By now you may have noticed that I have shared the full AIAVS Fellows Videos with you that were previously reserved only for Gold Fellows Subscribers of Gynflix. Here they are:

* AIAVS Fellows Video 40, Rim Labiaplasty with Medial A Incision, May 3, 2024

* AIAVS Fellows Video 61, Perineoplasty, Hybrid Labiaplasty, Lateral A Incision, O-Shot, June 17, 2024

* AIA…

“A” Incision Review: Avoid Dog Ears was released on September 28, 2024. It is 5 minutes long. A great summary. Click the link and watch that one first. I have the photos of the steps shown on that Newsletter.

This is the Full 18 Minute Version created for Gynflix Subscribers. Now you get to learn from it. Lots of new videos have been released rec…

* Carboxytherapy using Lumisque’s CO2Lift V for Pre-Treatment and Post Surgical enhancement of blood flow for Optimized Surgical Outcomes

* How to add this to your practice by linking to Lumisque’s program for doctors.

* No stocking of supplies or mailing of products

* Commission with online sales of CO2Lift

Enjoy the presentation.

Lumisque is at https://lumisque.com

POWERPOINT SLIDES

Past Newsletters and Carboxytherapy Presentations

* 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, 2022

FOR THE SURGEON

The BEST place to learn Cosmetic Gynecology from your home and office. Anywhere.

GYNFLIX Cosmetic Gynecology e-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Click here for Silver Bullet Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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 Gallerygo HERE. The patient’s Story from Start to Finish.

Let’s Stay Connected

I’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

I’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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty and Vaginoplasty Newsletter:

Follow me on my Adventures Worldwide

MY LOCATION

Alinsod Institute — Red M. Alinsod, MD📞 945-900-7576www.alinsodinstitute.comwww.gynflix.com

Labiaplasty and Vaginoplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a paid subscriber.

Personal 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 HERE

Description: 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 Below

REGISTRATION LINK: Click HERE

Past Newsletters and Carboxytherapy Presentations

More 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, 2022

FOR THE SURGEON

The BEST place to learn Cosmetic Gynecology from your home and office. Anywhere.

GYNFLIX Cosmetic Gynecology e-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Click here for Silver Bullet Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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 Connected

I’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

I’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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty and Vaginoplasty Newsletter:

Follow me on my Adventures Worldwide

MY LOCATION

Alinsod Institute — Red M. Alinsod, MD📞 945-900-7576www.alinsodinstitute.comwww.gynflix.com

Labiaplasty and Vaginoplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Desription: 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 Speculum

Here 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-Shot

Click on the picture below for more Combination Pictures

Labiaplasty 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.

Last 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 Labia

Today, 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 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…

I 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…

By Red M. Alinsod, MDAlinsod Institute | Revique Medical & AestheticsArlington, Texas

This 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 SEX

Painful 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 opening

Pain 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 canal

Vaginal 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 pain

Deep 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” sex

A 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 Surgery

Partner pain

Sometimes 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 Menopause

One 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 lubrication

ACOG 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 GSM

What low estrogen does to the tissue

Estrogen 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 hurts

This 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 Options

Vaginal 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 dosing

ACOG 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 Options

There 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 V

3. Tightness is not always vaginismus

Many 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 pain

Deep pain during sex often has a pelvic source.

Endometriosis

Endometriosis 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.

Adenomyosis

Adenomyosis 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 vagina

After 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 anchored

Mayo 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 disease

Not 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 sclerosus

Lichen 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 introitus

Lichen 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 Itch

Lichen planus and lichenoid disease

Lichen 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 depth

Size 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 cause

A larger partner may simply reveal an underlying medical problem that a smaller partner did not trigger.

Dilator Work

Surgical Band Release

This 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 Introitus

8. Birth trauma, episiotomy scars, and perineal damage

Childbirth 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 spasm

Treatments 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 sex

Take 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 space

Mayo 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 complications

Prior 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 symptoms

Some 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 pain

This 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 mobility

Revision 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 Repair

12. Vaginismus and pelvic floor guarding

Vaginismus 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 therapy

Pelvic 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 planning

Dilators: what they do and what they do not do

Dilators 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 Exercise

14. Treatment options: matching the treatment to the cause

Painful sex does not have one universal treatment. The best treatment depends on the diagnosis.

Foundational treatments

Problem: 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 sex

Vaginal estrogen

As 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 DHEA

Vaginal 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.

Ospemifene

Ospemifene 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 testosterone

Vaginal 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 adjuncts

This 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 Biologics

ThermiVa radiofrequency

ThermiVa 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 / plasmaporation

The 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 2025

Fractional CO₂ and Erbium lasers

Examples 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 biologics

Platelet-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 Response

17. Surgical treatment: when anatomy is the problem

Surgery 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 reconstruction

A 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 matters

Painful 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 Pain

Another 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 like

Patients 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 negative

NIDDK 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 sex

Sex 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 days

NIDDK 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 fatigue

Mayo 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 diagnosed

There 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 cases

The 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/BPS

Treatment is individualized. There is no one-size-fits-all cure, but many patients improve when the correct pain generators are addressed.

Lifestyle and trigger management

Many 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 training

Bladder 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 therapy

Pelvic 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 medications

Depending 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 cases

Mayo 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 instillations

Some 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 procedures

For 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 article

IC 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 pain

You do not need to know the diagnosis before you call. That is what the evaluation is for.

A personal note

Painful 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 done

For 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 SURGEON

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:

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For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Click here for Silver Bullet Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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!

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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.

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I’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:

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This 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…

No 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

I 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.

Time 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 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…

Now 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…

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✨ What Gynflix Español Offers

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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 Team

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Versión en español:

Ahora disponible: Gynflix Español — Educación avanzada en ginecología cosméticaAhora disponible: Gynflix Español — Educación avanzada en ginecología cosmética. Y bastante asequible.

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👉 Comience a aprender hoy

Visite 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 Gynflix

English: Suzette Peterson, +1 (909) 374-1000, sette.peterson@gmail.com

Espanol: Marizol Carranza: +1 (949) 573-5804, marisoll.parra@gmail.com

ALINSOD INSTITUTE and REVIQUE IN ARLINGTON, TEXAS

The 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 Arlington

This 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 decade

This is a union you will not find anywhere else. Teamwork at its best.

⭐ North Texas Is Now the Center of the Universe for Cosmetic Gynecology

I 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 & Contact

Revique Medical & Aesthetics — Amy Haddad, MSN, APRN, FNP-C

📍 4040 N Collins St, Suite 134, Arlington, TX 76005📞 817-533-0988📧 amy@reviquemedical.com🌐 www.reviquemedical.com

Alinsod Institute — Red M. Alinsod, MD

📍 Same location📞 945-900-7576🌐 www.alinsodinstitute.com🌐 www.gynflix.com

A Personal Closing Note

My 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, MD

Learn more about Amy Haddad, RNP: Click on picture

Learn more about Red Alinsod, MD: Click on picture

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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty and Vaginoplasty Newsletter:

ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576 Contact: Dian WhiteDr. Red Alinsod: red@gynflix.com

www.alinsodinstitute.com

Gynflix Contacts:

English: Suzette Peterson, +1 (909) 374-1000, sette.peterson@gmail.com

Spanish: Marizol Carranza: +1 (949) 573-5804, marisoll.parra@gmail.com

The 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:

Let'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 …

Founder, The Alinsod Institute for Aesthetic Vulvovaginal SurgeryFounder, Gynflix – Global e-Learning for Cosmetic GynecologyCosmetic Gynecologist • Urogynecologist • Surgeon • Innovator

Personal 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, Texas

For 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 standards

His 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 Vaginoplasty

Dr. 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 Techniques

These advances are now taught internationally—and began directly with Dr. Alinsod’s creativity, research, and hands-on development.

Patents, Devices & Technologies

Dr. 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 reconstruction

His inventions revolutionized how cosmetic and functional gynecologic surgery is performed in clinics worldwide.

Founder of the Field’s Most Respected Training Programs

Dr. 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 worldwide

His reach extends across all continents, shaping standards, guidelines, and techniques used by the global medical community.

A Recognized Leader in Revision Surgery & Restorative Feminine Repair

Dr. 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 recovery

Air Force Major, Surgeon, and Patriot

Dr. 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 Heart

Though 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 him

When 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, Texas

Dr. 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, 2024

CV and Bio

Bio Cv Inventions Awards Pubs Nov 2024 V2

44.2MB ∙ PDF file

Download

Alinsod Adventures

Click picture below for more pictures of Dr. Alinsod teaching worldwide

Let’s Stay Connected

I’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.com

I’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 Surgeon

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-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Click here for Silver Bullet Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576

Contact:Dr. Red Alinsod: red@gynflix.com

Before 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 (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

I have the Equipment List and Informed Consent below for subscribers.

Let’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 Instructions

Labiaplasty and Vaginoplasty Newsletter is a reader-supported publication. To access all content become a paid subscriber.

