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 by far the BEST Labiaplasty Education video for the general and lay public. It is 32 minutes long, detailed, and excellent. That newsletter has all the PowerPoint slides shown and explained.
I wrote this over a year and a half ago and it still applies today:
“Finally finished! Only took me 20 years to get all this content together and compacted into 30 minutes. My life’s work. My treatise on labiaplasty surgery. I dedicate this to all the women out there who have suffered pain and discomfort, humiliation and shame, embarrassment and ridicule. Quit listening to the naysayers that you just have to live with it. You have lots of choices now. Second chances are a blessing. Go grab it!
This Feminine Wellness Newsletter is more specifically diving into who the best candidates are for my Barbie 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 Feminine Wellness 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.
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.
Step 1: Linear Excision vs. Wedge Excision—Which Base Technique Fits Your Needs?
Labiaplasty primarily addresses the labia minora (inner lips), which can become enlarged due to genetics, hormones, childbirth, or aging, causing discomfort during activities like exercise, sex, or wearing tight clothing. The two main techniques are Linear Excision (also called Trim) and Wedge Excision. Both aim to reduce length, create symmetry, and tuck the labia minora within the labia majora (outer lips), but they differ in approach, outcomes, and ideal candidates.
Linear Excision (Trim Technique): The Straightforward Edge Remover
This method involves a curved or straight incision along the outer edge of the labia minora to trim away excess tissue, often following the natural contour for a "Curvilinear" result. It's like sculpting the edges to shorten and thin the labia while removing pigmented or thickened borders. I use radiofrequency energy in most cases for precise cutting and sealing, minimize bleeding, swelling, and scarring—key for my advanced variants.
Pros:
- Safer healing with lower risk of wound separation or Swiss Cheese Holes
- Excellent for addressing pigmentation issues, as it removes the darker outer edges, resulting in uniform, lighter-colored labia.
- Highly customizable for asymmetry—surgeons can adjust the amount removed on each side independently. So much more choice and options on how much to remove.
- Versatile for dramatic or subtle changes, making it ideal for aesthetic goals like a "petite" or streamlined look.
Cons:
- The straight or curved edge may look less "natural" if not done artistically and not following the natural curves of the labia potentially creating a more uniform but less contoured appearance. It can look “Too Plastic.”
- Scalloped edges if sutured too tightly
- In most cases, Linear Excision will require a companion clitoral hood reduction if the hood appears prominent post-surgery. You have to avoid the “Top Heavy” look that can occur of you leave the top clitoral hood alone and then dramatically trim down the middle and bottom labia minora.
Who Should Get Linear Excision?
Opt for this if your anatomy includes uneven pigmentation, thickened edges, or significant asymmetry that needs targeted removal. It's best for patients desiring a cleaner, more uniform aesthetic—think women who want to eliminate dark borders or achieve a "hidden" look without preserving the original edge texture. Functionally, it's great for those with irritation from rubbing or pulling, especially if you prioritize quicker recovery and minimal complications. Athletes or active individuals often favor it for its reliability in high-movement lifestyles. Swimmers, bikers, horseback riders, volleyball and tennis players are examples. If your labia majora are fuller, linear excision ensures the minora stay tucked away seamlessly. The chance of having Swiss Cheese Holes is less than 1%.
Wedge Excision: The Natural Contour Preserver
This technique removes a V- or wedge-shaped piece of tissue from the widest part of the labia minora, then stitches the edges together to shorten without altering the outer border. It can be more complex and involving advanced modifications like Z-plasty for better blood flow and reduced tension. Variants include Central Wedge Excision, Superior and Inferior Wedge Excision.
Pros:
- Preserves the natural ruffled edge, color, and contour of the labia, leading to a more "original" appearance that blends seamlessly with the clitoral hood. In my personal practice and in clinical research done by highly respected friends of mine, only a very small percent of women actually want to keep that ruffled and dark edge. Only about 4-6% of women wanting labiaplasty want to keep the original edges. About 94-96% of them want those darker edges removed and made smoother. This is the perfect choice for women who want to keep that original edge appearance.
- Scarring can be less visible once healed in many but some may continue to have a pale white line at the site of suturing.
- Effective for reducing length without changing the labia's overall texture, can be ideal for subtle functional improvements. Most wanting labiaplasty are not looking for a subtle change and seek more dramatic changes.
