89 results on '"Loren S. Schechter"'
Search Results
2. Abstract: A Survey Study of Surgeons’ Experience with Regret and/or Reversal of Gender-Confirmation Surgeries
- Author
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Sara Danker, MD, Sasha K. Narayan, BA, Rachel Bluebond-Langner, MD, Loren S. Schechter, MD, FACS, and Jens U. Berli, MD
- Subjects
Surgery ,RD1-811 - Published
- 2018
- Full Text
- View/download PDF
3. Association Between Mental Health Conditions and Postoperative Complications After Gender-Affirming Surgery
- Author
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Elizabeth Khusid, Morgan R. Sturgis, Amir H. Dorafshar, Loren S. Schechter, Ephrem O. Olweny, Edward E. Cherullo, and Adán Z. Becerra
- Subjects
Surgery - Abstract
This cohort study assesses whether postoperative complications are associated with having been diagnosed with a mental health condition in patients who have undergone gender-affirming surgery.
- Published
- 2023
4. Laryngochondroplasty: A Systematic Review of Safety, Satisfaction, and Surgical Techniques
- Author
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Alireza Hamidian Jahromi, Sydney H. Arnold, Andrew M. Bonett, Loren S. Schechter, and Amir H. Dorafshar
- Subjects
Surgery - Published
- 2022
5. Chondrolaryngoplasty with Endoscopic Direct Visualization of the Vocal Cords: Demonstration of Technique
- Author
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Alireza Hamidian Jahromi, Jennifer Ferraro, Sydney H. Arnold, Loren S. Schechter, and Amir H. Dorafshar
- Subjects
Surgery - Published
- 2023
6. Plastic Surgeon Financial Compensation–Incentivization Models in Surgical Care Delivery: The Past, Present, and Future
- Author
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Larry Chavis, Anaeze C. Offodile, Loren S. Schechter, Amir H. Dorafshar, Deana S. Shenaq, Joseph Lopez, and Charles Scott Hultman
- Subjects
Surgeons ,Value (ethics) ,business.industry ,Compensation (psychology) ,Fee-for-Service Plans ,Compensation methods ,Efficiency ,History, 20th Century ,History, 21st Century ,United States ,Physician Incentive Plans ,Incentive ,Organizational behavior ,Seniority (financial) ,Health care ,Humans ,Medicine ,Surgery ,Operations management ,Financial compensation ,Surgery, Plastic ,business ,Reimbursement, Incentive ,Forecasting - Abstract
BACKGROUND Surgeons are critical for the success of any health care enterprise. However, few studies have examined the potential impact of value-based care on surgeon compensation. METHODS This review presents value-based financial incentive models that will shape the future of surgeon compensation. The following incentivization models will be discussed: pay-for-reporting, pay-for-performance, pay-for-patient-safety, bundled payments, and pay-for-academic-productivity. Moreover, the authors suggest the application of the congruence model-a model developed to help business leaders understand the interplay of forces that shape the performance of their organizations-to determine surgeon compensation methods applicable in value-based care-centric environments. RESULTS The application of research in organizational behavior can assist health care leaders in developing surgeon compensation models optimized for value-based care. Health care leaders can utilize the congruence model to determine total surgeon compensation, proportion of compensation that is short term versus long term, proportion of compensation that is fixed versus variable, and proportion of compensation based on seniority versus performance. CONCLUSION This review provides a framework extensively studied by researchers in organizational behavior that can be utilized when designing surgeon financial compensation plans for any health care entity shifting toward value-based care.
- Published
- 2021
7. Strategic Planning and Essential Steps for Establishing a Uterine Transplant and Rehabilitation Program
- Author
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Jay M. Behel, Summer Dewdney, Amir H. Dorafshar, Liza Johannesson, Edward Cherullo, Anna T Alecci, Loren S. Schechter, Giuliano Testa, Badrinath R. Konety, Robert Shulman, Sydney R. Horen, Charles Hebert, Cynthia Brincat, Martin Hertl, Alireza Hamidian Jahromi, Jeannie Aschkenasy, Shruti Bassi, and Mary Wood Molo
- Subjects
Infertility ,Strategic planning ,medicine.medical_specialty ,Hysterectomy ,Rehabilitation ,business.industry ,medicine.medical_treatment ,General surgery ,Uterus ,MEDLINE ,Organ Transplantation ,medicine.disease ,Strategic Planning ,Uterine Agenesis ,Urogenital Abnormalities ,Transgender ,medicine ,Humans ,Female ,Surgery ,business ,Infertility, Female - Abstract
Uterine transplant (UTx) is performed to address absolute uterine infertility in the presence of uterine agenesis, a non-functional uterus, or following a prior hysterectomy. Following the initial success of UTx resulting in a livebirth (2014) in Sweden, there are over 70 reported UTx surgeries resulting in more than 40 livebirths worldwide. Currently, UTx has been performed in over 10 countries. As UTx is transitioning from an "experimental procedure" to a clinical option, an increasing number of centers may contemplate a UTx program. This article discusses essential steps for establishment of a successful UTx program. These principles may be implemented in cis- and transgender UTx candidates.