Happy 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 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…

Radiosurgery 101 for 2026: The Soniquence Difference

One 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 (red@gynflix.com)

www.alinsodinstitute.com

www.gynflix.com

Introducing my new Arlington, Texas, Practice

Dear 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 Innovation

For 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 Bio

Comprehensive Women’s Wellness

At 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 Plasmaporation

We’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 Connected

I’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.com

I’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 Surgeon

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-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Click here for Silver Bullet Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576Contact:Dr. Red Alinsod: red@gynflix.com

www.alinsodinstitute.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, become a paid subscriber.

This 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 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 Desires

Welcome 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.

I 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…

On 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 …

There 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…

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: VageniusMD

If 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 Management

This 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 (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Call to Action

Gynflix 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 red@gynflix.com 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 Surgery

GYNFLIX Cosmetic Gynecology e-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Subscriptions: GYNFLIX PRICING

SILVER 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 sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

ARLINGTON OFFICEAlinsod Institute Arlington, TexasPhone: 945-900-7576Dr. Red Alinsod: red@gynflix.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, be a paid subscriber.

I 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.

All 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…

THIS ZOOM WEBINAR

In 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, MD

WHAT’S UP NEXT

On 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 practice

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.

Webinar Details:

* Time: July 9th at 6pm CST

* Duration: 45 minutes with Q&A

If 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 Financing

Date and Time: July 9th at 6pm CT

Here is your specific link to next week’s program: GetHairMD Webinar

GYNFLIX 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-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Click here for Silver Bullet Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576Contact:Dr. Red Alinsod: red@gynflix.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Dear 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 details

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, become a paid subscriber.

This Labiaplasty Newsletter is $48 a month. It is free to subscribers of Gynflix.

Lichen Sclerosus: Understanding Incidence, Cancer Risk, Follow-Up, and Treatment Options

Part 2 of 4: Biopsy and Ruling Out Carcinoma

Dear Fellow Surgeons,

Welcome to my Part 2 Newsletter dedicated to lichen sclerosus (LS), a chronic inflammatory dermatosis primarily affecting…

This Labiaplasty Newsletter is $48 a month. It is free to subscribers of Gynflix.

Understanding and Treating the Buried Clitoris

Part 1 of 4: Surgical Techniques for Buried Clitoris Release

Dear Fellow Surgeons,

As pioneers in aesthetic and reconstructive gynecology, we continually strive to enhance our patients’ quality of life through precise, innovative…

Alinsod Institute for Aesthetic Vulvovaginal Surgery

Dallas, TX

BACKGROUND:

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 anesthesia

3. 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-Shot

The Short Version is 1:24:50 long: Feathering and Grooving Revision, CHR, and O-Shot for Botched Labiaplasty

The 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: Revisions

Photography: 2015

1st Row: Before Barbie Labiaplasty, Vertical CHD, and Labia Majoraplasty

2nd Row: Immediately After Surgery

3rd Row: Before Grooving

4th Row: Immediately After Grooving

5th Row: Four Months Post Op

6th Row: Six Months Post Op

Top Row: Before Grooving

Middle Row: Immediately After Grooving

Bottom Row: Six Months Post Op

Full Surgical History: Before all Surgeries and After Grooving Revision in 2015

LABIA MINORA RECONSTRUCTION USING A LABIA MAJORA FLAP

Click HERE for my September 2024 Newsletter on this publication.

GYNFLIX Cosmetic Gynecology e-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Subscriptions: GYNFLIX PRICING

SILVER 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 sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For 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: red@gynflix.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

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 IG

On 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-Learning

For Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

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.

Subscriptions: GYNFLIX PRICING

SILVER 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 sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For 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: red@gynflix.com

Labiaplasty 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.

I 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…

I 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

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 1

PROTOCOLS FOR JETT MEDICAL TREATMENTS

For more information contact Distributor: Dan Wray: dan.wray@neonaturals.com

GYNFLIX COMMUNITY

On 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.com

Subscription 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 sette.peterson@gmail.com.

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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For 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: red@gynflix.com

This 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.

Make 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 red@gynflix.com or text me at 945-900-7510 if you have questions about Feathering.

For the past 4 y…

What 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, 2025

Part 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: bbernstein@soniquence.com

Here 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 …

Not 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…

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 sette.peterson@gmail.com 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 Tags

Prepping 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 Revision

Labia Majoraplasty

* Labia Majoraplasty Anesthesia and Marking

* Labia Majoraplasty with Fat Pad Reduction, VCHR, LMF, O-Shot – Short

Unified 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 Tags

Clitoral 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 Approaches

Clitoral 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 2024

Botched 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 Revision

Vaginoplasty

* 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 Augmentation

Vampire Wing Lift/Majora Augmentation

* ThermiVa, O-Shot Clitoxin, Vampire Wing Lift with FemXHA

* ThermiVa with Vampire Wing Lift

Perineoplasty

* Small Perineoplasty

* Perineal Band Release

* Band Release

Radio Frequency Treatments

* Live Narrated Thermi-O

* ThermiVa with Vampire Wing Lift

* ThermiVa, O-Shot Clitoxin, Vampire Wing Lift with FemXHA

Hymenoplasty

* Hymenoplasty PIllar Technique

Luksenberg Incontinence Procedure

* The Luksenburg System for SUI

Anal Skin Tags

* Anal Skin Tag Excision with Bipolar RF

* Anal Skin Tag Excision Compendium

* Live Narrated Excision of Anal Skin Tag with LightScalpel Laser

Each 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 2025

On 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 (red@gynflix.com)

For More Detailed Videos Click on the Index Photo Below:

For more Cosmetic Gynecology Training join Gynflix.com

Click here for Silver Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For 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: red@gynflix.com

Will 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…

The 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 Reduction

Watch 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 picture

The 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, Poland

Red Alinsod, MD (red@gynflix.com)

The Steps for Medial Clitoral Hood Reduction Surgery

The 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

I 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 Majoraplasty

Watch 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 Gynflix

Examples 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 (red@gynflix.com)

The Steps for Vertical Clitoral Hood Reduction Surgery

The 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.com

Full Length Description of “Live Narrated Clitoral Reduction, Frenulectomy, Vertical Clitoral Hood Reduction

This 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 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 (red@gynflix.com)

The Steps for Lateral Clitoral Hood Reduction Surgery

Red Alinsod, MD (red@gynflix.com)

CO2LiftV by Lumisque

I 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 drghl@icam-usa.com 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 Gynflix

For More Detailed Videos Check Out My Index:

For more Cosmetic Gynecology Training join Gynflix.com

Click here for Silver Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For 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: red@gynflix.com

Red Alinsod, MD (red@gynflix.com)

Video Overview

This 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.com

Click here for Silver Subscription at $98 a month: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com 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: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For 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: red@gynflix.com

Labiaplasty 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.com

I 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 red@gynflix.com. Below is a direct text to me.

I am going to introduce you to the concept of the Unified Approach. What is that?

* Vulvovaginal surgery done in one session. Not staged.

* Labiaplasty of the Minora and Majora and Clitoral Hood all at the same time.

* Labiaplasty (Minora and/or Majora with Clitoral Hood) with Vaginoplasty and Perineoplasty all at the same time.

* To achieve a sleek and petite Ba…

AIAVS LABIAL MODULES CONTENT 2024

S1      Labia Minoraplasty + Clitoral Hood Reduction

S2     Labia Majoraplasty

S3     Clitoral Hood and Clitoral Surgery

S4     Perineoplasty

S5     Vaginoplasty

S6     Hymenoplasty

S7     Botched Revision Surgery

S8     Combination Labial Surgery

S9     Combination Labial and Vaginal Surgery

S10   All Access Labial Workshop

S11   All Access Vaginal Workshop

S12   Labiaplasty Core

S13   Vaginoplasty Core

S14   External Anal Skin Tag Reduction

AIAVS NON-SURGICAL MODULES CONTENT 2024

NS1  Synergy O-Shot and RF Training

NS2 Majora Filling and Vampire Procedures

NS3  Predictive Permeation

NS4  Miscl.