Cons:
- Higher Tension on the closure site pulling the wedge edges apart, with a significant risk of dehiscence (wound reopening), Pac Man Breakdown, or Swiss Cheese Holes. In the very best of hands this wound breakdown rate averages 10-20%. Compare that to less than 1% Swiss Cheese holes and less than 5% dehiscence when the Linear Labiaplasty is done.
- Doesn't address pigmentation well—if your edges are dark or irregular, they remain. You keep those dark and ruffled or irregular edges.
- Can be more technically demanding, so outcomes vary by surgeon experience; poor execution can lead to bunching or narrowing or dehiscence and Swiss Cheese Holes. The dreaded Pack Man Look happens 10-20% of the time.
Who Should Get Wedge Excision?
This is ideal if your anatomy features a naturally pretty edge you want to keep, with hypertrophy mainly in the inner width rather than the borders. Choose it if your desires lean toward maximal preservation of your innate look—women who value a "seamless, untouched" aesthetic or have minimal pigmentation concerns. It's particularly suited for those with pain from labial hypertrophy but who prioritize natural contours over color uniformity. Avoid it if you have very redundant tissue, as it may not remove enough for dramatic results.
Key Decision Factors: Anatomy (e.g., edge quality, majora fullness) and desires (dramatic vs. natural) guide the choice. A 2021 survey showed curvilinear (trim variant) as the most common (52.7%), followed by wedge (36.1%), reflecting its versatility. In speaking with the most renown and exceptional labiaplasty surgeons around the world (primarily Gynecologists) it is closer to 90% Curvilinear Labiaplasty versus Wedge Labiaplasty. I prefer linear/curvilinear techniques for fewer complications, and I avoid wedge techniques altogether. I just do not want problems.
Step 2: Within Linear Excision—My Alinsod Looks: Barbie, Hybrid, or Simple Trim?
If linear excision aligns with your needs, my radiofrequency-enhanced curvilinear approach offers refined sub-techniques. These vary by how much tissue is removed, balancing aesthetics, function, and reversibility. All use precise energy to cut and cauterize, reducing downtime and results in speedy recoveries and fewer complications.
The Barbie Look: The Ultimate Tucked-Away Transformation
I invented this in 2005. This aggressive linear excision removes *all or nearly all* of the labia minora, creating a smooth and straight vertical line with no protruding inner lips, even when legs are apart. It often pairs with clitoral hood reduction for a fully streamlined vulva.
Where did this “Barbie Look” terminology come from? It was from my patient in the San Fernando Valley who came up to me and announced “Dr. Alinsod, I want to look like Barbie!” I said to her “Barbie has no labia!” She said “EXACTLY!!!” The Barbie Look was born. Don’t blame me for the lay public terminology because it came from my lay public patient who visualized a certain look and gave it a certain name. And it went around the world like a wildfire. I did lots of interviews for magazines and got invited around the world for me to show what in the world this Barbie and Hybrid stuff is all about. Thank you San Fernando Valley!
Who Should Get the Barbie Look?
Anatomy: Best for those with sufficient labia majora volume to fully cover the vaginal opening post-removal—flat or deflated majora might leave you feeling exposed. Ideal if your minora are extremely elongated (e.g., >4-5 cm) or asymmetrical beyond correction and you have labia majora that have enough fat to protrude out and does not lie flat. If you have a very flat labia majora then a Hybrid or Rim may be better for cosmesis.
Desires: Women seeking zero maintenance—no more adjusting during sports, sex, or swimsuits. Popular among athletes, Olympians, and those prioritizing ultimate comfort and a "hidden" aesthetic. It's irreversible, so only for the fully committed; not for the indecisive. If psychological factors like embarrassment or hygiene issues dominate, this delivers confidence-boosting minimalism. It has very high satisfaction rates in my practice (most requested there). Hybrid Looks is a close second depending on the month and whether the patient is from the West Coast or East Coast. Definitely more of a West Coast Look. Southern California Beaches, specifically Laguna and Newport Beach, inspired the Barbie and Hybrid Looks.
The Hybrid Look: The Balanced Middle Ground
My "middle road" removes most of the labia minora but leaves a small remnant, positioned below the majora level for a tucked-in effect. It's nearly indistinguishable from the Barbie Look externally but retains subtle inner structure. It is a gorgeous look and made for those who are not so sure about the All In Barbie Look. There is an understanding that any Rim or Hybrid Look can always be made into a Barbie Look in the future when tastes or situation changes.
Who Should Get the Hybrid Look?
