Archive for the ‘FTM’ Category

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FTM needs some advice before male chest reconstruction and metoidioplasty/

Thursday, August 27th, 2009

possible phalloplasty.

Dr. Reed,

 I have been on T since Jan 2008. I am looking into having a hestorectomy, but also want to have both top and bottom surgery as well.
Specific_Questions: I am on psychratric medications. Seroquel, Methylphenidate ER, Methylphenidate, and Lexapro. Would these medications be a complication?

 Armando

 Hi Armando, 

Thank you for your interest in what we do.

Hysterectomy is performed by others, but if you have this done, please go for a laparoscopically assisted vaginal hysterectomy and simultaneous oophorectomy (removal of ovaries) as well.  2 letters of therapy clearance should be obtained prior to this irreversible surgery.

We operate on patients taking your medications all the time, and this is not a contraindication.  A letter of clearance from your psychiatrist will be requested, and also we do advise your taking any AM medication on the morning of surgery with a sip of water. 

A word about methylphenidate…

Methylphenidate is the most commonly prescribed psychostimulant and is indicated in the treatment of attention-deficit hyperactivity disorder

Contraindications:

Methylphenidate should not be prescribed concomitantly with tricyclic antidepressants, such as desipramine, or monoamine oxidase inhibitors, such as phenelzine or tranylcypromine, as methylphenidate may dangerously increase plasma concentrations, leading to potential toxic reactions (mainly, cardiovascular effects). Methylphenidate should not be prescribed to patients who suffer from severe arrhythmia, hypertension or liver damage. It shouldn’t be prescribed to patients who demonstrate drug-seeking behaviour, pronounced agitation or nervousness. Care should be taken while prescribing methylphenidate to children with a family history of Paroxysmal Supraventricular Tachycardia (PSVT).

Special precautions:

Special precaution is recommended in individuals with epilepsy with additional caution in individuals with uncontrolled epilepsy due to the potential for methylphenidate to lower the seizure threshold.

All the best,

Harold M. Reed, M.D.
305-865-2000

Posted in Electrolysis, FTM, FTM chest, male chest reconstruction, metoidioplasty, orchiectomy, phalloplasty, sex change, subcutaneous mastectomy | 1 Comment »

How old do you have to be for FTM surgery

Sunday, August 23rd, 2009

Good morning Mariah,

We would not recommend any surgery be done until a patient is over 18 years of age, unless there is some very strong compelling reason, and then your parents would need to be a part of the decision making process.

Have a restful Sunday,

Harold M. Reed, M.D.
305-865-2000

Posted in FTM, FTM chest, Testicular Implants, male chest reconstruction, metoidioplasty, penile implants, phalloplasty, sex change | No Comments »

Phalloplasty Patient Seeking an Implant

Saturday, August 22nd, 2009

Yes, two years on testosterone, have already had top surgery
Specific_Questions: It’s hard to find information about phalloplasties and sex. I’m just wondering, for phalloplasties, once the surgery is successful with an erectile device and is fully healed.. 1. what percent (estimate of course) of guys have complications with the device during sex? is there a big risk in the phalloplasty ripping or the device coming out…is it really suitable for sexual intercourse? 2. does the phalloplasty last long-term?  Nelson

Hi Nelson, 

It has been touted the incidence of revision surgery with an inflatable implant for FTM men is about 50%.   For genetic men, we tell them on average they may need a revision every 6 to 8 years.  Rarely a problem can become manifest in 3 months and recently revised one that had lasted 16 years.

Like a set of tires for you car, they don’t last indefinitely.

Semi-rigid rods may never require a replacement but there is a concealment problem (sometimes) and the continued pressure may lead to erosion.

We have done a few implants for FTM patients and the patient satisfaction rate has been good.  Most inflatable
implant manufacturers do warranty their product for life, bit the surgery and associated costs are not funded. 

If you have a friendly relationship with your urologist, usually he’ll understand you are not a money tree and charge token fees for revision to cover expenses only.  Please look at photographic examples of our work on penisdoctor.com   http://www.penisdoctor.com/prosthesis.htm

…

Have a restful weekend,

Harold M. Reed, M.D.