P       Gynecologic Photography and Videography

O      Office Forms

Red Alinsod, MD

Follow me on Instagram: VageniusMD

Module S1: Labia Minoraplasty and Clitoral Hood Reduction

1.    Webinar: #1 Labiaplasty 101 Webinar for Introduction to the course, 03:20:03

2.    Lecture: #1 Labia Minoraplasty Lecture 2020, 01:23:48

3.    Lecture: #22 Barbie and Hybrid Look Labiaplasty Steps, 43:23

4.    Lecture: #21 The Process Labiaplasty Start to Finish, 1:40:08

5.    Lecture: #15A Labiaplasty Set Up and Draping Doctor View, 16:36

6.    Lecture: #15B Labiaplasty Set Up and Draping Patient View, 04:25

7.    LNS6 v1 Live Narrated Table Height, 1:04

8.    LNS6 v4 Live Narrated Labiaplasty Set Up of Instruments and Draping, 26:46

9.    Lecture: #16 Labia Minoraplasty Anesthesia and Marking, 22:19

10. Lecture: #18 Clitoral Hood Reduction Review, 30:32

11. Lecture: #20 - Rim Labiaplasty Basics, 20:23

12. AIAVS Video 60, Live Narrated Rim Labiaplasty Gold Standard, 01:21:07

13. Surgical Videos Narrated: #3 Final - Barbie LP with CHR, A Incision Steps, 09:04

14. Surgical Videos Narrated: #3 Final - A Incision Steps Final, 05:44

15. Surgical Videos Narrated: #12 Final - Hybrid Labiaplasty with Clitoral Hood Feathering, 21:10

16. Surgical Videos Narrated: #13 Final - Perineoplasty, Sutureless Labiaplasty with Feathering Resurfacing Revision, 39:50

17. Surgical Videos Narrated: #15 Final - Hybrid LP, CHR, Anal Skin Tag Removal Full Steps, 48:30

18. Surgical Videos Narrated: #15 Final - Hybrid LP, CHR Anal Skin Tag Removal Short Steps, 04:46

19. Surgical Videos Narrated: #18 Final - Rim Labiaplasty, CHR, Perineoplasty, 29:02

20. Surgical Videos Narrated: #19 Final - Lateral Clitoral Hood Reduction, 13:33

21. Surgical Videos Narrated: #A1 Final - Incisionless LP with Feathering Revision, 04:42

22. Surgical Videos Review: Alinsod 2C Hybrid LP for Asymmetry & Majora RF Long, 19:07

23. Surgical Videos Review: Alinsod 2D Unified Approach LP, CHR, 11:37

24. Non-Surgical Videos Narrated: Alinsod Q-Tip Exercise v2, 01:58

25. Surgical Videos Review: Alinsod 6 Vaginal Softening Exercises, 02:39

26. AIAVS Fellow Video 1 Perineoplasty, Hybrid Barbie Labiaplasty with CHR, 49:22

27. AIAVS Fellow Video 2 Live Narrated Hybrid Labiaplasty v2, 01:12:19

28. AIAVS Fellows Video 9, Perineoplasty with Labiaplasty Revision for Gaping, Medial Labial Excision, 34:47

29. AIAVS Fellows Video 33, Live Narrated RF Feathering of External Anal Skin Tags, 38:39

30. AIAVS Fellows Video 40, Live Narrated Rim Labiaplasty with Medial A Incisions, 01:05:49

31. AIAVS Videos 45, Live Narrated Barbie Look Labiaplasty with Wide Clitoral Hood Reduction and Contouring, 01:56:09

32.  AIAVS Fellows Video 61, Live Narrated Perineoplasty, Hybrid Labiaplasty, Lateral A Incision, O-Shot, 01:35:06

33. LNS15 Live Narrated Barbie Look Labiaplasty with Medial and Lateral A Incisions, 46:20:12

34. AIAVS Fellows Video 71, Live Narrated Vertical CHR, Feathering, O-Shot, Vampire Wing Lift, 01:05:49

Rocking that Gynflix Life:

The Gynflix Life keeps you updated and on top of the heap.

For More Detailed Videos:

For more Cosmetic Gynecology Training join Gynflix.com

Click here for Silver Subscription: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com if you are interested in Fellows Gold Subscription.

If you want to go directly to O-Shot/Clitoxin and Vampire training go here: Runels CMA

I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

Social Media:

Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD. I have thousands of subscribers to this Cosmetic Gynecology Newsletter and I am hopeful you help me get that many on Instagram!

Instagram: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7510Contact:Dr. Red Alinsod: red@gynflix.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

* July 1, 2024: Labia Majoraplasty 101

* July 17, 2024: Labia Majoraplasty Anesthesia and Marking

* August 4, 2024: Labia Majoraplasty with Fat Pad Removal

At the end of this month I will show you how to use FemXHA to augment the Labia Majora. That will conclude our coverage of the Labia Majora until later on in the year when I will tackle the really tough cases.

In September I will show you how to do the Unified Approach to Labia Minoraplasty and Labia Majoraplasty performed at the same time alongside Clitoral Hood Reduction. Here is a list of more cases to view on Gynflix if you want to further refine your skills. Subscribe to Gynflix and supercharge your Cosmetic Gynecology skills.

Go to my Instagram for daily updates on my activities: Instagram: VageniusMD

Red Alinsod, MD (red@gynflix.com, 945-900-7510)

For more Radiosurgical Training join Gynflix.com

Click here for Silver Subscription: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com if you are interested in Fellows Gold Subscription.

If you want to go directly to O-Shot/Clitoxin and Vampire training go here: Runels CMA

I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

Social Media:

Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram as VageniusMD. I have around 100,000 subscribers to this Labiaplasty Newsletter and I am hopeful you help me get that many on IG!

Instagram: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7510Contact:Dr. Red Alinsod: red@gynflix.com

Discover the ultimate online platform for Cosmetic Gynecology training with GYNFLIX 2.0. Since its inception in October 2022, GYNFLIX has rapidly grown, attracting members from all 50 states and 75 countries worldwide. This August 5, 2024, GYNFLIX 2.0 launches with a visually appealing interface, easier navigation, and enriched content—without an increase in price! Our comprehensive training modules, once costing between $2,500 to $25,000, are now available to Gold Fellows at no additional fee.

Why Choose GYNFLIX?

* Premier Education: Access the best Cosmetic Gynecology education online at the lowest price.

* Increased Profitability: GYNFLIX training will enhance your practice’s profitability.

* Comprehensive Support: Benefit from premium support, including direct access to Dr. Red Alinsod, the developer of these groundbreaking techniques.

* Stay Competitive: Don't let competitors outpace you—train with the industry’s best and stay ahead.

The Benefits of GYNFLIX 2.0

* User-Friendly Interface: Easier navigation with pre-defined search terms.

* Exclusive Content: Access Full-length 4k narrated surgeries, live Zoom recordings, international expert discussions, direct access to Dr. Alinsod, and more.

* Enhanced Learning: Enjoy detailed video lectures, live webinars, and personalized calls/texts/Zooms and FaceTime.

* Marketing and SEO Support: Gain access to a custom physician profile page on www.vaginalrejuvenation.com to boost your online presence and attract more patients.

Join the Revolution in Cosmetic Gynecology Subscribe to GYNFLIX and embark on a journey to become a leading expert in Cosmetic Gynecology. Learn from Dr. Alinsod’s 20+ years of experience through high-definition videos, detailed modules, and live interactions. Enhance your skills, attract more cash-paying patients, and improve your quality of life.

Seeking Surgical Expertise? For those ready to elevate their practice with advanced surgical expertise, visit www.alinsodinstitute.com. Dr. Alinsod is a renowned expert in labiaplasty and vaginoplasty surgery, providing unparalleled resources to support and ensure you master these procedures with confidence and precision.

Don’t Miss Out! Transform your practice and stand above the crowd. Subscribe to GYNFLIX 2.0 today and explore the exceptional educational resources and marketing opportunities that await. Visit www.gynflix.com for more information and start your journey to becoming a Cosmetic Gynecology expert. From anywhere in the world.

Contact Us For more information, reach out to Suzette Peterson at sette.peterson@gmail.com or call (909) 374-1000. Transform your practice with GYNFLIX 2.0 and the Alinsod Institute today!

Red Alinsod, MD (red@gynflix.com, 945-900-7510)

Full Description of Gynflix: Watch this Video

I presented this to my Gold Fellows this Friday to describe the New Gynflix 2.0 on our Zoom:

Welcome to the launch of GYNFLIX 2.0!  The PREMIER Cosmetic Gynecology Online Learning platform second to none.  I have dedicated my entire career to cosmetic gynecologic surgery and sharing of this knowledge worldwide.  Now my 20+ years of photo and video collection are available direct to your home and office, computer and iPad, and phones!  You can learn from anywhere at any time on-demand. 

I am adding a tremendous amount of content and making it easier for you to find exactly what you want to learn in this rapidly growing specialty.  New and original content every month.  Both doctors and prospective patients can come here to learn and find the resources to make informed decisions. 

I have hundreds of original, detailed, narrated videos on these surgeries:

Labia Minoraplasty

* Barbie Look

* Hybrid Look

* Rim Look

* Sutureless Labiaplasty

* Feathering

Labia Majoraplasty

* Fat Pad Reduction

Clitoral Hood Reduction

* Lateral

* Medial

* Vertical

* “A” Incisions

Cliteropexy

Clitoral Reduction for the Protuberant Clitoris

Vaginoplasty

Perineoplasty

Combination Surgeries and the Unified Approach

Botched Labiaplasty Repair and Feathering

In-office Awake No IV Anesthesia Protocols

I also have an extensive collection of Non-Surgical Procedures covered:

* Radiofrequency therapies for the labia and vagina

* Laser therapies for the labia and vagina

* Predictive Permeation for Genital Use

* Emsella and HIFEM

* O-Shot and Clitoxin

* Amniotic Fluid Therapies

* Exosome Therapies

* Vulvar Plumping with Vampire Wing Lift

* FemXHA (PRP + HA Filler)

* Vampire Facials and Face Lifts

* Carboxytherapy

Gold Fellows Subscribers can now access specific training Modules that used to cost thousands of dollars at no additional cost.  Completing the Modules and passing the tests leads to an Alinsod Institute Diploma.

