARCH and type in any of these keywords: Botched, Revision, Feathering, Vertical Clitoral Hood Reduction, Grooving. Dozens of videos will pop up for you to choose from based on what you want to learn. It is an incredible selection of revision videos. For More Detailed Videos:For more Cosmetic Gynecology Training join Gynflix.comClick here for Silver Subscription at $98 a month: Gynflix SubscriptionContact Suzette Peterson at ‭(909) 374-1000‬ or email her at [email protected] if you are interested in Fellows Gold Subscription at $198 a month.Gynflix is an online e-Learning platform dedicated to Feminine Wellness. Videos of topics such as labiaplasty, vaginoplasty, cliteroplasty, clitoral hood reduction, anal skin tag excision.I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!Social Media:Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 70,000 subscribers to this Cosmetic Gynecology Newsletter and I am hopeful you help me get that many on IG!Instagram: VageniusMDFB: Vagenius - Red Alinsod, MDTicTok: VageniusMDWebsites:Alinsod InstituteGynflixMy Three Newsletters:For the Lay Public and Medical Professionals: Feminine Wellness NewsletterFor Medical Professionals: Cosmetic Gynecology NewsletterFor Surgeons: Subscribe to the Labiaplasty Newsletter:DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Contact:Dr. Red Alinsod: [email protected] Newsletter is a reader-supported publication. To receive new posts and support my work, become a paid subscriber of this Newsletter or get all my Newsletters for free if you join Gynflix.comI really do answer all my own emails and texts so feel free to connect with me and I will do my best to answer your questions and guide you to a more successful labiaplasty practice. Again, my email is [email protected]. Below is a direct text to me. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit labiaplasty.substack.com/subscribe