305-865-2000

Posted in FTM, penile implants, phalloplasty | 2 Comments »

Metoidioplasty with urethral extension, hysterectomy needed?

Tuesday, August 18th, 2009

Yes, I have been on Testosterone for almost 5 years and had chest surgery done 3.5 years ago.
Specific_Questions: Can I have the metoidoplasty and scrotoplasty (to stand to void)done now and later obtain a hysterectomy?  Monty

Hi Monty,

 Medical technology continues to evolve.

In this day and age, we have come to recognize colpocleisis, removal of the vaginal lining with subsequent closure by healing, helps to minimize the occurrence of urethral fistula.  However, and this a big however, you cannot close up the vagina and leave the uterus inside, as where will secretions and any mentral flow go.  What is needed is a laparoscopically assisted vaginal hysterectomy with bilateral salipingo-oophorectomy (removal of ovaries and tubes) first.  Doesn’t have to be, but is a recommendation.

You could have an attempt stand to void metoidioplasty and scrotalplasty done now but I must advise the likelihood of a urethral fistula is probably over 50%. Even if you have colpocleisis, the likelihood of fistula is probably about 25%

This is always more upsetting for the patient than for the doctor as we will pursue these problems one by one and hopefully ultimately give you an intact extended urethra.

That is the nature of this type of surgery, and this needs to be put out front.

Believe me I am in your corner and will do whatever possible to assure that you have the best possible result.

Sincerely,

Harold M. Reed, M.D.
305-865-2000
 

Posted in FTM, Testicular Implants, metoidioplasty | No Comments »

Great Therapists in South Florida

Wednesday, August 5th, 2009

Good morning  Dr. Reed!

 Conversion: hormones for 5 months dressing female for 5 or more years
Specific_Questions: what letters do you need from my doctors.

Terrry

Hi Terry,

 
You will need two letters of therapy clearance written by licensed therapists, one of whom, should have a doctoral degree and the other at least a master degree.  The longer you have “time in grade”, usually the simpler the process is,  i.e. an evaluation and clearance, not therapy.

If you are working with a therapist now, by all means stay with that therapist.

Here are some great, compassionate, no nonsense therapists, all with doctoral degrees.

Dr. Krista Bloom   (Plantation)  754-234-6991

Dr. Carol L. Clark   (closest to our office)  305-757-6070

Dr. Kathleen L. Farrell   (St. Petersburg, Fl)   727.551.9851

Dr. Anagloria Mora , South Miami,  (also speaks Spanish)  305 333 2263

Dr. Gladys Sanchez-Bello   (also speaks Spanish)  754 368 5114

Dr. Marcia Schultz (3111 N. University Drive Suite 400 Coral Springs, Fl. 33065)   954 649 1957

Dr. Marilyn Volker, (Coral Gables),  305-443-8850

Dr. Marcy D. Weiss, (West Palm Beach)   561 702 2228

Please present your history briefly: age, your present trans status, how long you have been living 100% en femme or as a man, and the surgical procedure you would like to have.

Ask for a price quote estimation, and possibility of teletherapy to be confirmed by a face to face meeting prior to generating a letter of clearance.

Have a restful Sunday and all the best,

Harold M. Reed, M.D.
305-865-2000

Posted in FTM, Feminizing vaginoplasty, MTF, Vaginoplasty, sex change | No Comments »

Hormones for transgendered patients

Sunday, August 2nd, 2009

GENETIC: Male
BECOME: Female – MTF
Hormones/Conversion: no but need some send to me for free or i will pay for it. Can you give me a prescible for it?

 Glendon

July 31, 2009

Good afternoon Glendon,
Thank you for your continued interest in what we do.  Yes, we do hormones.  You will need an appointment as we will be spending good hour together and a letter of therapy clearance from a licensed therapist with a doctoral degree.

