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Maggie McKay: Whether you're 23 or 93 and you just wanna restore your femininity, there are ways to do that and they will improve certain parts of your body. Joining us today to tell us about the true Mommy makeover for down there is Dr. Red Alinsod, otherwise known as Dr. Red, a Urogynecologist and pelvic reconstructive surgeon.

This is Top Docs podcast. I'm Maggie McKay. Thank you so much for being here. Dr. Alinsod, would you please introduce yourself?

Red Alinsod, MD: It's a pleasure to be here with a fantastic audience. I'm a solo urogynecologic surgeon and cosmetic gynecologist here in California and in Texas. So I have two places that I practice at. I've been in practice for over 32 years, mostly focusing on feminine wellness and surgical aspects of that. I do things like, I fix fallen bladders. I fix uteruses that are falling down. I fixed enlarged labias, do vaginal tightening surgeries. I fix rectal prolapse, I fix leaky bladders. So, those are the things, the feminine wellness things that, some patients will need after, let's say traumatic childbirth or the aging process such as menopause.

Maggie McKay: Tell us a little bit about your background. You are more specifically a cosmetic gynecologist. How did you get into that?

Red Alinsod, MD: Well, first I was a Air Force doctor. I was actually a major in the Air Force taking care of. our Armed Forces Ladies and I was at Ellis Air Force Base taking care of the Thunderbird wives way back when in the nineties and after my Air Force career, I joined a medical group and I did gynecologic surgery. And I did some deliveries, but my focus was on gynecologic surgery. So I went and developed some of the tools that are currently used, like retractors, slings, mesh kits. And from that I realized that I wanted to focus on the cosmetic portion of it because I actually enjoyed it.

It was so much fun. It was a joy going to work every day and doing surgeries and the patients were happy. So, in 2004, I decided to go full-time on my own solo. And just focus on cosmetic gynecology. So I left my Los Angeles practice and went to Laguna Beach, California and started a solo practice there and completely focused on cosmetic gynecology. Surgical gynecology, was I did. I developed some of the. Techniques for labial surgeries and in office, what I specialized in was in office awake, no IV surgeries. We figured out how to do it and so now the patients didn't have to have general anesthesia.

They didn't have to have spinal anesthetics or epidurals. We were able to figure out how to do it comfortably in the office where they're talking to. So they're talking to me. We're having good conversation while I'm deep in their pelvis doing surgery or fixing their labia. So it was so successful that I started my training program and started training internationally. And so now I have wonderful grads all over the world in Europe, India, middle East Brazil, Latin America, who are doing all these things in the office to keep it safe and less expensive for the patients.

So that's where my, career took me to teach all these types of, feminine surgeries safely and in the office and more recently. We launched our teaching program online. Doctors during the pandemic couldn't come to Laguna Beach, and so I put all my materials online. And if you've ever heard of Netflix, you've heard of Netflix, I'm sure. We started, an e-learning platform where we put all my, surgical training videos, hundreds and hundreds of them, many hours of them on a platform called Gyn Flicks. So that, is a new program out there to teach doctors how to do these type of surgeries. So my career is doing surgeries and educating, so now it's with Gyn Flicks. That's my recent project.

Maggie McKay: That's amazing. That's not only impressive. It's so innovative to think of, a new way of treating women and that sounds ideal, especially in Laguna Beach. I mean, it's so beautiful there. I imagine not all women, Dr. Red, know that there are things they can do to be proactive if they've noticed things look a little different down there after childbirth or just age, or who knows what. So what exactly is cosmetic gynecology?

Red Alinsod, MD: That's a good question. Cosmetic gynecology is a subset of gynecology. It's not a formal subspecialty in our field here in the United States. It is in India, and in the Philippines it's an actual subspecialty like you would. reproductive endocrinology or infertility or high risk obstetrics. It's actually a subspecialty there. Here in the US we come up with these treatments and programs, but it's not well accepted in the general OB GYN committee and the American College OB, GYN. So we're doing this more, as part of a cosmetic surgery field, and it is where we combine both the appearance improvement with our procedures.

For example, making things prettier on the external labia per se, but also making things functional so it's not just making things pretty, it's actually making them both beautiful and functioning. Stop the leakage of urine with the coughing or get rid of that unsightly bulge that's ha that hangs out of the vaginal canal after a traumatic childbirth or with, the onset of menopause, things start bulging and falling out. Or patients having symptoms of overactive bladder, feeling like they have to pee all the time.

