Yes, we do male chest reconstruction surgery.
While we will endeavor to utilize the smallest incisions possible, and strive for reasons of concealment to make those incisions along anatomical skin folds or planes if at all possible, a consultation would be required to best advise you.
We cannot do breasts larger than a C in the office, unless your breasts are pendulous and the base or pedicle (coming off the chest wall) is narrow.
Fees to include anesthesia and use of the facility range from $5,000 to $8,500. Scheduling for surgery requires a 50% deposit which is non-refundable.
The balance is due no later than the day before surgery and must be presented in cashier’s check or currency at that time. Credit cards and personal checks are not accepted.
Consultation is $250 and there will be some out of pocket fees for a compressive chest garment, laboratory tests (which could be done in your home town) and a letter of medical clearance (if indicated).
Any special pre-operative instructions?Do initiate a telephone consultation before surgery so we can get to know you better and answer any questions you may have. A CBC should be performed 2 months before your scheduled procedure. If your blood count is low normal or below normal values, a hematology consult may be needed. Usually patients on testosterone have normal to high blood counts.Better to learn of this well in advance.
Within 10 days before surgery, all patients are required to have these blood tests: a CBC (again), PT, PTT, and platelet count. Our lab fee is $100, but you could have this done in your home town perhaps more reasonably.
All patients over 40 and those on diabetic, neurological or cardiovascular medications require a letter of medical clearance with reference minimally to an EKG and chest X-ray to be obtained within 1 week of your scheduled procedure.
You may wish to stop testosterone a good month before surgery, as testosterone is metabolized into estrogens and may predispose to thromboses or emboli (unwanted clotting). You may resume 10 days after surgery.
No aspirin or aspirin products, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx for a week before surgery. No Vitamin E or excessive alcohol
or spices for a week before surgery as this may promote bruising. Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana (Boiron brand) dose 30C (take 4 small tablets sublingually, 4 times a day), vitamin C 500 mg (3 times a day) starting 1 week before surgery. Do take these medications unless there are specific reasons why you choose not to and let’s discuss it beforehand.
If for any reason, despite tight scheduling arrangements and eager anticipation of being converted, you have contracted an illness such as a flu like syndrome with coughing, sore throat, fever, or diarrhea, please reschedule allowing a good two weeks for recovery. These things happen and we are very sympathetic. Surely we do not want any patient with a very recent cold to have general anesthesia. If you have gained weight, please advise as we may have to postpone surgery.
If you are a smoker, you must stop completely for 2 months before surgery and please never again. Smoking causes vaso-spasm, impairs wound healing, produces excessive scarring, tissue necrosis, irritates and inflames pulmonary membranes and enhances anesthetic risk.
This goes also for any products containing nicotine or nicotine like agents including nicorette gum, nicotine patches, Nicotrol inhalers, and second hand smoke. Again not for 8 weeks before and not for 8 weeks afterward. Hopefully never again.
Obtain one pair of anti-embolism thigh high stockings. T.E.D. (by Futuro) or Jobst are common brand names. Yes, do try these on before you come here to be sure they fit comfortably. If you wash or dry them in a hot cycle, they may never fit properly again. So best not to wash them at all until after surgery.
As a courtesy to the hotel, please obtain and bring with you a bundle of “chucks” or disposable super absorbent pads with plastic liner on underside (typically 24 by 36 inches) to conserve hotel laundry and bedding.
Please keep up with a good fluid intake the day before surgery.
Nothing by mouth after midnight unless otherwise instructed. Do not shave yourself as we will do that for you.
We observe the guidelines of WPATH (World Professional Association for Transgender Health, formerly Harry Benjamin International
Gender Dysphoria Association)
Taken from the Standards of Care (SOC)
http://www.pfc.org.uk/files/medical/soc1998.pdf
1. legal age of majority in the patient’s nation
2. 12 months of continuous hormonal therapy for those without a medical contraindication
3. 12 months of successful continuous full time real-life experience. Periods of returning to the original gender may indicate ambivalence about proceeding and should not be used to fulfill this criterion
4. if required by the mental health professional, regular responsible participation in a psychotherapy throughout the real life experience at a frequency determined by the mental health professional. Psychotherapy, per se, is not an absolute eligibility criterion for surgery. In that removal of natural breast tissue is an irreversible procedure, two letters of therapy clearance, one written by a consultant with a doctoral degree (could be a psychiatrist, psychologist, or sociologist), and another with at least a master’s degree is required as mastectomy is irreversible surgery. You may already have such a letter(s). If written in the past year this is acceptable, or simply have it updated, and co-endorsed by an independent therapist with an appropriate educational degree. For those unable to completely satisfy the SOC requirements, individual consideration may be given especially if there is a plausible explanation and concurrence of support from the therapists. Please also consider joining a very stimulating discussion group re: SRS procedures by logging in on http://groups.yahoo.com/group/MTF-SRS-FTM/.
We hope you’ll join us!
With kindest regards,
Harold M. Reed, M.D.
305-865-2000