Continue reading ‘And another male chest (top surgery)’ »]]> Submitted on 2013/04/24 at 11:17 am

hello.. i just want to ask some help.. i’m aiza from las pinas here is my contact # 330-8592 .. i want to remove my breast, also i want to become a boy.. but i have no money to do that. hope you will understand my situation. thank you ..and god bless ..

Continue reading ‘Only a male chest’ »]]> Mr. Reed i don’t have any Insurance and i want to get a male chest only. So how much it cost? Please Rhonda

April 29, 2013

Hi Rhonda,

Please look at our web-site http://www.srsmiami.com/male-chest-reconstruction.html Hope you like what you see.

Our fee is related to how large your breasts are now. We can discuss that, then call Anne our amiable office manager for compassionate pricing. Hope this will bring a smile to your face.

Best,

Harold M. Reed, M.D.

305-865-2000

Continue reading ‘Had vaginoplasty elsewhere, incisions not that pretty, am overweight now’ »]]> April 15, 2013

Dear Dr. Reed,

Could you please help me?  I had SRS on the UK NHS (free) in March 2010 and since then have been suididal due to ugly scarring.  It looks not like a normal vagina.  On SRS upper BMI limit was 30 and mine was 29.  Since the SRS I’ve put on weight, too, and BMI is now 34.  I’ve read that being at this weight will affect wound healing.  So at least I can make sense, if only theoretically, of why I have these ugly scars (where the sutures were).

One side had haematoma, which has made ugly scarring.  The other side, though no haematoma, is still scarred more than the average, I have been told by my surgeon, though is not Keloid or Hypertrophic.  I have been told that a better result would have been obtained had my BMI been healthy.
The problem is that the NHS surgeon will only surgically revise the scar where the haematoma occurred (the worst side), and not the other side, which, as I’ve told you, is not Keloid or Hypertrophic, but is worse than the average result.   He says there is too high a risk that this side could end up worse than it is now.  But I am confused as a private surgeon has offered to do both sides.  Why is this?  Call me cynical but is it simply because I am paying for it?

Further, if I lose weight to a healthy BMI then have both sides revised, surely I’d have a reasonable chance of healing better on  both sides and having less scarring?   I am postulating this on the basis of being told that considerably overweight people are more likely to have poor wound healing.   (Assuming scarring comes under Wound Healing.)    No one can give me a direct answer to this simple question.
I just want to know what the chances are that if I lose weight to a healthy BMI and have scar revision on both sides, it will heal better with less scarring than that which I have now as a considerably overweight person?

Please help.  I am desperate and miserable.  Give costs of any procedures.
Victoria

April 16, 2013

Good morning Victoria,

Yes, you need to lose weight for 4 important reasons.

First, whether or not you are having surgery, your heart will say “thank you.”  Just stay away from Boston Marathons.  You’ll live a lot longer.
Second, you’ll look more attractive (my bias).
Third, fat against fat doesn’t heal as well.  Fat is not a well vascularized tissue.
Fourth, 150 pounds or so of torso weight on a small incision may very well split your incision and it will heal not so pretty.

You want cosmetic surgery, think about a BMI of no more than 25.  Sure you  will find brave doctors who will do you at 29 or higher.  Your cute bottom.

This is just a basic primer on what makes perineal wounds heal well. There is a lot more technical information we can discuss.  Other factors include perhaps undermining  skin to reduce tension, meticulous hemostats, multi-layered closure, application of steristrips for 4 to 6 weeks, a compressive dressing, and use of a ring pillow for 4 to 6 weeks to avoid torso compression on your suture line.

Cheers,

Harold M. Reed, M.D.

Continue reading ‘Scrotalplasty for FTM, more realistic?’ »]]> March 30, 2013

Dear Dr. Reed,

I have seen many photos of FTM scrotoplasty, but none has showed a desired shape and size results. If I may, could you give some results of FTM scrotoplasty that achieved the looks of  normal biological  male scrotum.

Thank You,

Elaine

Good morning Elaine,

I share your sentiments.

Perhaps a good way to access the literature and photographs is to think this way….

Fournier’s gangrene is a devastating disease usually seen in poorly controlled diabetics, and can result in rapid loss of scrotal tissue within 24 hours.  These patients later have reconstructive surgery.

So I felt looking for articles under “complete scrotal reconstruction post Fournier’s disease”
would be most helpful.  For example http://doctorsgates.blogspot.com/2010/11/fournier-gangrene-reconstructed-by.html

The scrotum has a certain laxity that other skin areas of the body do not have, and usually the volumetric
appearance is limited to the size of the implants or testes put within,.  Our experience with tissue expanders is once the expander is removed, there is rapid lose of the original volume, but could still be an improvement.