I gotta go. I gotta go. I gotta. and those are symptoms that start happening. And so our field cosmetic gynecology, bridges, the gap of beauty and function. So I think it's probably one of the most rapidly growing fields in my specialty. And it's actually approaching other specialties such as plastic surgery and cosmetic surgery and dermatology. So there's a lot of cross-pollination of ideas between all the specialties.

Maggie McKay: And I've heard the term mommy makeover from the plastic surgery community, but what type of mommy makeovers do you specialize in Dr. Red?

Red Alinsod, MD: It's a broad field. Mommy makeovers for plastic surgeon usually means breast and tummies, and for gynecologists it's a little bit different or cosmetic gynecologist. Mostly for cosmetic gynecologists. The mommy makeover, we call it makeover down under, that's restoring the beauty of something that had years of damage from either childbirth or aging or menopause or tissues that have stretched out. And so the patient is unable to feel their partner anymore. So we fix those so that it can increase the friction for both patient and her partner.

And we're able to do that. So the mommy makeover is both the external appearance such as labia, minor neuroplasty, reducing the size of the inner lips, or reducing the saggy labia majora. That's a labiamajoraplasty because they start sagging down or they start becoming cameltoe appearance. and that's a slang term that a lot of women know they don't want to have that camel to, so we're able to address all that. Or let's say the clitoral hood appears wider. It looks very saggy. So we're able to approach the genital tissues and make it beautiful, just like a delicate face surgery, doing the face, the neck.

It's the same concepts down there to tighten it and make it beautiful, but also look natural. And then the function of it to reduce the leakage, to reduce the bulge of the bladder. To get rid of the rectal bulge and get back that normal bowel movement. A lot of these women who have these makeover down unders also have a problem getting their stools out. They have a bulge in the rectum, and so the stools come down and get stuck. So that's part of my makeover, the functional part of it, to make sure that the bowel movements are smooth and easy and it comes out easily that they don't leak when they cough these and jump.

And also they don't have to wake up five, six times at night to, to empty their bladder or feel like they have to go every 30 minutes. These are the women that sit right by the exits in movies and their toilet mapping. They know where every toilet is on their trip to Dodger Stadium, let's say. And so, we're helping the function. We make it beautiful, but we also help the. That's my mommy makeover. But one more thing. I'm sorry. There are just fantastic doctors. For example, there's a wonderful doctor in New Jersey, doctor Marco Pelosi and others who are wonderful at doing this stuff I just described to you.

But they're also experts with breasts and tummies and Brazilian butt lips. These are fantastic doctors. So our specialty is expanding not just for genital care, but also for the things that you would think a plastic surgeon or a cosmetic surgeon traditionally does body work and the gynecologists are very, very good at this and a lot of them are starting to go into that field.

Maggie McKay: There's a lot going on down there that maybe we didn't even know about. Very Informative. So of course there are always women who don't want surgery, can't blame them, but they want the new look. So are there any non-surgical options that you can offer as well?

Red Alinsod, MD: This is probably the fastest growing area of my specialty, devices. For example, there are lasers, out there and the common ones the people may hear about is Mona Lisa Touch or Femi Lift or Cytan Diva. These are wonderful lasers that can help the reduce the aging or help repair the vaginal tissues and get the moisture back. This is specifically for vaginal dryness and it can help also with external appearance and making the tissue lighter in color so it's not so dark down there. So those are devices that have come out since about 2014, 2015 is when all these devices came out.

My special field is radiofrequency therapy and I developed some of the treatments that are called ThermiVa treatments, that's a device I invented about in 2014. Got it out in the market 2015. We obtained the patent in 2017. So ThermiVa is a radiofrequency treatment that treats the outside of the labia majora. Tightens it, treats the clitoral area to improve the sensitivity because we found out that this radiofrequency device unlike lasers, was able to increase the density of the small nerve fibers. And so the patient had improved sensitivity, so we were helping function and beauty at the same time.

And then we can treat the internal vaginal canal with the same radiofrequency device. It's about the size of my finger, so it's very comfortable. You just place it in the vagina and warm heat feels like a warm stone massage. We'll treat the bladder, help overactive the bladder, reduce the sense of having to peel the time or having to wake up at night. It can give a modest amount of tightening of the vaginal tissues because it's heat, and so it contracts the vaginal tissues and over time, new collagen and elastin comes in. So even in the menopausal, dry, rigid vaginal tissue.

