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Feminine Cosmetic Surgical/Thermiva

*Patient Results will vary.*

This in-office procedure is offered to correct or improve upon redundant/lax/bothersome tissue of the vagina and/or labia minora. For a variety of reasons, we may have excessive or lax tissue in this area which affects us as individual women in how we feel physically (even causing recurrent vaginal irritations) or psychologically.  A minor surgical treatment with limited downtime but beneficial results.

Anatomy of the Vulva

 

The vulva (Latin for womb or covering) consists of several layers that cover and protect the sexual organs and urinary opening. The fleshy outer lips of the vulva — the labia majora — are covered with pubic hair and contain fat that helps cushion the area. Inside the labia majora are the thinner, more pigmented and delicate flaps of skin called the labia minora. The labia minora join at the top to enclose the clitoris. The labia majora, labia minora, and clitoris are made up of erectile tissue, that is, tissue that can become engorged with blood. The area between the labia minora, the vestibule, contains the openings to the urethra and the vagina, as well as the Bartholin's glands, which are located on either side of the vaginal opening and produce lubricant for the vestibule. The flesh between the vaginal opening and the anus (not part of the vulva but often involved in vulvar skin problems) is the perineum. This is where the incision called an episiotomy is sometimes made during childbirth.

anatomy-of-the-vulva

*Caution, graphic images.

 

ThermiVa

Damage from vaginal birth can diminish sensation during intercourse, reduce sexual satisfaction and change the relationship between partners. Laxity of the skin is caused by numerous factors and no area is immune to this natural decline. Heat has become a standard for promoting collagen remodeling, which helps strengthen the structural support columns for the skin, improving the integrity of the skin.  Thermi is a leading developer and manufacturer of thermistor-regulated energy systems for medical and aesthetic applications. Thermi has mastered the delivery of controlled-heating.  The technology uses real-time temperature monitoring and regulation, ensuring that the therapeutic temperature delivered to the sub-q layer is reached, but more importantly, maintained. Thermi products are based on the science of heat, using SmartTip technology to enable physicians to use temperature as an endpoint.

ThermiVa, the most current Thermi procedure; using the “Science of Heat” in a new, non-invasive, non-surgical procedure has mastered the delivery of controlled- heating. The Technology uses real-time temperature monitoring and regulation ensuring the therapeutic temperature delivered to the sub-q layer is reached, but more importantly, maintained. ThermiVa contracts tissues to a tighter bundle. It encourages collagen production and may help in tissue and nerve healing. Radiofrequency’s therapeutic effects on muscular and tissue healing is well known and has been used in physical therapy practices for decades. Physicians who have used ThermiVa have reported results in one or more of these areas:

  1. Vaginal Laxity: to tighten the vagina at the introitus and the full length of the vaginal canal.
  2. Vulvar/Labial Laxity: to tighten the labial tissuesand reduce noticeable sag.
  3. Vaginal/Vulvar Dryness or Atrophic Vaginitis: to add softer and thicker skin and relieve dryness   without the use of hormones.
  4. Mild to Moderate Stress Incontinence: to reduce accidents and leakage, and possibly reduce urge symptoms. Used with consistent Kegel exercises, ThermiVa may reduce or eliminate the need for mesh slings.
  5. Sexual Dysfunction: to increase sensitivity and strengthen muscular contractions, leading to greater sexual satisfaction for women and their partners. The procedure takes approx. 10 minutes for labia majora treatment and three sessions of 15-20 minutes each for vaginal treatment, one month apart. Effects last an average of 9 to 12 months. Most patients will choose to have maintenance treatments 6 to 12 months apart. ThermiVa treatments are non-invasive, and require no anesthesia. There is no downtime. Women can resume their normal sexual activity the same day.

 

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Frequently Asked Questions

Testimonials

Before & After Photos

  • Pre-Treatment

    1. Is this procedure permitted if a patient is  breastfeeding?

    You can treat all breastfeeding patients.

     

    2. Can RF energy affect breast milk?

    It has no effect.

     

    3. What is the post vaginal delivery recommendation for  treatment?

    6 weeks for an uneventful normal vaginal delivery. By then, any vaginal repair has healed and tissue response to ThermiVa is outstanding.

     

    4. Can we treat women who complain of painful  intercourse?

    Those with painful intercourse may benefit dramatically from ThermiVa. It all depends on what the pain is stemming from. The patient will need a workup for painful intercourse before treat- ment. If the cause of painful intercourse is from atrophic vaginitis, then ThermiVa will be an ex- cellent therapy. If painful intercourse is from a pelvic surgery, such as a mesh repair, then that should have a surgical work up. Patients with mesh are considered safe, unless they have had complications. Again, we are early in this knowledge; those with mesh, should be evaluated by an experienced pelvic surgeon. Providers, who do not preform pelvic surgery, should not do ThermiVa on mesh repair patients without medical clearance.

     

    5. How should we treat undiagnosed pelvic  pain?

    ThermiVa has been an incredible treatment for the following complications; atrophic vaginitis, levator spasms, and even those with introital pain from lichen schlerosis and hyperplastic dys- trophy. I would not treat a patient with a vulvar lesion that has not been diagnosed or biopsied. You never want to treat a patient with VAIN/VIN/Precancer of the vulvar or vagina. To be perfectly safe, treat only those with a completely normal visual vulva/vagina.

     

    6. What is the recommended age range that can be treated?

    The average age treated is 18 + to infinity, depending on complaint and issue. This is a procedure for both the pre and postmenopausal  women.