Hope this gets you off to a good start.

Have a safe and  restful weekend,

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

Continue reading ‘MTF asks about orgasm, depth, letters, lubrication’ »]]> March 26, 2013

I have been on hormone replacement therapy since March 2009. I am living as a full time female at the present time.

I am wanting a SRS/GRS (male to female) surgery performed. I have never had any related surgeries in the past. I am looking for a vagina depth of 5 inches. My penis (when soft) is 1 to 1.5″ long. I am also wanting my body to be able to self lubricate during sex. And finally I want to be able to experience sex as a woman with orgasms.

I do not have any serious health problems. I am 69 inches tall and weigh 197 pounds. I feel that I am in great physical health.

I have been on hormone replacement theray since March 2009, and if need be I could get documentation to prove this. I also have a document stating that I have a gender identity problem and am suited/recommended for SRS/GRS surgery. This document is signed by a psychologist and a therapist that deals with gender identity cases. I also can have a nurse document that I have been living as a female for at least one year.

I can have my doctor here in Fort Smith, AR run any tests needed before surgery can begin. Also my doctor can be emailed with any other questions you might have about my health. Just notify me that you will need her email, and I will email that to you.

I do realize that a price quote given is just an approximation of the costs involved.

Respectfully,

Kelly

March 26, 2013

Good morning Kelly,

Thank you for your interest in what we do.  Sounds like you are well on  your way.

Taking your thoughtful questions and comments in  the order posed…

We can use scrotal tissue to extend your vaginal depth.  You will also derive more depth with early use of the stents (dilators).

Your 2 letters may be fine, but will have to be reviewed and may need to specify surgery.

That a transsexual vagina can be made to self lubricate is a myth.
Whereas a natal vagina makes transudate, penile and scrotal tissue cannot. We will extend your urethral mucosa along the vulvar plate which may appear moist.

If you are orgasmic now, plan on being orgasmic after surgery.

For 5′ 9″, would like to see your weight at 175 if possible.

After reading the attached, if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number
in an envelope along with a check for 250.  We’ll get started ASAP.  We’ll have a lot to talk about.

This coming year, 2013, we are re-vitalizing our Grant with a slogan similar to one a few years ago (“the first 10 in 2010″).  Now it is “the first 13 in 2013.”   This should reduce your fees
by 10 to 20%, based upon need and availability of funds.

So far 3 positions were filled this past month.

Call the office and speak with Anne our amiable office manager for details.

Cordially,

Harold M. Reed, M.D.
Transgender Surgeon

1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

Continue reading ‘Electrolysis for pubic hair’ »]]> March 25, 2013

Dear Dr. Reed,

Currently undergoing laser treatment to remove unwanted hair.
Any suggestions.

Veronica

Good afternoon Veronica,

Thank you for your interest in what we do.  Sounds like you
are well on your way.  Please review our electrolysis
zone posted on http://srsmiami.com/images/electrolysis-pre-op.pdf

Our bias is that electrolysis ( not laser)  done under local anesthesia
so your electrologist can use higher settings works the best, and is
less costly.

Allow for 2 touch ups, 3 to 4 weeks apart.

Cordially,

Harold M. Reed, M.D.

Transgender Surgeon
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

Continue reading ‘The G spot (gynecologic UFO). On again, off again. Patient requests it.’ »]]>

The G-Spot Discovered? Comments on Ostrzenski’s Article

1. TERENCE HINES PhD^1,2,
2. AMICHAI KILCHEVSKY MD^3,4

Article first published online: 13 DEC 2012
DOI: 10.1111/jsm.12025
? 2012 International Society for Sexual Medicine
Issue

The Journal of Sexual Medicine

Volume 10, Issue 3, pages 887?888, March 2013
The G spot has been called a “gynecological UFO” and supposedly represents a hypersensitive, erotic area on the anterior (top side) vaginal wall.  Recently a Dr. Ostrzenski posted an article in which he believes he found it in an 83 year old female.  The critique of his work is that if this is a hypersensitive area, nerve endings should be seen on histologic examination (microscopic examination of the specimen).  However, no histologic examination was done.  Simply a gross description of bluish grape-like area which could represent a portion of the clitoral body or vestibular bulb.  In a female the bulb of the urethra which is a midline structure in man, splits up on either side and lies medial to the legs of the clitoris which lie underneath the pubic bones.
Conclusion: Drs. Terrene Hines and Armchair Kilchevsky dispute the significance of Ostrsenski’s findings/article.