And I see many of those patients in their fifties, sixties, seventies. They come in and we're able to treat them once a month for three months, and their tissues get softer, they get more elastic, they get the spring back in their tissues, and they start producing more vaginal moisture and so the radio frequency treatments, and it's not just ThermiVa. There's other wonderful devices out there. There's another device by inMode and our patients may hear about this it's called the Morpheus eight, and that does the same similar thing.

And there's one by a company called BTL. It's called M Femm. And so the audience out there may hear about these things. Those are the radiofrequency device that restore and rejuvenate the external and internal vaginal tissue and also improve the function.

Maggie McKay: And Dr. Red, are there any new and other innovative technology procedures that you've developed and that you're going to be making available or maybe already are available?

Red Alinsod, MD: There are several other treatments. let me summarize. There's one called the O Shot. It's when you use the patient's own blood, we draw their blood, we spin it in a centrifuge, and then we take the yellow portion of that blood. It's the growth factors, and we reinject that into the anterior wall or right by the patient's urethra without pain. There's no pain on this. And then we can inject it also into the clitoris directly. Again, no pain because we've numbed this area and it may increase the sensitivity of the patient or a patient who's unable to have an orgasm, or it takes forever to achieve that orgasm. We can do these treatments.

This treatment with a PRP, or it's called an OShot can be combined with a radiofrequency treatment. A woman's, sensitivity and improved the ability achieve an orgasm. It was invented by a friend of mine named Charles Reynolds and he deserves all the credit cuz he did all the research. He took all the bows and arrows. I mean, he got really. Crucified early on cuz he's not a gynecologist and he was doing gynecologic procedures, but it turns out that he was right. He had this great procedure that's been able to help.

Also with Dr. Reynolds's help, the use of PRP or platelet-rich plasma has been combined with fillers such as hyaluronic acid. You've heard of Juvederm or Restylane to fill. creases in this area in faces? Well, if you mix the platelet-rich plasma and hyaluronic acid, hyaluronic acid is the active ingredient of Juvederm. You can mix them together and use that either in the face, it's called a vampire facelift, or you can use that in the genital area. And so I've focused my research on the use of that into the genital area to help symptoms such as lichens sclerosis. That's when lichens sclerosis is a terrible disease where the skin gets so thin that the patient's irritated.

They can't have sex, it's always itchy. It's pale white, and injection of this product in that area has transformed lives. It's really helped patients. Before we had no other treatment. We just gave steroids to reduce the inflammation and the steroids really actually was bad for the patient in the long term because the steroids kept thinning the skin. So an already thin skin that was irritated. You give more steroids, it gets thinner. And so that was not a good treatment that we had. And so now we've developed some products that have the combination of the two.

I developed the product called th Femxha, F E M X H A, it's going to be released into the market within the next month or so. I've been using it for, the past year, and actually the combination, I've been using it for several years, but we finally put it together so doctors can easily use this and help their patients. Before it was very tricky. You had to get this device, that device, this blood draw thing, this needle, it was complicated. You had to get a bunch of things. So we put it in a kit to make the lives of doctors easier so that they can just pull it off the shelf and help that patient who has pain.

Help that patient who is so sensitive that can't have sex and help that patient who also for beauty, because we can inject the same thing on their labiumajora and the flat saggy labiumajora we can plump up just like you have men and women that get sunken in right here, right? As you age, you get sunken in, you lose the fat. Well, this is the same idea of giving some volume in that area, but for my specialty, it's adding volume to the labiumajora. So that's one of the things that's coming out. And it's quite exciting because it's gonna help a lot of people, not just for beauty, but for their medical conditions and their personal comfort and try to get them back into their normal sex life hopeful.

Maggie McKay: I bet women coming to you for treatment are just so grateful. You must have a lot of best friends out there in the women you treat. Boy, those are game changers for people's lives. I mean, you really are changing their lives, not just the beauty part and the cosmetic part. Getting to that earlier we were talking about how you have patients as young as 23, which is surprised me coming from my age group. You know, in my day we didn't even talk about anything down there, let alone, think about improving the look. So why are 23 year olds coming to you, Dr. Red?