     

    7. Can patients with a verified proper IUD placement have ThermiVa treatments?

    That is perfectly fine. Patients with IUDs are safe to treat because IUDs are in the uterine cavity away from the vaginal cavity with the thick and firm cervix acting as a bank vault door. The only time it may even be an issue is if the uterus with an IUD is prolapsing into the vagina. In that case, it is advised not treating uterine prolapse patients earlier in this FAQ. Even if you did treat a patient with an IUD inside a prolapsing uterus, the uterine wall is of sufficient thickness to be a barrier to RF energy, therefore not affecting the IUD. Mirena IUD has no metal parts and is com- pletely safe to treat. Progestasert and other metal containing IUDs are protected by the cervix and uterine wall that RF energy will not affect.

     

    8. How should the diagnosis of prolapsed uterus be  ascertained?

    The patient should be cleared from prolapse and have a pelvic exam before treatment. Pelvic exams can come from anyone who does paps/pelvics and are proficient at it. If a doctor does not feel confident in their pelvic exam then the patient can see her primary care and get examined. The treating doctor should then request a report stating the pelvic exam is normal and that there are no vulvovaginal lesions and no uterine prolapse. If there is a bladder or rectal prolapse then that can be treated.

     

    9. Should patients have a recent pap smear?

    It is suggested to have a recent physical and or pap smear (when applicable) within the last 2 years (since women without a cervix do not have a pap smear). I believe that ThermiVa treat- ments are best for those with normal paps. However, I believe it is also acceptable to treat wom- en with low risk HPV subtypes. Those with high risk HPV should be managed and treated before proceeding with ThermiVa treatments. Once you have a normal pap, Thermiva treatments are acceptable.

     

    10. Can you treat a patient that has Lichen Sclerosus?

    Yes. Many patients have been treated that state their post treatment skin is less sensitive and irritated. It is thought that treating this skin may thicken it, making it less sympotomatic. It’s likely that ThermiVa will become a good option as a future treatment on those with a biopsy proving LS and/or any vulvar dystrophy short of pre cancer. ThermiVa has also been used on those with very thickened vulvar skin that patients complain to be itchy (hyperplastic dystrophy). Previously this condition was treated with topical steroids such as Lidex and Clobetasol Propionate. ThermiVa has helped these patients with symptoms. These symp-toms are not a contraindiction at   all.

     

    11. Who suffers from vaginal laxity?

    Vaginal Laxity is very common after vaginal delivery. This condition can also be the result of ag- ing, obesity, hormones, chronic constipation, straining, lifting, or any activity that would cause  the vagina to stretch beyond its normal  capacity.

     

    12. Who are candidates for ThermiVa?

    • Women who are experiencing vaginal laxity and a loose or rubbing feeling

    • Women who are displeased with the appearance of their labia majora, especially while wearing bathing suits, athletic attire, leggings, jeans, etc.

    • Women who are experiencing any sexual dysfunction or orgasmic issues

    • Women who are having difficulty retaining tampons or may have pelvic prolapse, such as fallen bladder or fallen rectum

    • Women who may suffer from urinary leakage or stress incontinence.

    • Women who may suffer from dryness of their vagina or labia (atrophic vaginitis) due to the effects of menopause

     

    13. Do women on hormone replacement therapy need to stop at any  time?

    No need to stop, change, or alter the way you are taking your hormone replacement therapy. If using vaginal estrogens apply AFTER treatment.

     

    14. Research has shown there is a correlation between vaginal dryness and orgasmic dysfunction in women who have been on birth control for extended pe- riods of time, due to a medical issue such as PCOS. Can ThermiVa help with this issue without having the patient stop the birth  control?

    Yes, definitely, if the patient had orgasmic dysfunction. ThermiVa can improve sensitivity in all patients, whether they are on hormones or birth control pills. In patients who suffer from orgas- mic dysfunction (anorgasmia or taking too long to achieve orgasms), it can reduce the time to reach orgasm by one third to one half. However, if you have no such problem, it will not make you hyper-orgasmic. It only helps those who have orgasmic issues. Those who have normal orgasms when treated with ThermiVa continue to have normal orgasms, but can experience stronger and more coordinated muscular  contractions.

     

    15. If a patient has had a previous hysterectomy or has an enterocele, are there any concerns for treating the vaginal apex for bowel injury  concerns?

    No concern. Hundreds of women have been treated post-hysterectomy. The tip is rounded and blunted, so the risk of perforating the vagina into the bowel/rectum/bladder is none, unless you force the device in with tremendous pressure. We recommend light pressure.

     

     

     

  • Treatment

    1. How do we explain M.O.A. and results seen in regards to urinary stress incontinence?

    This is a very remarkable story. Stress incontinence is from poor support of the mid urethra, re- sulting typically from stretched out pubocervical fascia that then fails to act like a backboard for the urethra to become compressed from pressure events of stress such as coughing/sneezing/ jumping. It can also occur because of damaged/stretched out or poorly contracting urethral muscles. This complex dual mechanism of the urethral muscles and the backboard theory are what provide continence. Anything that effects both, results in leakage or urine with stress. ThermiVa does two things to address these two issues. First, it contracts the pubocervical fas- cia, tightening it, and provides a firmer floor for the urethra to compress against when the pa- tient coughs or sneezes. Instead of flopping, the firmer pubocervical fascia is now not getting stretched and pushed down now and provides floor pressure upwards to compress the urethra that is getting pushed downward. Next, ThermiVa has healing effects on the muscle and nerves, as well as, the fascial tissue. The healing effect on muscle is well known and is why it is used on damaged or sore muscles by physical therapists in pro sports. So, now radiofrequency heals the torn or damaged muscles, plus the tightening effects, bring these torn and stretched out mus- cles closer in proximity together and now the individual muscle fibers act like a unit of muscle to increase pressure when contracted. Instead of individual muscle fibers working separately, the more closely tied in units of muscle; work together to improve the continence mechanism of the urethra. Lastly, it’s thought that the ThermiVa does have nerve healing effects that may increase the sensitivity of nerves of the urethral muscles and bladder. Nerves are more sensitive in de- tecting pressure changes and defensively contracting to provide continence. These same nerves that may be too sensitive or easily triggered from traumatic deliveries, menopausal changes, interstitial cystitis are now not “overactive” or spastic. Those with overactive bladder symptoms, typically feel a reduction in need to urinate frequently or sudden uncontrolled urge to urinate by  a third to a one half. They feel like they can go longer between voids, they have larger voids, and have a stronger stream, one that they can control better by the ability to stop midstream if they wanted to, when they could not prior to  treatment.

