Archive for the ‘Vaginoplasty revision’ Category

Depth now or later, Mr. Right

Sunday, December 6th, 2009

Can depth be added later on.  Now feel very asexual.

 Rundle

 

Our “party line” to all patients unless they insist, is go for depth as part of the original plan when you have vaginoplasty. This means if you need a scrotal graft, by all means this is the perfect time to do that. But you do have a responsibility to dilate to maintain depth and width, and even build upon that.

I have seen many patients acquire an additional 2 inches simply by using stents for 15 minutes with gentle pressure 5 or more times a day.

You never know when Mr. Right will come along and turn your latency upside down and re kindle all the loving and bonding mechanisms that nature has given you. They were there from the outset
but just dormant and maybe uneven suppressed for one reason or another. Yes, I also believe that female preference is a mentally acceptable expression, as does the American Psychiatric Association, however, this way you are ready.

Harold M. Reed, M.D.

Dr. Carol L. Clark holds non-stop sexuality seminar at Jackson North Hospital

Sunday, November 15th, 2009

I followed a GLBT advocate and counsellor. My talk on sexuality included as per syllabus from Dr. Clark…

Medical factors related to sexuality and sexual functioning

Objectives:

· Define the DSM sexual disorders, and discuss the following in relation to it: symptoms, factors increasing susceptibility, and prevention.
· Describe how surgical procedures, such as a hysterectomy, may affect a woman sexually, physically, and emotionally.
· Define hormone replacement therapy and explain its advantages and potential risks.
· Describe the incidence of, symptoms of, and treatment alternatives for penile cancer, testicular cancer, prostatitis, benign prostate hyperplasia, and prostate cancer. Describe tests for prostate cancer and treatment alternatives.
· Describe the reasons why women would choose to have or not have breast implants and controversies concerning the implants themselves.
· Learn how major disabilities my affect sexual function and expression. Learn coping and enhancement strategies for people with disabilities.

2 hours later with time for serious questions and answers, we were done. But aside from potty breaks their day was still going strong. Young therapists seeking their doctoral degrees, thirsty for knowledge. Commendable, Carol (who is a board certified sexologist with a doctoral degree, how many therapists can claim that!).   Dr. Carol L. Clark   (closest to our office)  305-757-6070 

Harold M. Reed, M.D.

305-865-2000

7 MTF procedures this week

Sunday, November 15th, 2009

3 full vaginoplasties,  2 orchiectomies,  scrtoal removal, a revision of work done elsewhere.

All patients are doing excededingly well, some have already left the Baltic Hotel with a smile.

Two received financial assistancce.

We insist on hand held mirrors for each patient during a dressing change, so they can appreciate what we accomplished.

Patients are seen daily including Saturday and Sundays.

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

Vaginoplasty Touch Ups

Sunday, November 8th, 2009

 

— In MTF-SRS-FTM@yahoogroups.com, “kennyhilnager” wrote:
 Dr. Reed,
What are the typical reasons for touch ups and how much can be done
at one time?

Kenny

Hi Kenny,

Touch ups are either planned as the doctors may knows they have not been able to attended to every little detail in the interests of patient safety. The patient should be apprised during her recovery if not known at the outset. Often there will be a critique (work list) made by the patient and which is often supplemented by the doctor after he/she sees the patient. Ideally everything should be done at once, and the best time is a good 3 months after complete wound healing. This does not mean 3 months after surgery.

Areas often include: asymmetry of labia, need to lower the posterior commissure (for a more direct approach into the vagina), a urethral spongiosum rest (left over urethral erectile tissue which swells during arousal), re-siting of the clitoris or need the hood the clitoris, lowering the opening of the urethra, closure or approximation of the upper labia majora (mirror image parentheses), providing greater opening (introits) to the vagina, revising an unsightly scar.