Red Alinsod, MD: Well, it's actually younger than that. Now imagine, you're a mom and your daughter's in swim team and you swim relays, right? And so you're in your swimsuit. And, you're middle school or in high school and you jump in the water, you do your leg on the relay, and then you get out of the pool. Well, I've had patient as young as 12 who was in swim team. This really happened to her. She got out of the pool and the next swimmer jumped in the pool. And so when she got out of the pool, her mom ran over to her with a towel. Her labiuminora were hanging out of her swimsuit because they were so large, she just had large swimsuits, some large labia.

And so these young teenagers, it's traumatic to them. it's quite damaging to their psych. And so I've done labial reduction surgery or labioplasty to patients as young as 12, 13, 14. They fly in from everywhere. California and Florida are the most popular ones because everyone in California and Florida wear swimsuits all day. And where leotards are all day and they outline, they don't want that outlining. And so those young ladies, it's not just for appearance, obviously, it helps with appearance, but it's also for comfort.

For example, volleyball players or equestrian writers, don't want to have to be adjusting themselves where they're performing at such a high level. I have Olympic athletes. I've taken care of because they don't want to hang out, they don't want to be adjusting When they're performing at an elite level, they want to be comfortable and they want it to be beautiful too. So that's the subset of my young patients that I see who want labial surgery. They're typically, like you mentioned in their twenties and thirties.

And by the time they're done having children in their middle years, thirties and forties, they perhaps some of the nonsurgical things such as the laser or radiofrequency to tighten tissues because they're starting to get dry also. They want a little more moisture. And then as they get older in their fifties and sixties, the major starts sagging and it looks like it's really loose tissue in their majora, they're the ones I do my labiamajoraplasty and pelvic reconstruction on my average age. Those patients is about 54. So 54 in their fifties, they're done with kids, they're in menopause.

Average age of menopause is 51. So within a few years of menopause, the collagen level in their tissues just plummets and things start sagging because there's no strong collagen there. And so that's when I start doing the surgeries on those patients in their fifties, sixties.

Maggie McKay: And you had a patient as old as 93. I'm wondering why at 93 you would need this procedure but you, tell us?

Red Alinsod, MD: Oh my goodness. I am in a beach community in Laguna Beach, and people are very healthy health conscious and believe it or not, they're still concerned about appearances and comfort. And I've had several, the oldest was 93. I've had a couple 90 year old patients, 91 year old patients who at the, later part of their lives want comfort. They're tired of having this pulling and tugging, and they know it's an outpatient surgery where they're awake and I can reduce it with them talking to me. So I have done labioplasty on 90 year old patients because they want comfort. And they know it's such a safe surgery because it's just under local.

It really doesn't endanger their lives. And you know, 90 is the new 60 perhaps. And they're active. They're very active. I'm, and they're sharp. They're very sharp. They can make their own decisions and they may not be sexually active, but they wanna be comfortable. They wanna still be able to go to the gym and take their walks. And they're all telling me, I should have met you 40 years ago. I should have seen you a long time ago. And so it's very gratifying to see these patients.

Maggie McKay: I'm sure it is. So outpatient, no pain. Why wouldn't you want to come for treatment there. I understand completely. You have certainly given us a lot of options to think about Dr. Red and an education on even the nonsurgical choices for down there. So thank you so much for being here and explaining a lot of things that I'm sure are new to many people. Where would someone go if they wanted to find out more or make an appointment with.

Red Alinsod, MD: It's pretty easy. You can go to urogyn.org. I'm a urogynecologist, so I own the website. Urogyn, UROGYN.org urogyn.org, and all the information is there for those, who want to watch videos on the procedures on the doctor level. And now we're creating a patient level platform. Also, you can go to gynflix.com if you've heard of Netflix, this is gynflix.com, and we will have a patient portal there, we're creating at this very moment. We have our first 10 videos there. So if a patient wants to see what a labioplasty is, a majoraplasty is, they want to see a vampire wing lift or an OSHA to give them improved sensitivity. They want to see a laser or a ThermiVa treatment. We have it there in 4K color for both patients and doctors.

Maggie McKay: What a great idea. That's awesome. Again, that's Dr. Red Alinsod, and if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you, this is Top Docs Podcast. I'm Maggie McKay. Thanks for listening.