I am most excited about my collaboration with Charles Runels, MD, and his Cellular Medicine Association and our ability to teach together at the highest level leading to full accreditation and licensure to use his trademarked terms O-Shot, Clitoxin, P-Shot, Vampire Wing Lift, Vampire Facial, Vampire Face Lift. This is priceless. My non surgical Modules will be used for training and accreditation with ongoing support provided by Charles and his team.

I want to personally invite you to check out what I have to offer and what Gynflix is all about and how it can transform your practice. Lots of stuff to see below.

The Value of Gynflix

* Get the best Cosmetic Gynecology education online

* At the lowest price

* With premium support

* Gynflix will increase your profitability

1.    Desire: You want cash cases in your office

2.    Problem: You don’t know how to do it.  You are afraid of getting into trouble and don’t know how to start.

3.    I will be your guide.  I developed the techniques and have taught the teachers worldwide.  Go to the source.

4.    I have a plan.  Step-by-step learning proven over 20 years.  From videos, to webinars, newsletters, to personalized calls/Zoom/FaceTime with me. 

5.    Subscribe to Gynflix and learn from me and your peers.  Benefit from our experience and follow the right path.

6.    Don’t get left behind.  Your competitor next door is eyeing this field.  Train with me and be light years ahead.

7.    Financial Value will expand over 100x!

8.    Your Quality of LIfe will improve. 

GYNFLIX 2.0 SUBSCRIPTION SERVICE FOR 2024

Download

Cosmetic Gynecology is the fastest growing segment of OBGYN that I have witnessed.  It certainly has been the most rapidly growing field in Plastic Surgery the past few years according to their professional societies.  The huge unmet demand for feminine wellness and feminine cosmetic surgery is everywhere and most regions of the world do not have an expert in the field.  Most regions of the world lack access to quality training programs.  That is why GYNFLIX was born.  I want to bring my 20+ years of experience and share my secrets with you with nothing held back.  Direct to your office and desk.  I want to open your eyes and get you highly trained, make you competitive and able to attract and meet the needs of women seeking to renew their femininity.   I will build GYNFLIX as the switchboard that brings doctors and patients together.  GYNFLIX will be where education and marketing shake hands and makes you stand out confidently and competently.   GYNFLIX is where the sole focus is on you and your bottom line. 

Quick Q&A:

How is GYNFLIX 2.0 different from the original Gynflix?

* Easier to navigate to find specific videos with a familiar look and feel

* Pre-defined SEARCH terms

* Alinsod Live Zoom Recordings have been added for Gold Fellows Access

* International team of experts discussing specific conditions and surgeries

* More Fellows Videos have been added to Silver and Gold subscriptions

* Dozens of new short Preview Videos (2-6 minutes long) for review before cases

* Schedule private time with me via Calendy

* Each member can choose to be listed on the Gynflix Directory and be given a listing on www.vaginalrejuvenation.com. 

* Gynflix subscribers can access my webmaster, SEO, and Social Media Team

1.       How will GYNFLIX benefit me?

* GYNFLIX will be your hub for education and marketing at very low costs.  You can learn on your computer or your phone at any time that fits your schedule.  You can focus on what interests and at what pace you want your learning to proceed.  You can come and go as you please and there are no long-term contracts.  You are in control. 

2.       How will GYNFLIX make me a better doctor?

* You will learn what your patients are looking for, how to meet their needs, how to talk to them, how to do the procedures safely and in the office, and how to run a cash practice to augment and perhaps replace your insurance-based practice.  I make you a better doctor by improving both your skillset and your mindset. 

3.       How will I gain experience?

* You will have my most detailed video lectures to watch and learn from as if you were sitting right beside me on my left side all in HD and mostly 4K quality.  You will hear my detailed instructions, my commentary that you cannot get anywhere else, the pearls that keep you out of trouble and keep you ahead of your competitors.  You will have access to my collection of articles, my discussion forums, webinars, and live Zoom Meetings.  You may have  personalized access to me at the Gold Fellow level. 

4.       How will I get specialized?

* There are detailed Modules you can choose to obtain a Diploma on.  The Modules themselves are free for Gynflix Gold Fellows and the actual Diploma is only $250 for those that want or need one printed or in digital form.  The Modules have a great depth and variety of videos to get specialized training.  Examples are separate and individual Modules on labia minoraplasty, labia majoraplasty (Barbie/Hybrid/Rim), clitoral hood reduction and contouring, clitoral reduction, perineoplasty, vaginoplasty, hymenoplasty, revision surgery, feathering revisions, O-Shot, Vampire procedures, anal skin tag management.

5.       How will GYNFLIX help me stand above the crowd?

* You will learn how to market to patients, to speak to them and attract and keep them.  You will learn exceptionally refined techniques that create beauty and provide safety.  You can review the videos before your cases on your phone before you start.  You will stay out of trouble and get consistent results with my techniques.  You will be the best trained expert in your region and the one with the best resources, made just for you, such as the forms, consents, and patient handouts and teaching videos.  You do not have to recreate the wheel.  Everything at your fingertips.

6.       How will GYNFLIX help me generate more cash paying patients?

* Once trained you will advertise to your patients the new services you offer above what your competitors offer.  You can now offer cash treatments for OAB, GSM, Lichen Sclerosis, labial hypertrophy and asymmetry, vaginal laxity, birth trauma.  You will learn how to generate cash paying patients in your insurance practice to augment your income.  At no additional cost you will be listed on the GYNFLIX Directory where patients can find you in your area. 

7.       How are videos better than newsletters and how is live teaching the best?

* Newsletters are wonderful to learn of new ideas and treatments and upcoming events.  They are a quick review.  Videos are best in teaching the actual detailed procedure and to learn as if you were present in the room.  We combine both.  But if you want the best experience and the fastest way to achieved procedural confidence, you can take live surgical courses and use my videos to supplement the training.  The videos reinforce and help review what you saw live.  

GYNFLIX 2.0 SUBSCRIPTION SERVICE

GYNFLIX DETAILS

1.    FELLOW VIDEOS: Monthly Releases, Live Narrated/Full Length, HD and 4K quality.  Silver Members will have access to select Fellows Videos and Fellows will get access to ALL Fellows Videos first.

2.    Alinsod Library collection of Cosmetic Gynecology articles in PDF format will be made available to you upon request.

3.    Office Forms and Dictations are available upon request for Gold Fellows.

4.    Quarterly ALINSOD LIVE Zoom Webinars for all subscribers

* a.    In-Depth monthly International discussions of specific topics

* b.    Alinsod Live Webinars from 2021-2024 are available for Gold Fellows on demand

5.    Private access to Dr. Alinsod via Private Phone/Text/Email/Zoom for Gold Fellows

* You can arrange a private Zoom/FaceTime/Phone call with Dr. Alinsod using Calendly to discuss surgery, your cases, management. 15 minute dedicated blocks for you alone with Dr. Alinsod.

6.    Expanded Listing: Contact information and practice details/photos/links placed on www.vaginalrejuvenation.com.  See comment below from my world famous SEO Provider, Sergei Baghdasarian.

7.    Marketing Support gives Fellows exclusive access to my team of webmaster, SEO, and Social Media specialists.  They are the best in the field.  They will be available for hire to my members. 

8.    GYNFLIX FOR WOMEN Previews: A section on GYNFLIX that caters to the lay public to give them information on Cosmetic Gynecology via videos and pictures, educational handouts, and access to the listings of GYNFLIX members.  It is educational and marketing aid for our members.  The “Previews” and “Alinsod Atlas” tabs are for lay public education also.

9. Marketplace: Where patients can see all the active members and have a choice of locations to consider.

From Sergei Baghdasarian, SEO Specialist:

GYNFLIX and VaginalRejuvenation.com have joined and will provide all active members of GYNFLIX a custom physician profile page. Non-GYNFLIX member rates start at $3250 per year.

How www.VaginalRejuvenation.com helps your practice:

* Drive direct traffic to your website

* Generate more patients

* Build link power from the #1 most relevant website and domain name for vaginal rejuvenation

* Fortify your credibility as an expert Vaginal Rejuvenation Surgeon.

* Never underestimate, undervalue, or under-rate a top tier keyword DOT COM. The power of a listing on Vaginal Rejuvenation is not dependent on the number of potential patients who will see your profile but also the power of the inbound link from this domain name. Your website ranking will improve because of a link from our website. Vaginal Rejuvenation generates over 88,000 unique visitors per month.