     

    2. Why are some patients experiencing spotting or  shedding?

    Spotting can occur when ThermiVa electrode touches the cervix. We can see the same results with a pap swear. It can also occur if the patient has an untreated vaginitis (bacterial vaginitis, candida vaginitis, trichonomas vaginitis). More serious, is if they have an active/untreated gon- orrhea or chlamydia infection. If patients have had a hysterectomy, then treat to the vaginal cuff. If bleeding is repetitive, encourage a pelvic exam be performed for visually inspection, vaginal cultures, GC and Chlamydia testing.

     

    3. Do you see an increase in menstrual cycle after treatment?

    No, increased menses has not been reported nor documented. Patients have reported no change in their cycle schedule, length or flow.

     

     

    4. How are nerves affected by RF?

    The RF affects nerves by increasing its release of vasoactive peptides that are then available at the nerve terminals. The increase in neurotransmitter activity at the nerve synapse is not clear. These vasoactive peptides result in vasodilation of the arterioles on the vulva/vagina/clitoral and G-Spot areas. The increased blood flow is similar in effect to Viagra in males. Increased blood flow results in increased plasma transudate from the arteriole through the vessel epithelium and out to the vaginal canal.

     

     

    5. Can it treat episiotomy, hemorrhoids and scar tissue?

    ThermiVa may soften scar tissue. It has been shown to soften skin. It’s likely to shrink hemor- rhoids. However, for hemorrhoids, the preference is to ablate and destroy them with higher tem- perature RF, such as the technology of the ThermiRase protocol at 80C.

     

    6. When treating internally you can sometimes see a white discharge. Is this sloughing or something else? Please explain.

    The white discharge when treating internally is transudate from stimulation or arousal. Not really vaginal sloughing per se. Very normal. This is actually a good sign that their response to treat- ment will be outstanding in terms of atrophic  vulvovaginitis.

     

    7. Can ThermiVa be combined with other procedures?

    ThermiVa can be used with many other vulvovaginal treatments. For example, when treating      a labia minoraplasty, ThermiVa treatments on the entire vulvar structures can provide an im- proved cosmetic appearance and post procedure improved skin softness/fullness/smoothness. For most patients, this is an added and unexpected benefit from ThermiVa. All of your vaginal surgical patients can be presented with ThermiVa as an add-on option that can be done at the same time as their insurance or cash based surgeries.

     

    8. Are anesthetics needed for this procedure?

    No. The treatment feels like a comfortable, warm heat and patient feedback is necessary.

     

    9. How long does the procedure take?

    Approximately 10-15 minutes for labia majora reduction and 15-20 minutes for vaginal tighten- ing. The protocol consists of 3 treatments recommended one month  apart.

     

    10. Is there any contraindiction to longer treatment?

    No. But whether anything longer than 5 minutes is better than 3-5 minutes is not  known.

     

    11. What would you say at this point would be your maximum treatment times for internal and external areas?

    About 5 minutes is my maximum treatment per zone with excellent  results.

     

     

  • Post-Treatment/Results

    1. Results: When should a patient expect to begin their “maintenance” program? Does this differ for internal and external treatments?

    External Treatments:

    If the patient has external issues and concerns, after the third treatment they may require addi- tional treatments between 4-6 months. You can give the example of: this treatment is typically going to last as long as a Botox treatment.

     

    Internal Treatments:

    The maintenance treatments can be between 6 to 12 months after the 3rd treatment. The inter- nal effects of comfort, moisture, fullness, incontinence and overactive bladder can have longer lasting effects than the external treatments. The results for orgasmic dysfunction can be longer lasting than other comlpaints and may last over 18 months. It’s an observation that when the nerves have been sensitized the effects are very enduring in terms of maintained sensitivity.

    Always consider the number of treatments the patient has had when educating them on a main- tenance program. If the patient has had less than the 3 treatments as recommended; than they may desire additional treatments sooner.

     

    2. What results can you see with prolapse? Does the technique change for blad- der prolapse?

    If the patient has pelvic prolapse, I would concentrate my treatment time on that particular compartment. Spend at least 5 minutes in the anterior compartment if the prolapse is of the bladder, then at least 5 minutes on the posterior compartment if the prolaspe is the rectum. Ten minutes total if the prolapse is located in both. ThermiVa has worked to reduce symptoms for patients with mild to moderate pelvic prolapse (up to stage 2 where the leading edge can go up to a cm past the hymen), but does not work well in severe prolapse when the tissue is visible and palpable. It will not be beneficial for those patients with uterine prolapse. What I have seen is that with ThermiVa treatments, you can reduce cystocele and rectocele stages by ½ to 1 Stage. This may be enough to avoid surgery in selected patients who have mild to moderate symptoms. It   is not recommend-ed for those with severe cystocele, rectocele, uterine prolapse or vaginal pro- lapse. Please note: ThermiVa reduces vaginal tissue stretched out and has no “tacking” abilities.

     

    3. What is the furthest data recorded for ThermiVa patients?

    For external vulvar treatments / introital treatments, patients are out almost two years. Different RF technologies have been used since 2009-2010, so we have RF patients out over 5 years. ThermiVa internal treatments, the patients are now out one year plus. We can report that with RF and ThermiVa we have had no reported serious complications.

     

    4. What are the post op instructions regarding hot tubs and  swimming?

    Hot tubs and swimming are permitted after treatment. If the patient has had a rare spotting epi- sode with treatment, they should wait a day or  two.