- Published
- 2021
8. ACR Appropriateness Criteria® Transgender Breast Cancer Screening
- Author
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Ana Lourenço, Samantha L. Heller, Maxine S. Jochelson, Daymen S Tuscano, Jennifer F. Tseng, Tejas S. Mehta, Ashley R Stuckey, Juliana E. Hansen, Katherine A. Klein, Baer Karrington, Bethany L. Niell, Mary S. Newell, Maggie L DiNome, Linda Moy, Mary E Swain, Mita Sanghavi Goel, Beth Cronin, Elizabeth H. Dibble, Ann L. Brown, and Loren S. Schechter
- Subjects
education.field_of_study ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Population ,medicine.disease ,Appropriate Use Criteria ,Breast cancer screening ,Breast cancer ,Family medicine ,Transgender ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hormone therapy ,business ,education ,Medical literature ,Cohort study - Abstract
Breast cancer screening recommendations for transgender and gender nonconforming individuals are based on the sex assigned at birth, risk factors, and use of exogenous hormones. Insufficient evidence exists to determine whether transgender people undergoing hormone therapy have an overall lower, average, or higher risk of developing breast cancer compared to birth-sex controls. Furthermore, there are no longitudinal studies evaluating the efficacy of breast cancer screening in the transgender population. In the absence of definitive data, current evidence is based on data extrapolated from cisgender studies and a limited number of cohort studies and case reports published on the transgender community. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2021
9. Uterine transplantation and donation in transgender individuals; proof of concept
- Author
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Lin Fraser, Jamison Green, Michelle Seu, Asa Radix, Loren S. Schechter, Giuliano Testa, Sydney R. Horen, Liza Johannesson, Amir H. Dorafshar, Alireza Hamidian Jahromi, Loren Schechter, and Erica Anderson
- Subjects
medicine.medical_specialty ,Health (social science) ,Behavioral Risk Factor Surveillance System ,business.industry ,Health Policy ,Medicine (miscellaneous) ,Disease control ,Gender Studies ,Uterine transplantation ,Family medicine ,Donation ,Transgender ,Medicine ,business - Abstract
According to the Center for Disease Control (CDC)’s yearly Behavioral Risk Factor Surveillance System (BRFSS) report, approximately 25 million individuals worldwide, including 1–1.4 million adults ...
- Published
- 2021
10. Trends of Medicare Reimbursement Rates for Common Plastic Surgery Procedures
- Author
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Gordon H Derman, Deana S. Shenaq, Amir H. Dorafshar, Michael A. Cheah, Jonathan Kelly, Kalliopi Siotou, Charalampos Siotos, Loren S. Schechter, and George Damoulakis
- Subjects
Inflation ,medicine.medical_specialty ,Relative value ,Actuarial science ,Descriptive statistics ,business.industry ,media_common.quotation_subject ,Medicare beneficiary ,Reimbursement rates ,030230 surgery ,03 medical and health sciences ,Plastic surgery ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Surgery ,Medicare reimbursement ,business ,Medicaid ,media_common - Abstract
Background Knowledge of Medicare reimbursement is essential for plastic surgeons providing care to Medicare beneficiaries. The authors sought to evaluate changes in Medicare reimbursement for common plastic surgery procedures from 2010 to 2020. Methods The authors assessed the Physician Fee Schedule of the Centers for Medicare and Medicaid Services website. Rates of work-, facility-, or malpractice-related relative value units and total monetary units for 26 common plastic surgery procedures between 2010 and 2020 were evaluated. Descriptive statistics were used to calculate relative differences and to compare observed changes over time with the rate of inflation. Results For the selected procedures, the authors found an average relative difference in terms of monetary units of an increase by 2.02 percent. However, after adjusting for inflation, the average relative difference was a decrease by 14.31 percent. The authors' analysis indicates that, on average, there was a 1.55 percent decrease in physician relative value units between 2010 and 2020. Conclusions Medicare reimbursement rates have changed significantly over the past decade. However, these changes did not keep pace with the rate of inflation. Plastic surgeons should be aware of these trends and advocate for more fair reimbursement rates.