This is a timely subject in that one prospective patient wrote to me…

“When you are creating the vagina, obviously you use sensate material to create the clitoris. Do you use that same material anywhere else in or around the vagina? The reason I ask; I have read of doctors creating a g-spot, if you will, near the inner labia and again in the vaginal canal. My understanding is to maximize on sensation, which is a good thing! Do you perform surgery this way?”

My response was that the erogenous tissue of the penile shaft is inverted as well as preservation of the neurovascular bundle attached to a neo-clitoris.  Anticipate being orgasmic.

Harold M. Reed, M.D.

Continue reading ‘Pubic Hair studied by Department of Public Health’ »]]> Pubic Hair Removal and Sexual Behavior, a survey of 2,453 +women ages 18 to 68 from School for Public Health (not pubic health), School of Medicine Indiana University, Bloomington, Indiana by Debby Herbernick, Devon Henset (et al). Journal of Sexual Medicine 2013, 10:678-685.

Pubic hair removal is associated with a younger age, greater interest in sex, vaginal fingering, finger-clitoral stimulation, having a casual sexual partner, use of vaginal products such as creams which may include shaving creams as well as creams for irritation, and creams to mask odors. Shaving was the most commonly used methods of hair removal.

Harold M. Reed, M.D.

Continue reading ‘Do I need to be on hormones for my MTF?’ »]]> In MTF-SRS-FTM@yahoogroups.com, “Danni” wrote:  HELLO! EXACTLY HOW LONG DO I HAVE TO BE ON HORMONES FOR MY TRANSITION? AND DO I HAVE TO USE THEM POST OP, AND FOR HOW LONG? ANYONE KNOW??

March 20, 2013

Hi Danni,

Welcome to our group.

There is no regulation or standard of care that I know of that says you need to be on hormones for any period of time before your surgery as some patients are very effeminate to begin with, as was one Filipino nurse we did last year, who worked in a hospital as a female and no one questioned. So I personally would not insist upon that. But for 95 plus % of transitioning patients, estrogens do help to provide secondary female sex characteristics such as softer skin, less hair and a pleasing redistribution of body fat (from abdomen to waist). And most important “home grown” breasts.

More important you do not rush into surgery unless you have been living 24/7 as a female for at least 1 year and have 2 letters of therapy clearance. One of which should be written by a licensed therapist with a doctoral degree, ideally both with doctoral degrees, as this is irreversible surgery.

We do ask patients having surgery to be off estrogens for one month and one week afterwards. Then they can resume. Normally after surgery your estrogen requirements are reduced by a third. But at all times if on estrogens, please be followed by a knowledgeable doctor who will monitor your blood tests. Overdosing estrogens can lead to hypercoagulability which could cause deep vein thromboses, pulmonary emboli, coronary events, and CVA’s (strokes). Smoking while on estrogens accelerates this potential.
I have noted that some of our patients managed by other endocrinologists are also on a little T (testosterone) as this is more than a male sex hormone. T promotes good bone density and a healthy vascular system. Women in the reproductive years have 1/10th the testosterone level of men, which peaks during ovulation. They also have enhanced testosterone receptors in the heart and blood vessels to capture more efficiently what little testosterone they have. Nature’s ingenious system.

Hope that gets you off to a good start.

Harold M. Reed, M.D.

Transgender Surgeon

Continue reading ‘Do you accept insurance for MTF Vaginoplasty’ »]]> March 17, 2013

Dear Dr. Reed,

I have been on hormones and androgen blockers for 3 years and have the approval of a psychologist. I would like information about having mtf sex reassignment surgery and know if the Dr accepts AETNA insurance my company provides.

Bonnielyn

March 18, 2013

Good afternoon Bonnielyn,

Thank you for your interest in what we do.  Sounds like you are well on your way.

While we are not a contracted provider with Aetna, our office will be happy to fill out a universal insurance form for maximal reimbursement to you under any “out of network” provisions of your policy. Please confer with your carrier about this option.

This December, 2012 we re-opened a Grant program with the slogan “the first 13 cases in 2013″ (was formerly the first 10 in 2010), based upon need of course. 3 positions have already been taken. The grant should reduce your fees by about 10% from our typically affordable price. Certain restrictions regarding age and medical history may apply. After reading the attached, if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250. We?ll get started ASAP. We?ll have a lot to talk about.

Cordially,

Harold M. Reed
Transgender Surgeon
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000