     

    5. How soon can Thermiva treatments be repeated?

    It is recommended that ThermiVa treatments should be done every 30 days for three treatments. Then start a maintenance program as needed based on results. Treatments have been done at 3-6 weeks. Treating every 2 weeks may be too soon because at 2 weeks is typically when my patients see and feel more dramatic changes occurring.

     

    6. What could patients experience post  procedure?

    Patients may say that they will feel tighter immediately after treatments, but that it improves even more with time. Another example is with incontinence, where it is not unusual to have patients become dry immediately after their treatment. We often see that a morning ThermiVa treatment, results in no stress incontinence that evening. In regards to vaginal dryness, the moisture starts more dramatically at 2 weeks and it may only be slightly improved after the first treatment and start presenting itself more significantly after the 2nd or 3rd treatment. The doctor and patient should not be concerned that they are not as wet as they want to be after only 1 treatment. After 3 treatments there are no known failures for atrophic vaginitis treatments.

     

    7. What are post-procedure expectations?

    Post procedure patient may resume normal daily activities. There are no restrictions for physical or sexual activity. Patients may feel the tightening effects the same day, others will take more time and notice changes at 2 weeks. Immediately there may be mild cramping, but this should resolve within 24 hours. If cramping persists contact your physician. To avoid possible cramping stop when you encounter moderate resistance. Patients should not see an increase or change  in discharge. The interpreted increase in discharge is probably the gel used during treatment seeping out. The improvement in vaginal moisture post treatment does not typically show itself in the first week and is seen starting 2 weeks post treatment. In short, the answer is that there is no increase in vaginal discharge with ThermiVa.

     

    8. When can women resume sexual activity?

    Women can resume their normal activities of daily living. This includes resuming sexual activity the same day as long as no abnormal bleeding is reported.

  • Patient Testimonials

    Ever since I was a young girl I always thought I looked a bit different. My inner labia were long and dark and uncomfortable. They would pull and tug and pinch with every move I made. It was extremely uncomfort- able on the daily. This made buying underwear a mission and I had completely eliminated leggings and any tight, thin clothing from my wardrobe because my labia were noticeable. I became extremely self-conscious of them at a very young age.

     

    When I started dating my high school boyfriend, who took my virginity. I had to convince him I was a virgin because he thought that my vagina looked “used.” As we grew older and started to have more sex he would always poke fun at my labia. He would pull on them and stretch them out and then call them “bat wings” or “beefy wings” or “flappy roast beef” He would say that he was “hungry for a roast beef sandwich.” Which made me want to hurl rather than set the mood. I’m sure he intentionally being hurtful but my already low self-confidence was then buried to non-existent.

     

    Not only was I horrified with how I looked and was convinced every man would do the same to me and my labia, but sex was very uncomfortable, even painful for me. My labia would roll inward. It would fold over and block penetration. I had to physically move it out of the way with my fingers. So I started researching enlarged labias and what I could do about it. I saw the prices for labiaplasty surgery and tried to forget about it because I had no source of income, my mom had passed away a few years earlier and I was too embarrassed/ashamed to ask my dad.

     

    After my high school boyfriend and I spilt up I dated a couple guys but didn’t let any of them touch me ex- cept for one. He further destroyed my measly self-confidence because he pulled his hand out of my panties like it was on fire and actually shook his hand off.  I was mortified.

     

    So again. I researched labiaplasty and surgeons in Southern California. That’s when I found Dr. Alinsod. At that time my dad had recently passed away and I was forced to drop out of college to work full time at min- imum wage. So I started a fund for the day I could afford surgery having made my mind up that Dr. Alinsod would be my surgeon.

     

    Fast forward a few years. I am happily married and had extra money saved up for surgery. I had been check- ing Dr. Alinsod’s website regularly. I would read and re-read all of his information, his patient testimonials, his case studies. Reviewed his before and after galleries. Everything. I did that for 2 years and then decided to finally send a email and get an estimate for surgery. His receptionist Diane, emailed me immediately and we chatted for a few minutes and then she emailed me an estimate. I had a ways to go before I had enough money to afford his expertise. And honestly, I had found a couple surgeons that were in my price range at that time, but I refused to go to anyone but Dr. Alinsod.  I told Diane I’d get back to her.

     

    About 6 months later, I got lucky with a settlement and had enough money for surgery! I contacted Diane right away and she set me a consultation for the very next week!!! AND she remembered me!!

     

    I was so extremely nervous on the day of my consultation. I was sweating and shaking. My anxiety was through the roof.  I was there to show the one thing I didn’t show anyone. The one thing that I kept hidden

     

     

     

    my entire life was about to have people staring at it. Close up. With lights. I wanted to crawl away and hide. Luckily, he had incredible bedside manner and his staff were just amazing. They calmed my anxiety a bit even tho I was still shaking like a leaf.

     

    The ladies in his office. Diane, Maria, and Marisol are the most comforting women I’ve ever met. They individually welcomed me into their office with warm smiles and a gentle touch on the shoulder. It’s the subtle, motherly gestures that sets them apart from other surgical staff I’ve met. They care about their patients. They each made me feel important, not like I was just one of the “assembly line of patients” that other offices portray.

     

    Dr. Alinsod was a pleasure to meet! He greeted me with a giant smile and a firm handshake. I immediately stared to relax in his presence. He was so easy to talk to. He asked about me, where I was from, what I did for work before we even started talking about what I wanted as far as surgery goes. You can absolutely tell that he cares about his patients and is very passionate about his work. It’s obvious that he enjoys what he does. He takes pride in his work. I already knew I wanted Dr. Alinsod to preform my surgery because of everything I had read on his website, his patient testimonials on other review websites, and his impressive before and after galleries. In all the research I’d done I had never seen the same effort put forth into before and after photos. Dr. Alinsod literally takes a shot of every angle, with a caption on every photo. He also uses a black background. To me, that shows a dedicated surgeon who is proud of his work. And those are the exact qualities he portrayed in person. Then his personal demeanor and that of his staff drove it home. I scheduled surgery at the end of my consultation.