You only pay for a consultation once and that is 250.  We charge 600 a year to initiate hormone therapy although we will delay billing for 3 months.  You will also need baseline laboratory testing and interval laboratory tests obtained every 3 to 4 months, until we see a pattern of stablizaion and then these tests can be spread further apart.

 All the best,

Harold M. Reed, M.D.
305-865-2000

Posted in FTM, Feminizing vaginoplasty, MTF, metoidioplasty, sex change | 1 Comment »

Grants replaced by “Individual Consideration”

Sunday, July 19th, 2009

To Tara at Tarareources.net 
Dear Tara, 
This is to advise you that we have not been able to offer grants, which had been solely based upon testicular donation,  for over 2 years. That project was concluded by the research lab.
We do offer individual consideration for needy people only. However, without any contingency funds to cover the unexpected, we cannot operate.  A financial statement may be requested. 
Thank you for referring the many nice patients who have made inquires, some of whom we have been able to assist.
As is, our fees run about 6000 below what other charge in North America if that is of any help. Unless you have an impulsive need for genital ablation, please select a doctor whose work is pleasing to you
and who may respond to your request for assistance (circumstances change for us all, for example some doctor may have a cancellation and be willing to fill that time slot for less).

All the best to your group.  Your good deeds will not go unnoticed.

Harold M. Reed, M.D. 

Posted in FTM, FTM chest, Feminizing vaginoplasty, MTF, MTF Grants, Vaginoplasty, breast implants, male chest reconstruction, metoidioplasty, sex change, subcutaneous mastectomy | No Comments »

Male Chest Reconstuction (subcutaneous mastetcomy)

Sunday, January 11th, 2009


The periareolar approach is good for size A breast, and will inevitably produce some (hopefully transient) wrinkles as a larger circle is worked into a smaller circle.  The smaller circle being the down sized areolar or pigmented shield that surrounds the nipple.  A way of minimizing  wrinkling is the leave the areolar halfway in size between an ideal male areolar and the original female areolar.   This works well aesthetically only for very big FTM patients, but not so for smaller FTM patients who do not want any tell-tale vestiges of their feminity.

 We are getting excellent results with a free nipple areolar complex graft.  In other words, once removed, the graft is down sized and reapplied precisely in the correct anatomical position judged by when the patient is sat up during anesthesia and after the skin incisions are closed.  Some compression is required for 7 days and this is done with both dressing and a compression garment vest which is essential for all patients to minimize bruising and swelling.

Harold M. Reed, M.D.

Posted in FTM, FTM chest, male chest reconstruction, sex change, subcutaneous mastectomy | No Comments »

FTM Testicular Implants not all the same

Wednesday, January 7th, 2009

Hi, I have been fitted with a Mentor silicone elastomer testicular implant a few months ago, but I am unhappy with the texture I found it too hard and not feel enough natural like my other (the real one).I would like to know:1. Do you have access to other type of prosthesis more
realistic and soft than the Mentor prosthesis ?

2. is there a difference between : silicone gel and silicone elastomer implants ?

3. Can I schedule an appointment for an
consultation only? and touch the different kind of
prosthesis?

4. How much will cost a consultation with you ? It is covered by my Quebec health insurance?

Thank you

Reply:

 January 7, 2008

Good morning and Happy New Year,

The technical term for hardness of an implant is called “durometer.”  The lower the number such as a 5, this equates to softness.   Too soft could be runny like a partially cooked egg, so that would not be desirable.  There are also techniques in surface finishing to reduce the possibility of capsular contracture.  

Our office has a vast experience with testicular implants
and we have been aware of the Mentor’s propensity for
capsular contracture many years ago.  Their published results, although the product does have some pluses such as percutaneous volume adjustments.

Yes, I do agree you should palpate demos that we have
in the office and I think you will be quite pleased.
You can initiate a consultation over the phone
by sending us your name, address, and phone number
in an envelope along with a check for 250 and we’ll get
started ASAP.

When you come to the office there is no additional
fee for your first visit.

Cordially,

Harold M. Reed, M.D.
305-865-2000

Posted in FTM, Testicular Implants, penile implants | No Comments »

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