GYNFLIX 2.0 SEARCH TERMS

Download

GYNFLIX 2.0 MODULES

Download

Non-Surgical Modules (NS1, NS2, NS3) will be tightly integrated with Charles Runels and his Cellular Medicine Association leading to membership and licensure to use his Trademarks O-Shot, Clitoxin, P-Shot, Vampire Wing Lift, Vampire Facial, Vampire Face Lift.

TO JOIN GYNFLIX

Click here for Silver Subscription: Gynflix Subscription

Contact Suzette Peterson at ‭(909) 374-1000‬ or email her at sette.peterson@gmail.com if you are interested in Fellows Gold Subscription.

If you want to go directly to O-Shot/Clitoxin and Vampire training go here: Runels CMA

I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!

My Three Newsletters:

For the Lay Public and Medical Professionals: Feminine Wellness Newsletter

For Medical Professionals: Cosmetic Gynecology Newsletter

For Surgeons: Subscribe to the Labiaplasty Newsletter:

Social Media:

Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD. I have around 70,000 subscribers to this Cosmetic Gynecology Newsletter and I am hopeful you help me get that many on IG!

Instagram: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Websites:

Alinsod Institute

Gynflix

DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7510Contact:Dr. Red Alinsod: red@gynflix.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a paid subscriber at only $48 a month. Gynflix Gold Fellows subscribers receive this at no charge.

First be sure to watch “Labia Majoraplasty 101” released July 2, 2024. You will need that background as your foundation and then this current video as your upward piling on of skillset. This is not for the faint of heart. Join Labiaplasty Newsletter and to view all these amazing surgeries that are done in the office with local anesthesia.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Patient Selection:

* Labia Majora with a great deal of fat

* Outlining in her clothing

* Chronic irritation, sweating, discomfort

* Here are my thoughts on the procedure:

* Do these in the surgery center until your comfort level is higher. Don’t do these Fat Pad Reductions unless you have the basic Majoraplasty skills down pat.

* It is hard to control pain. Fat has lots of nerves. You will need about 20cc of local per side. Probably more.

* This can be bloody.

* You may need to place multiple interrupted 4-0 Vicryl sutures to control the bleeding

* Standard cautery and Bipolar RF work well to control bleeding

* CO2 Lasers are not very effective in controlling the bleeding

* Removing too much majora skin can cause a gaping appearance.

More Labia Majoraplasty Photo Sets on Alinsod Institute

More Fat Pad Removal Videos on Gynflix

By now you have hopefully finished watching Labia Majoraplasty 101 published July 2, 2024. If you have not seen that CORE video then watch it first. This current short video focuses on just the anesthesia and the markings for a basic Labia Majoraplasty. This one was for a fat pad reduction to go along with the Majoraplasty. It is a short session but well worth it with my commentary. You need to be a paid subscriber to see these videos and photos. It is only $48 a month. This newsletter is also free to all Gynflix Gold Fellows.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

I am asking ALL of you, my Labiaplasty Newsletter subscribers, to follow me as the VageniusMD on Instagram and get the most updated info daily!

Follow VageniusMD on IG, TicTok and LinkedIn. Follow Vagenius on FB.

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a paid subscriber.

I have used this PowerPoint slide set for over a decade and it is still the best out there for learning how do to a Labia Majoraplasty. I recorded my lecture to teach from afar. It is a bit over an hour and a great place to start our journey together into the treatments for the often forgotten vulvar regions.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Follow Vagenius on FB and VageniusMD on IG, TicTok and LinkedIn.

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a paid subscriber.

For Gynflix Subscribers:

Here are screenshots of videos available on Gynflix for more advanced cases: Click on the pictures to go to the web pages:

The Steps in Detail

Screenshots from the video are shown with expanded details on every step discussed. Watch the video first then use these dozens of pictures to review the content and get more of my inside pearls. There is no place on earth you will get this level of detail and shared experience. You have to join our group and subscribe. Watch the video on one screen and follow these slides on another screen side by side.

I want to introduce you to my AIAVS Fellows Video Collection. This is #61 of several hundred “Fellows Gold” videos found on Gynflix. Every month I release one or two exceptionally detailed videos of my cases that are edited to make you feel as if you were sitting right beside me on my left. I narrate and speak to you as if you were doing a solo stint with me in Laguna Beach like I did for almost two decades. I am sharing this video to my Labiaplasty Newsletter subscribers. This screenshots shows the available Fellows videos on Gynflix as of June 5, 2024. There will be a hundred more by July. My 4 year collection of Alinsod Live Zoom meetings will also be available to Fellows in July. Be disciplined and watch one or two every week and you will the expert of your region.

This video is a perfect way to end the first half of the year concentrating on my method of Curvilinear Labiaplasty surgery. This happens to be a Hybrid Labiaplasty with significant Lateral A Incision to reduce the clitoral hood bulkiness without doing a clitoral hood reduction. This avoids Dog Ears. It could easily also have been a Rim or Barbie Look Labiaplasty. The steps are the same. Only the placement of the marks are different. I also show you a small perineoplasty that makes the appearance more refined and youthful. Nothing gapes, there is more tightness on the vulvar appearance. Plus I show you my O-Shot and PRP use at the end. You will notice that I did not do a Labia Majoraplasty but the final results hint at a tighter Labia Majora from the use of a small perineoplasty and PRP injection.

I will focus on Labia Majoraplasty starting in July’s newsletter. After that I will cover Combination Surgery in the Fall. We will finish the year with Advanced Clitoral Surgery and Botched Labiaplasty Repairs. I will show you how to make a labia where there was none! My Grooving technique I teach my Fellows. Really really cool stuff only for my Labiaplasty Newsletter and Gynflix subscribers. Click the Subscribe Now button below.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Follow Vagenius on FB and VageniusMD on IG, TicTok and LinkedIn.

The Steps in Detail

Screenshots from the video are shown with expanded details on every step discussed. Watch the video first then use these dozens of pictures to review the content and get more of my inside pearls. There is no place on earth you will get this level of detail and shared experience. You have to join our group and subscribe.

I spend a great deal of time concentrating and teaching you on how to make sure there are no Dog Ears and that you never have a Top Heavy appearance. This is a good review. This June 2024 will be dedicated to complete my Basic Training for labia minoraplasty surgery. July starts with Labia Majoraplasty surgery.

The Steps covered in today’s video:

* Ane…

I covered Lateral Clitoral Hood Reduction on May 10, 2024 and gave a sneak peak of how to do the Vertical Clitoral Hood Reduction at the 25:31 mark of that video. Watch that one first before this video. This is the full 18:49 video of the Vertical Clitoral Hood Reduction Surgeryu for you to see each step along the way without commentary from me. This video also shows how I do my Sutureless Labiaplasty covered on May 17, 2024 but without commentary. Go see that one if you have not already done so as I describe in full details the steps to my method of Sutureless Labiaplasty. The actual start of the Vertical Clitoral Hood Reduction is at the 8:15 mark.

Next week we will put it all together with a full-length hour long video called Live Narrated Clitoral Hood Reduction and Contouring, A Incisions for Severe Asymmetry. You will love that one! If you are not a paying subscriber now is the time you really should jump in and join the Labiaplasty Newsletter. It is inexpensive at only $48 a month. You will multiply that investment 1000x easily over your career. There is nowhere else you can get his level of detail and education to become the best labiaplasty surgeon you can be. You can also get this Labiaplasty Newsletter and Cosmetic Gynecology Newsletter at no additional fee if you are a Gynflix Gold Fellow subscriber.

I will start on the Labia Majoraplasty training in July. This will help complete your labiaplasty education and place your skills above your competitors. Here is a screenshot of the Majoraplasty videos available now on Gynflix.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Follow Vagenius on FB and VageniusMD on IG, TicTok and LinkedIn.

The Before and After Photos of the procedure are below with description of the technique seen in the video.

I want to show you how I do labiaplasties without suturing. This is an extension of my Feathering Technique for Botched Labiaplasties and Revision Surgery using Soniquence RF. This can also be done with a highly precise CO2 Laser. I use the LighScalpel Laser. It is the best surgical CO2 laser for Vulvovaginal surgery. I will dedicate future newsletters to the LightScalpel for labial surgeries.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Follow Vagenius on FB and VageniusMD on IG, TicTok and LinkedIn.

Subscribe now to this Labiaplasty Newsletter for the most updated labiaplasty information available anywhere. It is easily going to be worth 1,000x your small monthly investment of $48 a month in just a few years. You can also get this Labiaplasty Newsletter and Cosmetic Gynecology Newsletter at no additional fee if you are a Gynflix Gold Fellow subscriber.