     

    I don’t remember anything from my actual surgery day. I do remember talking to Dr. Alinsod and his staff the day before. They answered all my questions and met my husband and answered his questions. Again, they all made me feel so comfortable. They gave me detailed post-surgical instructions which were easy to follow. Dr. Alinsod preformed Labiaplasty on my inner labia and after that he preformed ThermiVa three times spaced 4-6 weeks apart.

     

    The recovery was easy, I followed the post-surgical instructions exactly and everything went great. I went back to work within 7 days and I wasn’t in any pain. I was obviously swollen but icing and the creams helped a lot.

     

    5-6 weeks into healing and I could really start to notice Dr. Alinsod’s beautiful work. I was so amazed at what I looked like!! I couldn’t believe it was me in the mirror. I showed my husband for the first time and I started crying! Happy tears, of course! It was the most beautiful feeling in the world. I was no longer ashamed. I no longer felt self-conscious. I was willingly letting my husband look directly at it without covering up or getting that weird, nervous feeling that I had always felt for the last 10 years of my sex life. I can’t even put into words how good that moment felt for me.

     

    Im comfortable now. I can wear whatever I want. I can wear underwear without worrying about a lip slip. I can run, hike and work out with out worry. I can cross my legs without pinching. I can ride a horse or bicycle without rubbing.  I can wear swimsuit without the cameltoe.

     

     

     

    As far as the appearance: My Labia is so beautiful now! Omg! It looks so neat, tidy, and smooth. It’s ab- solutely gorgeous! My clitoris and inner labia fit neatly inside my outer labia and my outer labia are now smooth and tight. With the ThermiVa treatments, my clitoris labia are highly sensitive and achieving an orgasm is easy and the actual orgasm is mind blowing!! I highly recommend getting ThermiVa! Seriously, the intensity of the littlest touch down there is amazing! Dr. Alinsod is truly a gifted a surgeon. I can’t say that enough.  He really is master at his craft.

     

     

    Dr. Alinsod, Maria, Marisol, Diane:

     

    I don’t have the words to express how grateful I am to have found your office 2 years ago. For the confi- dence you’ve given back to me. For giggling and laughing with me at my stupid jokes. For providing me a comfortable environment. For the hand on my shoulder to insure me that I’m okay. For positive energy and good vibes. You guys have changed my negative self image into a healthy self love. I will always remember the compassion and kindness that all four of you showed me. You guys were well worth the wait. I LOVE LOVE LOVE my labia so much!

     

     

    Thank you. Xoxo

     

    ~A.X.

     

     

     

    Dear Dr. Alinsod,

     

    I wanted to write you a letter about my ThermiVa experience after only one session a month ago. So far, pretty exciting and “Happy Happy!” Such a comfortable and pleasing treatment with absolutely no com- plications. Immediately I felt my labia and vulva to be tighter, a lot less saggy, and a definite “WOW!” in the way it looked. So much more moisture and less irritation in my jeans and softer and smoother skin. This started about 2 weeks after treatment. I loved the way I looked in front of the mirror and I felt sexier. Funny how a simple treatment can give so much confidence.

     

    I am over 50 and I have never had a baby so I don’t have the typical damage down there or the looseness that many ladies have after childbirth.  But I had some vaginal looseness that I wanted tighter and after the first treatment I definitely felt tighter inside my vagina, was able to have more muscle control, and did not leak urine anymore! I used to sit down and pee and then dribbled down my legs when I stood up. My muscle control was not good. That all went away immediately after the ThermiVa treatment! I did not have to wait two weeks for this effect. I could now stop and start my urine flow as I wished! It was really amazing to do that again after so many years of no control.

     

    Dr. Alinsod, I wanted this treatment more for my problems with orgasms than the tightness or the dryness or the leaking so I have to tell you that ThermiVa is a Home Run in this regard. I don’t know what it did

    or how it did it but ThermiVa made my “sensitive spot” easier to find and identify!  I can now find that

    “G-Spot” place that now gives me my ultimate highs! My climaxes are more intense, my muscles contract stronger and more coordinated, and I can come with my partner on top, which was not possible before treatment. Most of my improved stimulation is in that G-Spot inside and not on the clitoris itself. It is so nice to have orgasms easier and faster. I am not so stressed and focused on getting orgasms now and I enjoy sex with my partner so much better.  So glad you did not have to do injections on my nerves like they do with the G-Shot and O-Shot. Too scary for me. Radiofrequency is less scary and obviously works with no pain. You have used radiofrequency for so many years so I trust you. I am so relieved that now I have something I know can help me with my personal and intimate needs. This is definitely a life changer that needs to get out to the world.

     

    I will see you soon.

     

    A Patient for Life

     

     

     

     

    Dear Dr. Alinsod,

     

    I have forwarded in a separate email a photo of my vagina the day before my first ThermiVa treatment and another photo 24 hours following my first ThermiVa treatment. The results of the tightening of my labia majora was unbelievable. I took these pictures to share the dramatic change with my husband as I had to travel out of state to obtain the treatment and did not return home for a week following the treatment, he was very impressed. I believe his exact words were wow that looks beautiful.

     

    I wanted to share with you some additional and very exciting news since you completed my first ThermiVa treatment. My urine incontinence has stopped completely. I have regained the ability to start and stop my urine flow which I have not been able to do for years.

     

    When I returned home and made love to my husband for the first time since my initial treatment I was able to have intercourse without the aid of ALOT of lubricant. My comfort level was so much better I suppose due to the increased natural lubrication and my orgasm was much stronger.