As you know there is no charge in our office for this revision which is typically performed under local with IV sedation. For those patients who require or request general anesthesia, this amounts to 600 or less. We want you to look your very best. Please bring your work list.

Harold M. Reed, M.D.

Male to Female Surgery, Vaginoplasty, Breast Implants

Wednesday, October 14th, 2009

Good morning Jasmine,

While we do breast augmentation and feminizing vaginoplasty, FFS and tracheal shave are done by others.  Our fees are posted on our web-site.

I certainly appreciate these are difficult economic times, and any news that recovery is around the corner is pure cheer up.   The good USA cannot be fighting wars and expending billions of dollars and printing paper money with unemployment at the rate it is, and expect prosperity.

For that reason, we do offer individual consideration to move you along, further to your goals.

Anne, our office manager is the maker of deals and the brains behind pa.  Please read over the attached and see if I am the doctor for you.

All the best,

Harold M. Reed, M.D.
305-865-2000
At 11:20 PM 10/13/2009, you wrote:

Specific_Questions: What is the cost of a total male to female make over (breast,face,voice,vagina) thanks  Jasmine

Lost depth after MTF vaginoplasty

Thursday, October 1st, 2009

hello dr. i talked to u a few months ago about wantin depth. i had surgery in bangkok and never had a chance to to dialate. so i may have to have a skin graph done. an was wantin to know again how much would u charge me? an when can i come down for a consultation, i live in atlanta.      Virginia

Good morning Virginia,

Thank you for your continued interest in what we do.

You touched upon one of the most important aspects of  achieving a successful and enduring depth.  Dilation.

I would propose a skin graft obtained from the lower abdomen as this area should heal with a fine transverse scar, as opposed to an inner thigh graft which may always cause as second look.

Then it is dilation for 15 minutes 8 times a day with numbing cream if needed, but you must, must dilate aggressively for a few weeks.   With time, especially if you are sexually active, you can space out the sessions.

Our fee is 7600 which includes anesthesia, probable overnight with a registered private duty nurse and myself  in attendance, use of the facility and any aftercare we provide.  You will need daily visits for one week.

On the 7th post operative day, the packing will be removed, and you could return to Atlanta that day and rest for one more overnight.

We will also have to examine the lower abdomen for any hair which needs to be removed by electrolysis.  Usually that area has sparce hair growth, if at all.   If your doctors left an excessive amount of labial tissue,  we may employ that as well.  By all means we will strive to avoid a colonic vagina for many reasons probably well known to you.

Perhaps you may opt to be seen first in consultation and without committing to surgery the next day, to give you time to reflect upon my recommendations.

You will need to have a bowel prep starting the day before surgery.   There is a remote possibility that we may be able to dilate you under anesthesia avoid incisional surgery altogether.

Please reviewed the attached as many of the advisories are applicable for you.

All the best,

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

Urethral spongiosum rest, swelling with arousal impeding penetration

Sunday, September 6th, 2009

I had my SRS in July 2008 with Dr. —- in Thailand, and have been on hormones for over three years. I’m essentially fully transitioned.
Specific_Questions: Hello Dr. Reed, I believe that I have what a patient in your blog described as a ‘urethral spongiosum rest’ and am inquiring about getting this problem corrected. During sexual arousal, a circular mass of what seems to be leftover erectile tissue swells to about 1/2′-1′ outwards from my pubic area, surrounding my urethral opening and making urination very difficult until the swelling has subsided (sometimes as long as an hour or two afterwards). When I’ve been more sexually intense or if it has been awhile since my last time, there is bleeding afterwards. Also, I have been unable to use dilators larger than 1′ (or copulate) because the swelling is larger than a US $.25 quarter and occupies space into which my dilation would have extended were there not erectile tissue in the way. Can you give me an estimate of what the cost would be if my health insurance will not cover this correction of a urological dysfunction? How extensive is the procedure and what would I do well to expect?    Kathy

Good afternoon Kathy,

Thank you for your interest in what we do.  The attached is more applicable for “virginal” MTF patients but could be of interest.