Anatomy: Suited for moderate-to-severe hypertrophy where full removal isn't needed or wanted, but significant reduction is. Works well with average majora fullness, as the remnant provides a natural buffer without protrusion and reduces the chance of visualization of the internal vagina. There is some coverage still present that a Barbie Look may expose. Great for asymmetries, as the linear cut allows precise tailoring.
Desires: Patients wanting Barbie-like smoothness (no tugging or visibility) but with a touch more "naturalness" for sensation or aesthetics. My personal favorite—it's less extreme, easier to adjust if needed, and appeals to those hesitant about full removal but craving the tucked comfort. Ideal for everyday women dealing with irritation during exercise or intimacy, seeking a competitive alternative to Barbie without full commitment. Healing mirrors Barbie: quick and low-pain with radiofrequency. I do almost all my labiaplasty surgeries in the office under local anesthesia. 99+%.
The Simple Trim Look (Rim or Sculpted Linear): The Conservative Edge Refiner
This minimal linear excision trims only the protruding edges, preserving most of the labia minora's length and shape while removing dark or irregular borders for a refined rim. I get few requests for this surgery. Most want more tissue removed.
Should Get the Simple Trim Look?
Anatomy: Perfect for mild elongation or just edge irregularities—labia that are slightly longer than desired but not overly hypertrophic. Best when majora are not overly full and even flat, as it maintains proportion without aggressive shortening. Avoid if tissue is very thick, as it may not suffice. This does not really debulk the area like a Hybrid and Barbie Look Labiaplasty can.
Desires: Women across ages wanting a subtle, natural enhancement—think removing pigmentation for even tone without altering overall size. Least requested in specialized practices like mine, but ideal for those prioritizing preservation over transformation, like first-timers or those with minimal symptoms. It addresses functional tweaks (e.g., less chafing) while keeping a "real" look, with the shortest recovery among options.
Final Thoughts: Your Anatomy + Desires = The Right Choice
Choosing a labiaplasty technique is deeply personal—start with a consultation with me or your chosen surgeon to assess your labia's size and shape, skin quality, and majora support. Linear excision shines for customization and speed, especially the looks I developed: Barbie for bold minimalism, Hybrid for balanced elegance, and Simple Trim for gentle refinement. Wedge suits naturalists. Whichever path, seek surgeons experienced in your specific look. I personally do not do Wedge Labiaplasty anymore because of the higher complication rate and I am more than happy to refer you to the best Wedge Labiaplasty Surgeons I know. I just do not want 2 out of 10 patients to have problems and regrets when a Wedge is done. I would rather have zero out of 10 breakdown. My personal favorites are definitely Barbie and Hybrid Labiaplasties with Clitoral Hood Reductions that are tailored and personalized and infinitely adjustable. A perineoplasty is sometimes needed to complete the makeover down under.
Choose Wisely! If you have questions, drop us a line. Until next time, embrace your body. Be thankful for choices!
BARBIE AND HYBRID LABIAPLASTY RESULTS: How I think
Hope you enjoyed this Feminine Wellness Newsletter. I am off to Maui for a much needed Vacay. Then back for more Barbie, Hybrid, and Rim labiaplasties!
Please share this Newsletter with your interested friends:
Red Alinsod, MD ([email protected])
www.alinsodinstitute.com
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Alinsod Institute Has Moved to Arlington, Texas!
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.
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 Fellows worldwide, 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 [email protected] if you are interested in Fellows Gold Subscription at $198 a month.
GOLD FELLOWS MEMBERSHIP: This unique and valuable service provides access to all future surgical and non-surgical videos on www.gynflix.com.There will be 1-2 complete and unique videos per month. Dr. Alinsod will be available to discuss the intricacies and details of topics covered in the videos and answer specific questions that may arise . This is the first and only true Master’s Course for continuing education focused on cosmetic gynecology.
I love hearing from my Fellows, Grads, subscribers. Text or email me. I answer questions from all around the world!
Social Media:
Follow my Social Media adventures below as I educate and entertain every week. Join me on Instagram asVageniusMD. I have around 190,000 subscribers to my Cosmetic Gynecology Newsletter and 90,000 subscribers to this Labiaplasty Newsletter. Follow me on Instagram for fun and knowledge.
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ALINSOD INSTITUTEArlington, TexasPhone: 945-900-7576Contact:Dr. Red Alinsod: [email protected]
www.alinsodinstitute.com
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