     

    But here was the real surprise for me. My husband said that it felt incredible to him, I think the term he used was Oh My God as he orgasmed. I asked him to describe the difference as to how it felt to him versus before and here is what he said.

     

    During penetration in the past he has only been able to get significant pleasure when thrusting his penis in and out of my vagina sufficiently to gain the tightness of my vagina which has been concentrated around the opening of the vagina only. Once he had full penetration prior to my treatment there was really very little if any sensation on the entire penis. After my treatment he said it felt like his entire penis including the head and shaft were surrounded and gripped by soft, warm and moist tissue. It did not require him to work as hard and his orgasm was twice as intense. He told me to give you a million thanks.

     

    I am so happy with how I look, how I feel and how I am able to give both myself and my husband such in- credible pleasure.  You have transformed both our lives.

    I cannot begin to express my gratitude to you.

     

    By they way in case anyone wants to know, the treatments are relaxing, comfortable and actually feel good.

     

     

    Your advocate forever,

     

    P.A.

     

     

     

     

    I am a 53 year old woman who has had two children. My labia had become loose and a bit saggy and no matter how many Kegels I did, my vagina felt large and loose. Sex was ok, but I had lost some confidence in myself and ability to please my partner. I didn’t really know what to think about “the procedure performed”, but there was no down side to it. There was no pain during or after, no burning, no discharge, no mess. After the first treatment in a series of three, I was surprised that my labia seemed closer to my body and there also was some vaginal tightening.

     

    It was after the second treatment that I noticed a significant difference. My labia were fuller and softer and my vagina was noticeably tighter. Sex was very good.

     

    I had not told my partner that I was having the procedure. He is ten years older than me and has difficulty ejaculating during intercourse. So I was surprised when my new tightness created enough friction for him to alleviate that issue. Sex became better for both of us I could feel him more and sex was more pleasurable for both of us.

     

    I did not think things could get tighter or sex better, until after the third treatment. But they did and I am so thankful to Dr. Alinsod for recommending this procedure to me.

     

    I feel better about myself, more youthful and sexier. My partner is a happy man and our sex life, which was good, is now better than ever.

     

     

    Thank you again Dr. Alinsod

     

    A Very Happy Wife

     

     

     

     

     

    Dear Dr. Alinsod,

     

     

    Now that I have completed all my treatments I wanted to give you my impression on ThermiVa. The treat- ments have really been wonderful and quite easy. I had no blisters, no burns, no discharge, and not a single complication. I had sex the same day of my treatments and I went to my gym immediately and it’s as if no procedure had been done. It’s crazy! Your design for ThermiVa handle so comfortable and very slim that I barely felt it being inserted and I felt just gentle pressure. All I felt was pleasing warmth on my labia and my vagina. It really helped that you were gentle and slow and did not rush. Putting a tampon inside is probably more uncomfortable than using your device. Your device was smooth and rounded and not scary at all.

     

    So Dr. Alinsod, let me summarize how I felt immediately after your treatments and how it is now that I am months done. The first treatment definitely got me tighter and my husband and I loved it. It wasn’t’ imme- diate for me and it took me two weeks before I felt significantly tighter. I got tighter more after the second treatment and then even more after the third treatment. My husband said that my muscles felt stronger and that I had better grip and more noticeable friction. He loved the way the outside labia looked and he said it made a big difference visually. My husband said I look more youthful and pretty and appealing. Men are so visual. Appearance and comfort was so much better in both our eyes. Now I can wear my tighter clothing without the rubbing or at least not feeling irritated anymore. There was no difference in my vagi- nal moisture or how I got wet but that had never been a problem for me. My orgasms come quicker now with the same intensity and there’s been no change in the frequency of my orgasms. I’m not sure why my orgasms are better but perhaps it can be because of my improved appearance giving me more confidence and less self consciousness worries.  For sure I can feel my husband more and I’m definitely tighter.

     

    I couldn’t have multiple orgasms in the past now I’m able to have multiple orgasms for the first time in my life. I have more sensitivity. The strength of my orgasms are about the same as before but it feels better for some reason I can’t really explain. Anyway this is probably the best lunchtime rejuvenation available out there!  I’d pay for this procedure over and over and over!

     

    I’m so glad you included me in your study. This is really going to help so many women around the world. I hope you get this out in the market soon and train doctors from all over the world.

     

     

    With sincere thanks,

     

    A Loving Wife and Mother

     

     

     

     

     

    Dear Dr. Alinsod,

     

     

    You asked me to write about my experience so I hope you don’t mind that I am writing you not a very formal letter. I think it’s better if I write from my heart. Thanks so much for taking care of me this past year. It has really changed my life in so many different ways. You have been so kind and open with me. You understood my needs and insecurities as a dancer and adult entertainer. So you knew how important this whole Ther- miVa treatment was for me.

     

    When you first started ThermiVa early last year I noticed immediately how the texture and tightness of my labia majora improved. Super dramatic changes for sure which got rid of my camel toes. Gave me lots more confidence when I performed. On the inside I had more vaginal tightness and it just kept getting tighter. My boyfriend loved the way it looks and how I was suddenly able to have orgasms one right after another when in the past I had none before treatments. My two kids really messed up my vagina and I thought I would never have orgasms again! It had been over 5 years since I had one before you treated me. Now I have multiple orgasms and they are super intense since the treatments. They are the “good kind” of orgasms and they come within seconds of each other to about three minutes apart. At one time I had seven in a row, which was completely unbelievable. I used to have only orgasms with oral or manual stimulation but now I’m able to have orgasms with penetration. This is really important to me. When you first treated me I was a little bit worried that you got me too tight because I couldn’t insert my vibrators anymore. But now I don’t need them because I can have great sex with my boyfriend and have orgasms without the toys. I notice I am more aroused and more wet and don’t need lubrication anymore. I don’t know how ThermiVa has done this whether it helped heal some of my nerves or if it’s all in my head because now I feel healthier and sexier.   I know the radiofrequency has helped both the inside and outside my vagina. Doesn’t really matter if it is mental or physical healing with me, it helped!

