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Surgical Trans-Formation Hope Sherie, MD, FACS Medical Director - PowerPoint PPT Presentation

Dec 19, 2022 •327 likes •1.08k views

Surgical Trans-Formation Hope Sherie, MD, FACS Medical Director Cosmetic Concierge, PLLC IT takes courage to grow up and become who you really are. e.e. cummings The Cosmetic concierge, PLLC About our practice South End Charlotte, NC The

  1. Surgical Trans-Formation Hope Sherie, MD, FACS Medical Director Cosmetic Concierge, PLLC

  2. IT takes courage to grow up and become who you really are. e.e. cummings

  3. The Cosmetic concierge, PLLC About our practice South End Charlotte, NC

  4. The Cosmetic concierge, PLLC About Dr. Sherie Over 10 years general surgery practice in military and civilian hospitals Board certified by American College of Surgeons 2005-present Dedicated cosmetic surgery fellowship 2012 Began performing top surgeries & advanced body 2012 Private practice opened February 2015 Currently performing 4-5 top surgeries / week Member of WPATH and Charlotte Transgender Healthcare Group.

  5. The Cosmetic concierge, PLLC About our practice Private Surgical Center with full Operating Rooms Licensed Anesthesia Providers in every case 85-90% Transgender Procedures Only Regional Practice Certified in VASER Hi-Definition Liposculpture Only practice offering “buttonhole” nipple technique Amazing Trans-Friendly Staff We support multiple LGBT organizations & events

  6. The Cosmetic concierge, PLLC

  7. The Cosmetic concierge, PLLC About our practice Informed consent practice: do not require therapist’s letters for most surgeries (one letter for orchiectomy) Top surgery for 16-17 year olds with prior therapy and parental/guardian consent We offer three types of financing: descriptions and applications available at www.cosmeticconciergemd.com No specific waiting time for surgery – we are adding O.R. days as needed Phone & skype consultations available Many out of state, and International, patients

  8. The Cosmetic concierge, PLLC About our practice

  9. Proud to stand with the community and allies in North carolina !

  10. Despite modern taboos, Long history of body modifications, trans-genderism, and intersexuality

  11. Biblical Recognition of 3rd Gender: Matthew 19:12 – “For there are eunuchs who have been • so from birth, and there are eunuchs who have been made eunuchs by men, and there are eunuchs who have made themselves eunuchs for the sake of the kingdom of heaven. Let the one who is able to receive this receive it.”

  12. Billy tipton: 1914 - 1989

  13. Let’s start from the top…

  14. Top surgeries FTM Chest Reconstruction MTF Breast Augmentation Androgynous Chest

  15. FTM Chest Reconstruction Anatomical Considerations Natural Male Chest…not just flat ! Preserve Upper Pole Remove Lower Pole & Fold Accentuate Pectoralis Muscles Nipple Placement More Lateral - At Edge Of Pectoralis Symmetry Important

  16. FTM Chest reconstruction: Nipple placement

  17. FTM Chest Reconstruction Types of Surgeries Being Performed Today: Double Incision With Free Nipple Grafts Inverted T Keyhole / Peri-Areolar Free Nipple Pedicle – “Buttonhole”