I transformed a modified vulvectomy skill I had learned as a former GYN ONC wannabe Fellow to a beautiful slimming and reducing technique to enhance labiaplasty surgery back in 2005. I noticed that the dramatic Barbie and Hybrid Look labiaplasties I was performing were gorgeous but it left a “TOP HEAVY” appearance. I had dramatically reduced labia minora tissue which left the clitoral hood sometimes looking huge and eventually was termed a “penis deformity.” This newsletter will show you how I perform my Lateral Clitoral Hood Reduction. There are dozens of these 4K videos shown on Gynflix.

I will be releasing Gynflix 2.0 later this month. It is a major upgrade that will make navigating and finding the videos you want easier. I will also offer all my modules at no additional charge for the Gynflix Gold Fellows members. That saves thousands and thousands of dollars and gives you the training diplomas you have requested. Best of all, it will have dozens of new full-length AIAVS Fellows Video and all my recorded webinars of the past 3 years. It is a serious upgrade! Gynflix Gold Fellows members will continue to receive this Labiaplasty Newsletter at no additional cost.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Follow Vagenius on FB and VageniusMD on IG, TicTok and LinkedIn.

Lateral Clitoral Hood Reduction Technique

Below is an example of a patient I saw who had a beautiful labial reduction but was left with a very wide clitoral hood, dog ears, and asymmetry. Not good enough. How can I make the flow from top to bottom smoother and more attractive? Which Clitoral Hood Reduction technique works best for most of these patients?

I had seen several patients who had an attempt at clitoral hood reduction by renown plastic surgeons which gave an improvement in the length of the clitoral hood but not the width of the clitoral hood. I did not like the appearance of that technique as it left a prominent upside down “U” smack dab in the middle of the clitoral hood. Several had firm scars you could easily feel. Here is one of my Case Studies.

I ended up feathering the thick scar over the clitoral hood, removing the little guitar-like strands left, and creating a Barbie Look Labiaplasty. I will cover more about Feathering/Resurfacing/Revision on a future newsletter. Here is the photo set of the case from Before to Immediately After to After:

Now onto the way I like doing my Lateral Clitoral Hood Reductions. I have taught this to hundreds of surgeons for the past two decades and now sharing it for the first time outside my office or Congress podium. The video goes along well with the photos.

The pictures below show step by step how to do a Lateral Clitoral Hood Reduction.

We are back to surgery! I spent the past month teaching you my core office strategies for obtaining a great H&P, bullet-proof Informed Consents, clear Post op Instructions, awesome Gynecologic Photos, and how to do Labiaplasty Consults Online. Be sure to watch ALL of those. They are precious. I even introduced you to our GetHairMD practice. But now I want to focus once more on surgery, surgery, and more surgery. After a series of full-length labiaplasty videos I will move on to Clitoral Hood Reduction techniques I developed. Lateral/Medial/Vertical Clitoral Hood Reduction. If you have not signed up to be a paying Labiaplasty Newsletter subscriber NOW the time to do so. You cannot find this level of detail anywhere else but here and on Gynflix. Which you should join.

Let’s review quickly. I showed you the Rim, Hybrid, and Barbie Look techniques and how to do “A” Incisions. Medial and Lateral. I developed all these techniques starting in 2005 and have taught them worldwide for almost 20 years. This particular video is made for my Gynflix Gold Fellows (hence the title “AIAVS Fellows Video”) that I pamper monthly with my newest and most updated 4k videos. There are over 120 AIAVS Fellows Gold Videos and about 50 more waiting for my edits. I want to share this one with you to focus on the Rim Labiaplasty with Medial A Incisions. It is about an hour long with my comments and thoughts as I perform surgery. The pictures of the Labiaplasty Steps are all below with my comments added. Lots of pearls below. Tell your friends and colleagues about this.

I will be releasing Gynflix 2.0 later this month. It is a major upgrade that will make navigating and finding the videos you want easier. I will also offer all my modules at no additional charge for the Gynflix Gold Fellows members. That saves thousands and thousands of dollars and gives you the training diplomas you have requested. Best of all, it will have dozens of new full-length AIAVS Fellows Video and all my recorded webinars of the past 3 years. It is a serious upgrade! Gynflix Gold Fellows members will continue to receive this Labiaplasty Newsletter at no additional cost.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

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Red Alinsod, MD (red@alinsodinstitute.com, www. alinsodinstitute.com, www.gynflix.com)

The Labiaplasty Slide Set for the Everyday Woman

Here are the screenshots of my presentation that can help you follow along my video. Just open up a second browser window and have this set beside the video and follow along. You can review this quickly at another time also. Please share this. I will put it up on my website (www.alinsodinstitute.com and www.gynflix.com). This is for all 3 of my Substack newsletters:

* Feminine Wellness Newsletter: For the Lay Public

* Cosmetic Gynecology Newsletter: For Medical Providers

* Labiaplasty Newsletter: For the Surgeon

Social Media:

Follow my Social Media adventures below as I educate and entertain every week. I will integrate my Newsletters with Social Media and Podcasts. I just launched all my “Vagenius” handles so they are new and at the early stage of growth. I need your help so please Follow and Like:

Instagram: VageniusMD

FB: Vagenius - Red Alinsod, MD

TicTok: VageniusMD

Contact Red Alinsod, MD

Alinsod Institute: https://alinsodinstitute.com/

Gynflix: https://www.gynflix.com

DALLAS OFFICEAlinsod Institute DallasWomen’s Wellness Institute of DallasPreston Sherry Plaza8201 Preston Road Suite 520Dallas TX 75225Phone: 945-900-7576Secondary: 214-442-0055EFax: 949-315-3076Contact:Dr. Alinsod: red@gynflix.com

LAS VEGAS OFFICEAlinsod Institute Las VegasAesthetic Revolution Las Vegas9130 W Post Road Suite 100Las Vegas NV 89148Phone: 945-900-7576Secondary Phone: 702-360-6686Dr. Alinsod: red@gynflix.com

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a paid subscriber.

In the eyes of the consumer you are only as good a surgeon as your photos can show. So spend the hour with me and do an upgrade or your gynecologic photography skills. Take a look at my Gallery. This may be the most important “procedure” you will learn this year. I have all the PowerPoint slides below to go along with this new video. I presented this on Alinsod Live Zoom Webinar to my Fellows on March 1, 2024 which you can find on www.gynflix.com. Gynflix Gold Fellows get first dibs of all my assets.

I first gave this talk at my Congress of Aesthetic Vulvovaginal Surgery in 2006 and last presented it at the European Society of Aesthethetic Gynecology (ESAG) Congress in Edinburg in the summer of 2019. Right before the Pandemic. I re-tooled it with much love to cover new advances in the field including iPhone photography, 3D Photography, TouchMD, and an introduction to Adobe Lightroom. I show a narrated Live Photo session from start to finish on how I do my photo sessions.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

AN INVITATION FROM RED ALINSOD AND ALEX BADER

Dr. Alex Bader, the Founder of ESAG, is a tremendous surgeon and organizer and dear friend. I got to catch up with him a few weeks ago in Fort Lauderdale at our International Society of Cosmetogynecology Congress. Here is our chat:

The 8th World Congress of the European Society of Aesthetic Gynecology will be in Istanbul from November 7-9, 2024 at The Bosphorus Hotel. I will be there presenting at the Master’s Course and General Assembly. ALL Labiaplasty Surgeons should attend to learn and connect with a rapidly growing worldwide community.

GYNECOLOGIC PHOTOGRAPHY FOR DUMMIES WITH DIGITAL ASSET MANAGEMENT SLIDES

With this Post Op Labiaplasty Instruction Form the patient read, initials, and signs the document so that there are few to no “You did not tell me” moments.

Watch this 15 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 Labiaplasty Instructions that you can use with your own logo. Simple and premade for your practice. A most valuable asset.

I created this Informed Consent Form in 2005 and have been updating it regularly for almost two decades. Specific for Cosmetic Gynecology and Urogynecology. It has been reviewed by legal and has been tested by time. For over 30 years I have run Risk Management Departments, gave Expert Opinions and have been an Expert Witness for both defendants and plaintiffs. Almost always it comes down to the Informed Consent as what makes or breaks a case. Quite sad at times because the doctor just rushed things, didn’t explain, didn’t document and relied on “I said so.”

Watch this 24 minute video carefully and absorb it, copy it, modify to your needs. Join Gynflix Gold Fellow Group if you want the PDF version that you can use with your own logo.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

The Informed Consent

Trial and error through the decades. Finally have it the way I want it. This is my History and Physical Form. My initial intake. Specific for a Cosmetic Gynecologists. Subscribe to Gynflix Gold Fellows Group to get a PDF copy. You will get all my other forms and sample dictations too. This video is 24 minutes long.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

The Alinsod H&P Form

Now you have the basics. Let’s watch a Full-Length surgery (46 Min) for you to see how I used the principles of the “A” Incisions to create Dog-Ear-Free labiaplasties. Does not matter if it is Barbie/Hybrid/Rim Look. Works for all looks. The video is fully narrated at the time I am doing the surgery. You will feel as if you were sitting on my left side learning one-on-one.