     

    You asked me also if there were any areas I thought it didn’t help at all. Well, it didn’t help me with my uri- nation because I really had no problems with it before treatments. I don’t leak when I cough or sneeze or jump around and exercise. I do have less feeling that I have to go all the time after the treatments. I don’t know what that’s about. One thing I did notice was that I had more control of my urine stream. My urina- tion muscles are stronger and I can start and stop anytime I want now. Some other things I noticed where that my labia majora were softer and smoother but also more full feeling. I said earlier they feel more comfortable when I’m in tight clothes like jeans or bikinis.

     

    So Dr. Alinsod, I will definitely be a regular customer coming to your office every six months. There is no way I want to lose what I have gained from your treatments. Have told all my close friends about you. Seeing you is so worth the drive.

     

     

    A Happy Hot Mom from the Inland Empire

     

     

     

     

     

    I have now finished all three of the ThermiVa treatments and am still in awe of the results I have gotten. I can’t believe all this has happened to me without the need for surgery and with treatments that were com- fortable, felt actually good, and were totally relaxing. And having absolutely no downtime was great. I could have sex the same day as the treatment, had no blisters, burns, or complications.

     

    I was pessimistic at first after Dr. Alinsod did my first ThermiVa treatment. It only took half an hour and I was relaxed during the treatment of both my labia majora and my outer and inner vagina. I noticed some tight- ness immediately on the majora but did not feel a huge change inside my vagina during the first two weeks. I thought I was the failure for his treatments. So many other women had amazing and lasting results and here I was thinking “Great, it would be me that does not respond!” Then 10 days after the first treatment my vagina got really really tight! Significantly tighter! I felt better muscular control and increased strength in my vagina and urinary muscles and my husband sure felt that benefit! He also liked the tightness and softness of my labia majora and the moist smoothness inside my vagina. One thing I really liked was that my labia majora did not sag anymore and I got rid of the “Camel Toes.” Never thought that would happen without surgery.

     

    I used to have this pain on the left side of my vagina, for decades in fact. It was always tender when hit. The wand that Dr. Alinsod used treated that area on the floor of my vagina, a very sore muscle probably, and now the muscle is not sore at all! There is no more pain, as if my muscles were healed. That sure makes a world of difference not and both Dr. Alinsod and I can’t really explain how a painful and sore area of muscle is now non-painful and working more strongly and more coordinated. I know radiofrequency treatments are used for sore and damaged muscles for professional athletes and physical therapy offices so now I can related to others who have had relief of muscle pain due to the healing effects of radiofrequency. Dr. Alinsod told me that it does encourage new collagen to form does help with tissue healing. I am a prime example.

     

    There is one other wonderful thing I have noticed that got better with each ThermiVa treatment and that is the control of my urine. Dr. Alinsod did not do the treatments on me for the control of urine but simply to tighten my labia and vagina. When I reported to him that I leaked less urine, in fact I don’t leak at all now since after the first treatment, he told me that it was a pleasant result of tightening the “pubocervical fas- cia” that help with urine control and fallen bladders. I can hold my urine longer now, can produce a stronger squeeze to prevent accidents, and can make it to the bathroom in plenty of time.

     

    Lastly, I also noticed that after treatment around my clitoral nerves and the supposed G-Spot, my orgasms are now easier to achieve. I can’t have multiple orgasms and my orgasms are about the same intensity but now it does not take me all night to get there! What a wonderful thing! I did not even have many orgasms before treatment and now it seems like I can get one on any lovemaking with my husband. I enjoy the love- making between my husband and I more and the stress and anxiety of getting that orgasm is gone. It is just a pleasure now being with my husband. That is worth everything. ThermiVa has really been a blessing for us. I hope it becomes available to all my friends and family.

     

    With hope and happiness,

    Reborn in OC

     

     

     

     

    Dear Dr. Alinsod,

     

     

    I wanted to write you a letter about the ThermiVa treatment you gave me over a month ago. I know I have two more to go but thought it would be important for you to know how your patients feel and respond after just one treatment.

     

    First of all, ThermiVa was a gentle and comfortable massage-like treatment that caused absolutely no dis- comfort for me. It was nice for me to guide the treatments by telling you to go up or down on the heat. No anesthesia, no zaps, no numbing creams to use. I heard the laser treatments gave you little shocks or rubber band snaps that sometimes needed numbing.  Glad to avoid that.

     

    Let me start with the effects I saw on the outside and then go inside. My majora felt tighter and more snug, less bulgy and fatty, and much more comfortable in my jeans with less rubbing irritation. I had the problem with thickened skin (my dermatitis) and I can say that my skin now feels thinner and normal and I have less itching there. I really did not want to use my steroids cream anymore and this radiofrequency has helped a ton.  I hope the next couple of treatments improve it more.

     

    Internally, my vaginal definitely feels tighter in the opening and down deep. My partner certainly noticed the tightening and better lubrication and he was a very happy camper. I noticed more wetness too and was surprised how much it was when I was aroused, a very pleasant surprise. Getting to my orgasms took a shorter period of time, which was great. The orgasms felt amazing and quite different than my usual. It was better. The clitoral area was much more sensitive in a good way probably because there was some pull- ing back of my clitoral hood from the shrinkage of loose skin. It was not irritating and was quite pleasing. Inside my vagina on the G-Spot area was also a new pleasurable sensation that was very stimulating. It is hard to describe other than to say it felt really good. I am extremely happy with what I have experienced in ThermiVa Treatment #1. I will definitely tell others about this and will recommend it highly. The flights from Northern California are well worth it. Now I know why your patients fly in from Texas, Arizona, and from all over the world.