Removal of a urethral spongiosum rest or erectile tissue surrounding the urethra, in our office based surgery center is 2750 when done under local.  If you have other critiques, there will be some lesser add-on charges. 

If you initiate a consultation with our office by sending us your name, address and phone number in an envelope along with a check for 250, that might be a good time to enclose some well focused photos as well.

We have a great deal of experience with removing this annoying remnant.  Please understand doctors are very skittish about doing this primarily, if there is untoward bleeding in the first portion of the surgery, as the urethra is also a well known source of oozing when transected.  However, when this area alone is focused on, there are a few techniques we employ to minimize this.

Have a safe and restful Labor Day weekend,

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

Thailand MTF patient requests vagina

Friday, August 28th, 2009

no im not on hormones,havent took a hormone shot in months, i have the srs surgery done i went to thailand in 2001 and had the srs surgery i believed my vagina is closed and they didint do my surgery right because i have alot of skin that pertrudes from out of my vagina, i am overweight and currently have had the lapband surgery done i know u said drop down to like 200 thats what im doing but i want to know the cost to fix my vagina and labia plasty i am lookin forward to you helpin me with this problem so please contact me asapSpecific_Questions: no im not on hormones,havent took a hormone shot in months, i have the srs surgery done i went to thailand in 2001 and had the srs surgery i believed my vagina is closed and they didint do my surgery right because i have alot of skin that pertrudes from out of my vagina, i am overweight and currently have had the lapband surgery done i know u said drop down to like 200 thats what im doing but i want to know the cost to fix my vagina and labia plasty i am lookin forward to you helpin me with this problem so please contact me asap

Letrisha

Good afternoon Letrisha,

If you look at the photo galleries from Thailand, there seems to be a tendency from many surgeons to put too much penile and scrotal skin in the perineum.  To my eye, doesn’t look right.  Please A-B this with our post op results.

Please initiate a consultation with our office by sending us your name, address, phone number, any below the waist photographs, your critique of what needs to be done, along with a check for 250 and we’ll get started ASAP.  When you are seen at the office, there will.be no further charge for your first visit.

With  every best wish,

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

Reason I am Considering a Smoothie

Friday, August 28th, 2009

Dr. Reed, the reason I may be interested in a smoothie is thay I have a wife of 30 years and she is completly supportive of my transition, intercorse is not something either of us think we,ll miss, we have lived as two women for more than 10 years now. my main concern is than I would stiill be able to have sex either oral or manual, is this possible? Madelaine

Good morning Madelaine,

Many thanks for your continued interest in what we do.

Yes, we can do that.

With kindest regards,

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

P.S. We have cared for several patients like you and should
be able to provide the result you anticipate.

An excellent electrologist offers her services

Sunday, August 23rd, 2009

I perform Electrolysis and Laser Specific_Questions: Removal if you could recommend me i would appreciate it,www.electrolysisbymichelle.com—-786-306-7987—-licensed 34 yrs very experienced with Transgender clients,  Thank you Michelle.Regards to Anne

Good morning Michelle,

We would love to recommend you.

Looked at your web-site http://www.electrolysisbymichelle.com/ and this is exactly what we need.

I am posting your name on our MTF-SRS-FTM yahoo.com group message board and well keep you in mind for patients who need electrolysis.

Please keep in mind our electrolysis diagram for feminizing vaginoplasty. http://www.srsmiami.com/images/electrolysis-pre-op.pdfYou are encouraged to join
http://groups.yahoo.com/group/MTF-SRS-FTM/  and personally introduce yourself
to over 5600 members and be available to answer some questions that members may pose.  This would give you a lot of recognition.

Additionally your announcement will also be up in lights on http://srsmiami.com/blog/

I have always said, “let people know what you do for a living and do it well.”  There is always room at the top.

All the best,

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