Red Alinsod, MD

Alinsod Institute for Aesthetic Vulvovaginal Surgery

Dallas, TX

BACKGROUND on LABIAPLASTY:

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.

Here are my Photo Sets on Labiaplasty Surgery to help you understand the various “Looks” and degrees of labial reduction: Click on Labiaplasty Case Studies

RIM

Barbie

Hybrid

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 in May 2025. Just SEARCH the term “Grooving” on the website and it will pop up. It is meant for the Surgeon.

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.

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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.

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