- Published
- 2021
11. An Updated Overview of Gender Dysphoria and Gender Affirmation Surgery: What Every Plastic Surgeon Should Know
- Author
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Loren S. Schechter, Louisa C Boyd, and Alireza Hamidian Jahromi
- Subjects
Gender dysphoria ,medicine.medical_specialty ,business.industry ,MEDLINE ,Context (language use) ,Vascular surgery ,medicine.disease ,Surgery ,Cardiac surgery ,03 medical and health sciences ,Plastic surgery ,0302 clinical medicine ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,business ,Abdominal surgery - Abstract
Gender dysphoria refers to the medical condition experienced by individuals whose physical anatomy is not consistent with their gender identity. Surgery is a safe and effective treatment for many individuals, yet the current demand for surgery exceeds the number of trained surgeons. This article reviews gender-affirming surgical procedures and emphasizes an individualized approach within the context of a multidisciplinary team. We review pre-, intra-, and postoperative care including the preoperative requirements for surgery.
- Published
- 2021
12. The Affordable Care Act and Its Impact on Plastic and Gender-Affirmation Surgery
- Author
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Amir H. Dorafshar, Kellan E. Baker, Aaron L. Wiegmann, Deana S. Shenaq, Michelle Seu, Ezra I. Young, Syed I. Khalid, and Loren S. Schechter
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Male ,medicine.medical_specialty ,Gender affirmation ,030230 surgery ,Health Services Accessibility ,Insurance Coverage ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Transgender ,Sex Reassignment Surgery ,medicine ,Health insurance ,Humans ,Value-Based Health Insurance ,Healthcare Disparities ,Craniofacial surgery ,Medicaid ,business.industry ,Patient Protection and Affordable Care Act ,Plastic Surgery Procedures ,United States ,Surgery ,Plastic surgery ,Socioeconomic Factors ,030220 oncology & carcinogenesis ,Female ,business ,Insurance coverage - Abstract
SUMMARY The Affordable Care Act's provisions have affected and will continue to affect plastic surgeons and their patients, and an understanding of its influence on the current American health care system is essential. The law's impact on pediatric plastic surgery, craniofacial surgery, and breast reconstruction is well documented. In addition, gender-affirmation surgery has seen exponential growth, largely because of expanded insurance coverage through the protections afforded to transgender individuals by the Affordable Care Act. As gender-affirming surgery continues to grow, plastic surgeons have the opportunity to adapt and diversify their practices.
- Published
- 2020
13. Impact of social media presence on online reviews among plastic surgeons who perform gender confirming surgeries
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Oscar J. Manrique, Antonio J. Forte, Trishul Kapoor, Pedro Ciudad, Samyd S. Bustos, Loren S. Schechter, and Gabriel Del Corral
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Sex reassignment surgery (female-to-male) ,MEDLINE ,Surgery ,Patient satisfaction ,Patient Satisfaction ,Sex Reassignment Surgery ,medicine ,Humans ,Social media ,Surgery, Plastic ,business ,Social Media - Published
- 2020
14. Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 2: Genital Reconstruction)
- Author
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Wilmina N. Landford, Brandyn D. Lau, Devin Coon, Claire Twose, Norah Oles, Chanjun S. Park, Matthew Garza, Phuong Tran, Loren S. Schechter, and Halley Darrach
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Patient-centered outcomes ,Transgender Persons ,Patient Satisfaction ,Family medicine ,Patient-Centered Care ,Outcome Assessment, Health Care ,Sex Reassignment Surgery ,Medicine ,Humans ,Surgery ,Sex organ ,Female ,Patient Reported Outcome Measures ,business ,Transsexualism - Abstract
To perform the first systematic review of all available GAS publications across all procedures to assess outcomes reported in the literature and the methods used for outcome assessment.Assessment of GAS results is complex and multidimensional, involving not only complication rates but also anatomic (eg, vaginal depth), functional (eg, urinary), and psychosocial outcomes. A fully comprehensive aggregation of all prior research would offer an essential cornerstone for continued progress.A systematic review was performed after PRISMA guidelines to identify all outcomes measures in GAS cohorts, including patient-centered outcomes, complications, and functional outcomes. Data were aggregated to assess pooled rates of complications, satisfaction, and other outcomes.Overall, 15,186 references were identified, 4162 papers advanced to abstract review, and 1826 underwent full-text review. After review, there were 406 GAS cohort publications, including 171 vaginoplasty, 82 phalloplasty, 16 metoidioplasty, 23 oophorectomy/vaginectomy, and 21 with multiple procedures.Although 68.7% of genitoplasty papers addressed patient-centered outcomes, only 1.0% used metrics validated in the transgender population. Forty-three different outcome instruments were used. No instrument was used in more than 15% of published series and 38 were used in only 1 or 2 publications.Our review found high patient satisfaction for genital procedures but little concordance between study methods, with almost 90% of patient-focused outcome metrics appearing only once or twice. Standardization of outcome instruments and measurement methods through patient-inclusive, multidisciplinary consensus efforts is the essential next step for quality improvement. As GAS continues to mature, building on current foundations with the goal of improving both surgical and patient-reported outcomes is essential.