The video starts off having had the vaginoplasty and perineoplasty already done. For future reference, you always want to do the internal vaginal surgeries first and labial surgeries then follow. I then show you how I do my markings, do the local anesthesia, then do the incision/excision, then suturing. On the right labia I perform a Medial A Incision. On the left labia I perform a Lateral A Incision. I demonstrate the inverted mattress suturing with 5-0 Monocryl on a P3 needle. I finish with 5-0 Vicryl interrupted about half a centimeter apart.

This next month we will focus on obtaining proper H&P, Informed Consent, Post Op Instructions. I have the forms for you if you need them. Then in April will go back to surgery with the start of Clitoral Hood Reduction techniques I have developed over the past 20 years. Tell your colleagues about Labiaplasty Newsletter and Gynflix. Thanks in advance.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

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Labiaplasty Steps

Now that you know the concept of the Medial A Incision and of Debulking shown last month (Barbie and Labiaplasty Steps Explained) I want to show you the same case from start to finish. From labiaplasty to clitoral hood reduction in Stop Motion Photography of over 900 pictures as a review. For those who have been thinking about joining do so now! I am releasing a full-length case and you will feel as if you are sitting right next to me this week right when ISCG Starts. ISCG is the International Society for Cosmetogynecology and our yearly Congress begins Thursday, March 7, 2024, in Fort Lauderdale, Florida.

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Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Labiaplasty Steps

This is Part 1 of a 2 Part series explaining and showing you how I avoid Dog Ears by using my Alinsod “A” Incisions. Watch this short video as a Primer, look below at the explanations and descriptions. Part 2 to be released in the first week of March 2024.

By the way, our new telephone number is 945-900-7576. Always love hearing from you. Text or call and either Dian or myself will respond right away. You can email me directly for questions and clarifications. This is what you are paying for and I aim to deliver both content and quality.

Join and like Vagenius on FB and VageniusMD on IG.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

I will show you all the details of each step of labiaplasty surgery. Narrated, 317 pictures, with no secrets held back. I cover markings, anesthesia, “A” Incisions, Canal Incisions, suture choice, closure techniques. You have to be a subscriber to watch this video. It will transform your practice.

I covered the basics of labiaplasty surgery in my “Labiaplasty Newsletter Liftoff in 2024.” I then tackled the Labiaplasty Set Up and Draping and Labia Minoraplasty Anesthesia and Markings, Predictive Permeation, Rim Labiplasty Basics. Make sure to watch all of those first. This video has more detail and Stop Motion Photography and live commentary and instructions. Below the PayWall are my photos of each step along the way. No more excuses. You need to subscribe.

If you want even more extensive details then subscribe to Gynflix.com. For $98 a month you get hundreds of HD and 4K videos for every imaginable labial condition. Plus you get this Newsletter at no additional cost. For $198 a month you get the Gold Fellows Membership, access to me and an exclusive club of doctors, Fellows Only Video selection, monthly Zoom Meetings, copies of my Forms and Op Reports. And you get this Labiaplasty Newsletter at no cost. Hundreds of videos to choose from. Short summaries to hours long treatise on each subject.

The next set of videos in the coming weeks will cover my forms on obtaining the History and Physical, Informed Consent for Labiaplasty, Post Op Labiaplasty Instructions. Later on we will cover Gynecologic Photography in detail.

Enjoy the learning!

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

Labiaplasty Newsletter is a reader-supported publication. To receive new posts and support my work become a paid subscriber.

I do curvilinear labial excision and avoid wedge labiaplasty in general.  Significantly fewer complications and breakdowns with the curvilinear approach.  You don’t want to handle awful wedge breakdowns, Swiss Cheese labias, and face a bunch of lawyers. There are many superb wedge labiaplasty surgeons out there but even the most experienced ones have a breakdown rate of 11%. I would rather have a breakdown rate in the 1% range. Choose curvilinear excisions as your first choice in the vast majority of labiaplasty cases. If you have a patient who wants to retain the dark and irregular and ruffled edges that look more natural and appealing to her then choose the wedge labiaplasty. This video is for the Basic Curvilinear Labiaplasty.

Never will you find such a massive union of world class experts, key opinion leaders, pioneers, entrepreneurs, and virtuosos, so eager to share their unique and unparalleled knowledge, strategies, tips and tactics in a single venue. They come from all over the world as the very best. This is the crucible that forges progress. These are the ones who take on the challenges. These are the ones who make the impossible possible. These are the ones that everyone copies. This is what your career needs to ensure your success, to get you to the top and keep you there. Get ready to change your life. Feel the excitement. Register now for ISCG 2024.

Red Alinsod, MD (red@gynflix.com, www.gynflix.com, www.alinsodinstitute.com)

The Awards

The VIP Dinner

The Agenda

THURSDAY 7 MARCH 2024

GENERAL SESSION 101 | 08:00 - 10:00 AM

7:55a

m​Welcome and IntroductionMarco A. Pelosi, II, MD and Marco A. Pelosi, III, MD | USA

8:00 amVaginal Health Empowerment: The Final FrontierSherrie Palm | USA

8:20am Pelvic Magnetic Field Therapy: 5 Years Experience and OutcomesHichem Bensmail, MD | France

8:40 am ​Vaginal Radiofrequency MicroneedlingJudy Wei, MD | USA

9:00 amDysparenia: The Importance of a Good Diagnosis to Establish the Best TreatmentLaira Ramos, PhD | Brazil

9:20 am​Diving for Useful Pearls from 27 Years of Genital PlasticsMichael Goodman, MD | USA

9:40 amBack to the Future with Erbium Laser Micro ManipulatorJorge Gaviria, MD | USA and Venezuela​

10:00 - 10:30 AMEXHIBIT HALL COFFEE BREAK

GENERAL SESSION 102 | 10:30 - 12:30

10:30amIn-Office Clitoral Reduction and Medial Clitoral Hood ReductionRed Alinsod, MD | USA

10:50 amLabiaplasty Wound Dehiscence. How to Avoid ItDawid Serafin, MD | Poland

11:10 amClitoropexy: How I Do ItTina Batalha, MD | Brazil

11:30 amGenital Harmonization: Combined Labia Minora Reduction and ​​Labia Majora Autologous Fat Transfer Marco Antonio Gaxiola, MD | Mexico

11:50 amIs Clitoropexy Effective?​Dulce Henriques, MD | Brazil​

12:10 pmDouble Folded Labia Minora Management​Alex Bader, MD | London and Dubai​

12:30 - 1:30 PMEXHIBIT HALL LUNCH BREAK​HOT BUFFET "GRILL"

GENERAL SESSION 103 | 1:30 - 3:30

1:30 pm​Exosomes for Genitourinary Syndrome of Menopause (Video)​Maryory Gomez, MD | Venezuela

1:50 pm17 Years Experience with Lasers in Regenerative Gynecology. What Have We Learned?Adrian Gaspar, MD | Argentina

2:10 pm​Cosmetic Gynecology 2024Marco Pelosi III, MD | USA

2:30 pmPercutaneous VaginoplastyMaria Jose Araujo, MD | Argentina

2:50 pm​How to Deal with the Protruded Clitoral Hood (video) Alexandros Bader, MD | London and Dubai

3:10 pmManaging Anatomical Challenges in Aesthetic Genital SurgeryChristine Hamori, MD | USA

3:30 - 4:00 PMEXHIBIT HALL COFFEE BREAK

SPANISH SESSION 104 | 3:55 - 6:30

Moderators: Dr. Jorge Gaviria and Dr. Adrian Gaspar

4:00 pm​Introducción y Comentarios InicialesDrs. Gaviria and Gaspar

4:05 pm​17 Años de Experiencia con Láseres en Ginecología Regenerativa: ¿Qué Hemos Aprendido?(17 Years Experience with Lasers in Regenerative Gynecology: What Have We Learned)Adrian Gaspar, MD | Argentina

4:20 pmRegreso al Futuro con el Manipulador Micro de Láser de Erbio(Back to the Future with Erbium Laser Micro Manipulator)Jorge Gaviria, MD | Venezuela and USA

4:35pmExosomas en Síndrome Genitourinario de La Menopausia(Exosomes for Genitourinary Syndrome of Menopause)Maryory Gomez, MD | Venezuela

4:50 pm​Labioplastia Combinada con Injerto de Grasa en Los Labios Mayores: Armonización Genital Completa(Genital Harmonization: Combined Labia Minora Reduction and ​​Labia Majora Autologous Fat Transfer)Marco Antonio Gaxiola, MD | Mexico

5:05 pm​Ginecología Regenerativa en La Disfunción Sexual(Regenerative Gynecology and Sexual Dysfunction)Jorge De Leon Soto, MD | Guatemala

5:20 pm​Luksenburg Systems: Un Programa Completo No Quirurgico para IUE(Luksenburg Systems: A Complete Nonsurgical Program for SUI)​Ariel Luksenburg, MD | Uruguay