  18. Ftm chest reconstruction double incision with free nipple grafts curved incision, muscular patient

  19. Ftm chest reconstruction double incision with free nipple grafts curved incision, muscular patient after weight loss

  20. Ftm chest reconstruction DouBle Incision with free nipple grafts curved incision, average weight patient

  21. Ftm chest reconstruction DouBle Incision with free nipple grafts Curved incisions, heavy patient

  22. Ftm chest reconstruction DouBle Incision with free nipple grafts Curved incisions, heavy patient

  23. Ftm chest reconstruction DouBle Incision with free nipple grafts Curved incisions, thin patient

  24. Ftm chest reconstruction DouBle Incision with free nipple grafts thin patient

  25. Ftm chest reconstruction Double incision with free nipple grafts straight incision, average weight patient

  26. Ftm chest reconstruction DouBle Incision with free nipple grafts Straight incisions, thin patient

  27. FTM Chest Reconstruction Keyhole / peri-areolar

  28. FTM Chest Reconstruction Keyhole / peri-areolar Note: nipple position cannot be moved

  29. FTM Chest Reconstruction Keyhole / peri-areolar

  30. FTM Chest Reconstruction ButtonHole Technique (free nipple pedicle technique)

  31. FTM Chest Reconstruction ButtonHole Technique

  32. FTM Chest Reconstruction ButtonHole Technique WARNING: GRAPHIC IMAGES IN NEXT SLIDES

  33. FTM Chest Reconstruction ButtonHole Technique DE-EPITHELIZATION

  34. FTM Chest Reconstruction ButtonHole Technique SKIN FLAP AND DERMAL PEDICLE

  35. FTM Chest Reconstruction ButtonHole Technique FLAP CLOSURE AND NIPPLE THROUGH “BUTTONHOLE”

  36. FTM Chest Reconstruction ButtonHole Technique FINAL

  37. Ftm chest reconstruction “buttonhole” technique Curved incisions, thin patient

  38. FTM Chest Reconstruction ButtonHole Technique thin patient

  39. FTM Chest Reconstruction ButtonHole Technique average patient

  40. FTM Chest Reconstruction ButtonHole Technique average patient

  41. FTM Chest Reconstruction ButtonHole Technique hEAvy patient

  42. FTM Chest Reconstruction ButtonHole Technique hEAvy patient

  43. FTM Chest Reconstruction ButtonHole Technique heavy patient

  44. FTM Chest Reconstruction ButtonHole Technique heavy patient

  45. Buttonhole technique Information: Primary advantage is preservation of nipple sensation – intensity is variable Avoidance of scar distortion of grafts in patients with hypertrophic or keloid scarring Increased operating time Current Contraindications due to risk of nipplie loss: nicotine use, diabetes (microvascular disease) Caution in older patients, larger breasts with long pedicle distance from nipple to breast fols

  46. The androgynous chest A little more or a little less nipples optional

  47. Mtf breast augmentation Anatomical Considerations Chest Width Skin Amount and Elasticity Surgery Types Implants Silicone Gel vs. Saline Above or Below Muscle Incision Site Fat Grafting

  48. Mtf breast augmentation implant placement

  49. Mtf breast augmentation insertion sites

  50. MTF breast augmentation trans-axillary submuscular gel

  51. MTF breast augmentation trans-axillary submuscular gel

  52. MTF breast augmentation trans-axillary submuscular gel

  53. MTF breast augmentation trans-axillary submuscular gel

  54. MTF breast augmentation trans-axillary submuscular gel

  55. MTF breast augmentation trans-axillary submuscular gel

  56. MTF breast augmentation trans-axillary submuscular gel

  57. Body contouring Characteristics Masculine Feminine Torso Shape V from chest to waist Hourglass Waist Straight Line or Taper Exaggerated Indentation Abdomen Smooth or Muscular “6-pack” Curved or Vertical Lines Outer Thighs/ Hips Straight or Concave Curved, Convex Thighs Overall Smaller, Straighter Overall Larger, Gentle Slope Buttocks Smaller, Central Fat Pad Larger, Blends into Hips

  58. Torso & abdominal shape

  59. Male vaser liposuction

  60. Male vaser liposuction

  61. Male vaser liposuction

  62. Male vaser liposuction

  63. Male vaser liposuction

  64. Male vaser liposuction

  65. Male vaser liposuction

  66. Male vaser liposuction + Fat Grafting

  67. Male vaser liposuction + Fat Grafting

  68. Female vaser liposuction + fat grafting

  69. Female vaser liposuction + fat grafting

  70. Female vaser liposuction + fat grafting

  71. Other Procedures offered For Trans Men For Trans Women Pectoralis Implants Orchiectomy Top Surgery Revision Top Surgery Revision & Breast Lifts Buttock Reduction Buttock Augmentation Botox for Forehead Lengthening & Forehead Reduction/Scalp Advancement Brow Lowering Botox & Facial Fillers Botox & Facial Fillers Electrolyss under sedation or numbing injections Lip Fillers & Lip Implants Multiple Minor Procedures: Multiple Minor Procedures Scar revisions, Mole/Wart Removal, Skin Tag Scar revisions, Mole/Wart Removal, Skin Tag Removal, Hemorrhoid Removal, Hernia Removal, Hemorrhoid Removal, Hernia Repairs Repairs

  72. Bilateral orchiectomy + scrotal excision

  73. Surgery preoperative requirements 18 years old or 17 with parent or guardian consent Medical Clearance if older than 55 or significant medical problems Do not require a mental health letter for most surgeries One letter for orchiectomy Do not require hormonal therapy prior to surgery If taking, skip one dose before surgery Do not require weight loss unless BMI > 45 BMI > 35 need airway exam Avoid Blood Thinners (aspirin, NSAIDS, herbals) Ride home & caregiver for night of surgery

  74. General Postoperative recommendations & Expectations Draining for first 48 hours (up to 10 days with large volume liposuction) Stiffness & soreness, not sharp pain, for first week Moderate swelling for 1-2 weeks-often asymmetrical ! Mild swelling, firmness for up to 3 months Aerobic activities, light work within 1-2 weeks Heavy lifting, push-ups at 4 weeks Scar remodeling and fading for 1-2 years

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