- Published
- 2021
15. Discussion: Quantifying the Psychosocial Benefits of Masculinizing Mastectomy in Trans Male Patients with Patient-Reported Outcomes: The University of California, San Francisco, Gender Quality of Life Survey
- Author
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Loren S. Schechter
- Subjects
Male ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,MEDLINE ,Breast Neoplasms ,Quality of life (healthcare) ,Male patient ,Family medicine ,medicine ,Quality of Life ,Humans ,Surgery ,San Francisco ,Patient Reported Outcome Measures ,business ,Psychosocial ,Mastectomy - Published
- 2021
16. Trends of Medicare Reimbursement Rates for Common Plastic Surgery Procedures
- Author
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Charalampos, Siotos, Michael A, Cheah, George, Damoulakis, Jonathan, Kelly, Kalliopi, Siotou, Loren S, Schechter, Deana S, Shenaq, Gordon H, Derman, and Amir H, Dorafshar
- Subjects
Insurance, Health, Reimbursement ,Humans ,Plastic Surgery Procedures ,Medicare ,United States - Abstract
Knowledge of Medicare reimbursement is essential for plastic surgeons providing care to Medicare beneficiaries. The authors sought to evaluate changes in Medicare reimbursement for common plastic surgery procedures from 2010 to 2020.The authors assessed the Physician Fee Schedule of the Centers for Medicare and Medicaid Services website. Rates of work-, facility-, or malpractice-related relative value units and total monetary units for 26 common plastic surgery procedures between 2010 and 2020 were evaluated. Descriptive statistics were used to calculate relative differences and to compare observed changes over time with the rate of inflation.For the selected procedures, the authors found an average relative difference in terms of monetary units of an increase by 2.02 percent. However, after adjusting for inflation, the average relative difference was a decrease by 14.31 percent. The authors' analysis indicates that, on average, there was a 1.55 percent decrease in physician relative value units between 2010 and 2020.Medicare reimbursement rates have changed significantly over the past decade. However, these changes did not keep pace with the rate of inflation. Plastic surgeons should be aware of these trends and advocate for more fair reimbursement rates.
- Published
- 2021
17. Cheek Augmentation Techniques
- Author
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Loren S. Schechter and David M. Whitehead
- Subjects
Male ,Aging ,Filler (packaging) ,Cephalometry ,Dentistry ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Dermal Fillers ,Fat grafting ,Humans ,Medicine ,Feminization ,030223 otorhinolaryngology ,Sex Characteristics ,business.industry ,Skull ,food and beverages ,Prostheses and Implants ,Plastic Surgery Procedures ,Facial implant ,Cheek ,Face ,Cheek augmentation ,Rhytidoplasty ,Female ,Surgery ,business - Abstract
The restoration of a youthful appearance to the midface can enhance its femininity. In this article, we discuss several strategies and techniques, both surgical and nonsurgical, for augmentation of the lateral and centro-lateral midface.
- Published
- 2019
18. Vaginal Canal Reconstruction in Penile Inversion Vaginoplasty with Flaps, Peritoneum, or Skin Grafts: Where Is the Evidence?