     

     

     

    Warmest regards,

     

    A Very Happy NorCal Mom

     

     

     

     

    Dear Dr. Alinsod,

     

     

    I wanted to write a letter to let you know how happy I am with the results of my ThermiVa treatments. I fly in to California all the way from Missouri because of your reputation and because ThermiVa is not of- fered out here yet. I did not consider surgery and I was not impressed with the laser treatments available for my loose, dry vagina and poor orgasms. None of the lasers can help me with all of my problems. I did not even consider MonaLisa Touch, FemiLift or IntimaLase. They are so limited in what they can do and extremely expensive. When I heard of ThermiVa, I realized right away, this is the perfect treatment for me. After my first treatment I saw immediate results! I continued to do the 2nd and 3rdtreatment and I can honestly say that I am very pleased and satisfied with my sex life and my confidence.

     

    Let me break down in all honesty what I felt and what I observed after the one treatment in March of 2015.  You told me to keep some kind of diary so here goes…

     

    First, the result I have now at the opening of my vagina is amazing. I am very extremely tight and both my partner and I are ecstatic! With each passing week we both felt progressive tightening that is measurable and can be felt.  For example, in the past 4 days before I come fly to see you I feel like a virgin again.  How is that possible? I want to be tight all the way to the top of my vagina and I can’t wait to see what that will be like after all three treatments are done. So as far as vaginal tightening after only one treatment I give ThermiVa an A!!!

     

    Second, my labia majora are both softer and smoother and more sensitive to touch in a good way. I am more comfortable in my clothes and don’t feel like I have a camel toe now. At the same time the inside of my labia majora feels fuller and healthy. The sensitivity of my majora and clitoral areas is giving me more sensation and oral sex is amazing.  I give this an A also!!!

     

    Since you treated my G-Spot area with ThermiVa my orgasms are easier and faster to achieve probably by over 50%. I don’t know how or why but my orgasms are both stronger and with more intense sensa- tion.  I can even now have orgasms when I am on bottom when I used to never do that.  It’s crazy.  Now I am consistently multi-orgasmic and I absolutely never thought I could do that.  I have 3 to 4 in a row on a regular basis now! My partner playfully rated me a minus 50 before my treatments in my difficulty in achieving orgasms and now he says I have improved 100% to a score of 50! We both are shooting for

    more improvement towards a score of 100! Overall this has help tremendously with improvement of our sex lives.  My partner was initially hesitant and against me coming out to see you but he is so supportive of my decisions. We love each other very much and would like nothing more but to please each other. He now thinks you are a genius.  My partner and I give this area of treatment an A+!

     

    ThermiVa had no side effects. I did not have any urinary problems. It had no effects on my skin color and did not cause any blisters or burns or discharge. There was no pain and I could have sex or go to the gym or do all normal things in life the same day. So in all I rate it an A+ in that treatments have no downtime or complications whatsoever.

     

    After the 2nd and 3rd treatments, I am 100% cured. I decided to complete my 3rd treatment so I can be completely satisfied with myself. This procedure has changed my life. I can enjoy intimacy with my partner and have pleasure from it. It is truly a blessing to have found Dr. Alinsod. The environment is welcoming and the nurses are so helpful. They comfort me each time and that is also another reason why I came back.

     

    My sister will be coming along also to start her treatments with you. We are both exited to fly out to Laguna Beach to see you.

     

     

    With sincerity,

     

    A Mid-West girl with a New Found Smile

     

     

     

     

    Hi Dr. Alinsod!

     

    Here’s my letter for my ThermiVa written from the point of view from after my first treatment. I’m sorry it’s kinda long but I just have so much to say about it! :)

     

    I had long, dark, and bulky inner labia that would pinch and pull while I walked, ran and worked out. They were visible in tight clothing. Sex was extremely uncomfortable and sometimes painful. I was so embar- rassed of them for so long. I even stopped having sex just so no one would see them.

     

    I found Dr. Alinsod doing some online research and scheduled a consultation. Then after falling in love with him and his wonderful staff I booked my surgery which was a Labiaplasty of my inner labia and a treatment called ThermiVa that treats the clitoris and inner and outer labia. ThermiVa is controlled ra- diofrequency energy that transfers heat directly to the labia making it appear tighter and smoother and increasing sensitivity. My 3 treatments are spaced 4 weeks apart.

     

    I was a nervous wreck and Dr. Alinsod and his girls made me feel right at home. I don’t remember the day of surgery but I remember my husband telling me he was impressed with the compassion they showed when he picked me up and dropped me off. The healing process was very easy, Dr. Alinsod gives you de- tailed post surgical instructions. The swelling started to go down and I looked more normal at 6 weeks.

     

    I’m now just past 10 weeks post surgery and my labia looks absolutely beautiful!  My clitoris and inner lips fit neatly inside my outter lips! It looks nice and tidy.  It looks gorgeous from every angle! It looks like a perfect little clamshell, which is the exact word I used to describe my desired look in my consultation! I never thought that I could look the way I do now from what how I looked before surgery. Dr. Alinsod is a brilliant surgeon!  And I’m so thrilled with the outcome!

     

    I just had my first ThermiVa and OMG! My outter(and inner) labia look tight and smooth and are super soft to the touch.

     

    My sensitivity went from a 2 to an 8! Just the littlest touch down there feels amazing. I never thought I could have the sensations and intense sexual arousal that I’ve had since I’ve had ThermiVa. I’m so excited for 2 more treatments! I get warmed up faster, I reach orgasms faster AND the intensity of my orgasms blow me away! I even finish before my husband! My entire vagina, not just the labia feels very tight. I strongly recommend Dr. Alinsod and having ThermiVa done! It’s well worth it! You will not regret it!

     

     

    Happy and Renewed in OC

     

     

     

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