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

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

Dec 19, 2022 327 likes •1.09k 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

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

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

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The Cosmetic concierge, PLLC About our practice

South End Charlotte, NC

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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.

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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

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The Cosmetic concierge, PLLC

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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

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The Cosmetic concierge, PLLC About our practice

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

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

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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.”

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Billy tipton: 1914 - 1989

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Let’s start from the top…

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Top surgeries

FTM Chest Reconstruction MTF Breast Augmentation Androgynous Chest

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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

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FTM Chest reconstruction: Nipple placement

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FTM Chest Reconstruction

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

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Ftm chest reconstruction double incision with free nipple grafts

curved incision, muscular patient

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Ftm chest reconstruction double incision with free nipple grafts

curved incision, muscular patient after weight loss

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Ftm chest reconstruction DouBle Incision with free nipple grafts

curved incision, average weight patient

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Ftm chest reconstruction DouBle Incision with free nipple grafts

Curved incisions, heavy patient

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Ftm chest reconstruction DouBle Incision with free nipple grafts

Curved incisions, heavy patient

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Ftm chest reconstruction DouBle Incision with free nipple grafts

Curved incisions, thin patient

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Ftm chest reconstruction DouBle Incision with free nipple grafts

thin patient

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Ftm chest reconstruction Double incision with free nipple grafts

straight incision, average weight patient

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Ftm chest reconstruction DouBle Incision with free nipple grafts

Straight incisions, thin patient

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FTM Chest Reconstruction Keyhole / peri-areolar

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FTM Chest Reconstruction Keyhole / peri-areolar

Note: nipple position cannot be moved

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FTM Chest Reconstruction Keyhole / peri-areolar

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FTM Chest Reconstruction ButtonHole Technique

(free nipple pedicle technique)

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FTM Chest Reconstruction ButtonHole Technique

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FTM Chest Reconstruction ButtonHole Technique

WARNING: GRAPHIC IMAGES IN NEXT SLIDES

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FTM Chest Reconstruction ButtonHole Technique

DE-EPITHELIZATION

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FTM Chest Reconstruction ButtonHole Technique

SKIN FLAP AND DERMAL PEDICLE

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FTM Chest Reconstruction ButtonHole Technique

FLAP CLOSURE AND NIPPLE THROUGH “BUTTONHOLE”

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FTM Chest Reconstruction ButtonHole Technique FINAL

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Ftm chest reconstruction “buttonhole” technique

Curved incisions, thin patient

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FTM Chest Reconstruction ButtonHole Technique

thin patient

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FTM Chest Reconstruction ButtonHole Technique

average patient

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FTM Chest Reconstruction ButtonHole Technique

average patient

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FTM Chest Reconstruction ButtonHole Technique

hEAvy patient

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FTM Chest Reconstruction ButtonHole Technique

hEAvy patient

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FTM Chest Reconstruction ButtonHole Technique

heavy patient

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FTM Chest Reconstruction ButtonHole Technique

heavy patient

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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

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

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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

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Mtf breast augmentation implant placement

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Mtf breast augmentation insertion sites

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MTF breast augmentation trans-axillary submuscular gel

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MTF breast augmentation trans-axillary submuscular gel

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MTF breast augmentation trans-axillary submuscular gel

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MTF breast augmentation trans-axillary submuscular gel

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MTF breast augmentation trans-axillary submuscular gel

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MTF breast augmentation trans-axillary submuscular gel

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MTF breast augmentation trans-axillary submuscular gel

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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

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Torso & abdominal shape

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Male vaser liposuction

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Male vaser liposuction

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Male vaser liposuction

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Male vaser liposuction

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Male vaser liposuction

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Male vaser liposuction

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Male vaser liposuction

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Male vaser liposuction + Fat Grafting

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Male vaser liposuction + Fat Grafting

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Female vaser liposuction + fat grafting

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Female vaser liposuction + fat grafting

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Female vaser liposuction + fat grafting

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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 & Brow Lowering Forehead Reduction/Scalp Advancement Botox & Facial Fillers Botox & Facial Fillers Electrolyss under sedation

  • r numbing injections

Lip Fillers & Lip Implants Multiple Minor Procedures: Scar revisions, Mole/Wart Removal, Skin Tag Removal, Hemorrhoid Removal, Hernia Repairs Multiple Minor Procedures Scar revisions, Mole/Wart Removal, Skin Tag Removal, Hemorrhoid Removal, Hernia Repairs

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Bilateral orchiectomy + scrotal excision

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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

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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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