5:35 pmEl Rol de Physio Magneto en La Disfunción Sexual(Physio Magneto in the Management of Sexual Dysfunction)​Ajakaida Renaud, MD | Venezuela

5:50 pmVaginoplastia Percutánea(Percutaneous Vaginoplasty)​Maria Jose Araujo, MD | Argentina

6:05pm​Abdominoplastia Inversa Bajo Anestesia Local(Reverse Abdominoplasty under Local Anesthesia)Ivanhoe Ortega, MD | Chile

6:20pmTécnicas con Colgajo Vulvar para La Reconstrucción de Los Labios Menores(Botched Labiaplasty Revision with Clitoral Hood Flaps)Alejandro Carbone, MD | Argentina

6:35pmAdjourn

Friday 8 March 2024

GENERAL SESSION 105 | 08:00 - 10:00 AM

8:00 amSmart Marketing on a Budget (sponsored by Medical Marketing Whiz)Lori Werner | USA

8:20 amPulsed Electromagnetic Field Therapy (sponsored by Aura Wellness)Pat Ziemer | USA

8:40 amGetting Your Consults to Say Yes and Agree to SurgeryJohn Gonzalez, MD, MBA | USA

9:00 amLatest Updates on the State of the ArtCharles Runels, MD | USA

9:20 amBuilding a Foundation that Optimizes Hormones and PeptidesJason Schottel, PhD, APRN | USA

9:40 amBioidentical  Hormone OptimizationMark Lowney, MD | USA

10:00 - 10:30 AMEXHIBIT HALL COFFEE BREAK

GENERAL SESSION 106 | 10:30 - 12:30

10:30 amThe "Snatch That" Procedure for Lower Face/Neck RejuvenationJason Rupeka, DO | USA

10:50 am​Male Genital AestheticsPaul Perito, MD & Alfred Suarez-Sarmiento, MD | USA

11:10 am​The Penuma Implant: Clinical Update 2024Kambiz Tajkarimi, MD | USA

11:30 amReverse Abdominoplasty under Local Anesthesia (Video)Ivanhoe Ortega, MD | Chile

11:50 amMedspa MasteryChad Deal, MD | USA

12:30 - 1:30 PMEXHIBIT HALL LUNCH BREAK​HOT BUFFET "MIAMI SPICE"

GENERAL SESSION 107 | 1:30 - 3:30

1:30 pmThe Dr Miami ExperienceMichael Salzhauer, MD | USA

2:30 pmThe Brazilian Butt LiftMark Lowney, MD | USA

2:50 pmHigh Definition Body Contouring for BeginnersChad Deal, MD | USA

3:10 pmBody Contouring in a Urology PracticeKambiz Tajkarimi, MD | USA

3:30 - 4:00 PMEXHIBIT HALL COFFEE BREAK

GENERAL SESSION 108 | 4:00 - 6:20

4:00 pm​Simultaneous Breast Augmentation and Lifting Made Simple: The StapleShape TechniqueChad Deal, MD | USA

4:20 pm​Peptides: The New Frontier of Aesthetic MedicineKevin Jovanovic, MD | USA

4:40 pm​Combined Intraurethral-Vaginal Laser: Why, When and How?Adrian Gaspar, MD | Argentina

5:00 pm​Mons Pubis Laser LipoMarco Antonio Gaxiola, MD | Mexico

5:20 pm​Flexible CO2 Laser for Labial and Anal SurgeryRed Alinsod, MD | USA

5:40 pm​​​Regenerative Gynecology and Sexual Dysfunction​Jorge De Leon Soto, MD | Guatemala

6:00 pmAdjourn

8:00 pm -10:00 pm​President's VIP DinnerAt Fort Lauderdale's Hottest 5-Star Restaurant

Special Ticketed EventTickets Must be Purchased at Online RegistrationRegistrants May Purchase up to 2 TicketsPrivate Chartered Buses Depart Hotel at 7:30pm sharpDress Code is Business Casual

Saturday 9 March 2024

GENERAL SESSION 109 | 8:00 - 10:00

8:00 amNew Dyspareunia Protocol using Oxygen and Hyaluronic AcidClaudio Catalisano, MD | Italy

8:20 amYou Have It. They Need It. More Tools. New SkillsCarolyn DeLucia, MD | USA

8:50 amExosomes in Sexual Health and GynecologyHenry Ramirez, MD | USA

9:20 amAdvanced Treatment Options for Pelvic PainNeeraj Kohli, MD | USA

9:40 amCellulite: What's New and What WorksJaime Sepulveda, MD | USA

10:00 - 10:30 AMEXHIBIT HALL COFFEE BREAK

GENERAL SESSION 110 | 10:30 - 12:30

10:30 amHow I Perform Segmental Clitorectomy without Loss of SensitivityDulce Henriques | Brazil

10:50 amClitoral Hoodplasty - Techniques, Tips and TricksJose Antonio Zelaquett, MD | Brazil

11:10 amVagilanegelo: It's All About the AngleAmir Marashi, MD | USA

11:30 amFully Conscious Breast Augmentation in a Submuscular PlaneJulio Novoa, MD | USA

11:50 amBreast Augmentation under Local AnesthesiaArturo Henriquez, MD | Chile

12:10 amHow to Succeed in a Female Genital Cosmetic and Reconstructive Surgery PracticeMichael Goodman, MD | USA

12:30 - 1:30 PMEXHIBIT HALL LUNCH BREAK​HOT BUFFET "TEX MEX"

GENERAL SESSION 111 | 1:30 - 3:30

1:30 pmBotched Labiaplasty Revision with Clitoral Hood FlapsAlejandro Carbone, MD | Argentina

1:50 pmManagement of Lichen Sclerosus of the Clitoral and Vestibular AreasHichem Bensmail, MD | France

2:10 pmThe Luksenburg System for Severe Stress Urinary IncontinenceAriel Luksenburg, MD | Uruguay

2:30 pmSynchronized Labia Majoraplasty for Maximum PrecisionMarco Pelosi III, MD | USA

2:50 pm​HA and Hyperstacked Erbium Smooth Laser for GSM after Poor Response to LaserAdrian Gaspar, MD | Argentina

3:10 pmBotched Labia Reconstruction: Labia Majora Flap TechniqueTina Batalha, MD | Brazil

3:30 - 4:00 PMEXHIBIT HALL COFFEE BREAK

GENERAL SESSION 112 | 4:00 - 6:00

4:00 pmNon-Crosslinked Hyaluronic Off-the-Shelf Treatment for Lichen SclerosusRed Alinsod, MD | USA

4:20 pmPhysio Magneto in the Management of Sexual Dysfunction (Video)Ajakaida Renaud, MD | Venezuela

4:40 pmThe Surgical Anatomy of GluteoplastyMarco Pelosi II, MD | USA

5:10 pmReconstruction After Botched Labiaplasty: Double Flap Rotation TechniqueDawid Serafin, MD | Poland

5:40 pmLaser Recipe for Genital 4D TighteningJorge Gaviria, MD | Venezuela and USA

6:00pm​Adjourn

7:00 pm - 8:00 pmISCG AWARDS CEREMONYIn the Lecture HallOpen to All Registrants & Non-Registrants

ISCG AWARDS CEREMONY | 7:00 - 8:00

Moderators: Marco A. Pelosi III, MD | Marco A. Pelosi II, MD

Hopefully you have seen my “Alinsod Labiaplasty Technique: Barbie Goes International” and”Labiaplasty Set Up and Draping” and ”Labia Minoraplasty Anesthesia and Marking” videos to give you a head start and overview. Now I will get more specific and detailed. You were introduced to Predictive Permeation science and now I will take a deep dive and intro…

First, you must watch the very first video of released on Labiaplasty Newsletter. Here is the link, go to the end of this newsletter and watch “Alinsod Labiaplasty Technique: Barbie Goes International.” Got to have your basics down to understand these next series of videos better. If you have seen that one then proceed!

What you will learn:

* Be sure all consents are signed before any anesthesia of any kind is given.

* Be sure all Pre Op Photos are already done, preferably the day before. Numbing cream makes the labia look puffy and edematous.

* Patient comes to the office already numb: they place the BLT numbing cream at home an hour before arriving at the office. She places clear plastic wrap over it to prevent soiling her clothes.

* Have a blue marker or two for placing the dots then connecting them

* I prefer placing the microtumescent local anesthesia first before markings because markers run and disappear when local anesthesia gets it wet and you wipe it off with a 4x4.

* Be conservative in your initial markings so you avoid removing too much labia.

* You can always remove more tissue but you really cannot add tissue when you overdo it.

It is not rocket science. Get the basic tools and a low cost but efficient set up and you can do all labial surgeries in your office. The list below is what I shared with my grads when they visited me in Laguna Beach. A few things have changed. I no longer use the Ellman Surgitron and have switched over to Soniquence. They are a small company that …