- Author
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Mark-Bram Bouman, Lee C. Zhao, William M. Kuzon, Rachel Bluebond-Langner, Loren S. Schechter, Ara A. Salibian, Wouter B. van der Sluis, Plastic, Reconstructive and Hand Surgery, APH - Methodology, Other Research, and APH - Quality of Care
- Subjects
Male ,medicine.medical_specialty ,030230 surgery ,Surgical Flaps ,03 medical and health sciences ,0302 clinical medicine ,Gynecologic Surgical Procedures ,Penis surgery ,Sex Reassignment Surgery ,Medicine ,Humans ,Evidence-Based Medicine ,business.industry ,Skin Transplantation ,medicine.disease ,Surgery ,Study Characteristics ,Stenosis ,Vaginal canal ,030220 oncology & carcinogenesis ,Expert opinion ,Vagina ,Vaginoplasty ,Female ,Peritoneum ,Complication ,business ,Penis - Abstract
Background To optimize neovaginal dimensions, several modifications of the traditional penile inversion vaginoplasty are described. Options for neovaginal lining include skin grafts, scrotal flaps, urethral flaps, and peritoneum. Implications of these techniques on outcomes remain limited. Methods A systematic review of recent literature was performed to assess evidence on various vaginal lining options as adjunct techniques in penile inversion vaginoplasty. Study characteristics, neovaginal depth, donor-site morbidity, lubrication, and complications were analyzed in conjunction with expert opinion. Results Eight case series and one cohort study representing 1622 patients used additional skin grafts when performing penile inversion vaginoplasty. Neovaginal stenosis ranged from 1.2 to 12 percent, and neovaginal necrosis ranged from 0 to 22.8 percent. Patient satisfaction with lubrication was low in select studies. Three studies used scrotal flaps to line the posterior vaginal canal. Average neovaginal depth was 12 cm in one study, and neovaginal stenosis ranged from 0 to 6.3 percent. In one study of 24 patients, urethral flaps were used to line the neovagina. Neovaginal depth was 11 cm and complication rates were comparable to other series. Two studies used robotically assisted peritoneal flaps with or without skin grafts in 49 patients. Average neovaginal depth was approximately 14 cm, and complication rates were low. Conclusions Skin grafts, scrotal flaps, urethral flaps, and peritoneal flaps may be used to augment neovaginal canal dimensions with minimal donor-site morbidity. Further direct comparative data on complications, neovaginal depth, and lubrication are needed to assess indications in addition to advantages and disadvantages of the various lining options.
- Published
- 2021
19. Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 1: Breast/Chest, Face, and Voice)
- Author
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Matthew Garza, Wilmina N. Landford, Chanjun S. Park, Devin Coon, Phuong Tran, Brandyn D. Lau, Norah Oles, Claire Twose, Halley Darrach, and Loren S. Schechter
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Outcome (game theory) ,Transgender Persons ,Patient-Centered Care ,Transgender ,Outcome Assessment, Health Care ,medicine ,Humans ,Gender Dysphoria ,Mastectomy ,business.industry ,Patient-centered outcomes ,Surgery ,Clinical research ,Face ,Cohort ,Voice ,Female ,business - Abstract
Objective : To perform the first systematic review of all available gender-affirming surgery (GAS) publications across all procedures to assess both outcomes reported in the literature and the methods used for outcome assessment. Summary background data Rapidly increasing clinical volumes of gender-affirming surgeries have stimulated a growing need for high-quality clinical research. While some procedures have been performed for decades, each individual procedure has limited data, necessitating synthesis of the entire literature to understand current knowledge and guide future research. Methods A systematic review was performed following PRISMA guidelines to identify all outcomes measures in GAS cohorts, including PCOs, complications, and functional outcomes. Outcome data was pooled to assess currently reported complication, satisfaction, and other outcome rates. Results Overall, 15,186 references were identified, 4,162 papers advanced to abstract review, and 1,826 underwent full-text review. After review, there were 406 GAS cohort publications. Of non-genitoplasty titles, 35 were mastectomy, 6 mammoplasty, 21 facial feminization, and 31 voice/cartilage. While 59.1% of non-genitoplasty papers addressed PCOs in some form, only 4.3% used instruments partially-validated in transgender patients. Overall, data were reported heterogeneously and were biased towards high-volume centers. Conclusions This study represents the most comprehensive review of GAS literature. By aggregating all previously utilized measurement instruments, this study offers a foundation for discussions about current methodologic limitations and what dimensions must be included in assessing surgical success. We have aggregated a comprehensive list of outcome instruments; this offers an ideal starting basis for emerging discussions between patients and providers about deficiencies which new, better instruments and metrics must address. The lack of consistent use of the same outcome measures and validated GAS-specific instruments represent the two primary barriers to high-quality research where improvement efforts should be focused.
- Published
- 2021
20. Surgical Anatomy: Phalloplasty
- Author
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Loren S. Schechter and Alexander R. Facque
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Anterolateral thigh ,Microsurgery ,eye diseases ,Surgery ,Fasciocutaneous flap ,Catheter ,Gracilis muscle flap ,Surgical anatomy ,Medicine ,Phalloplasty ,Circumflex ,business - Abstract
Early surgical techniques for phalloplasty involved the transfer of pedicled, tubed abdominal tissue in order to create or reconstruct a phallus. The advent and advances in the field of microsurgery led to the emergence of free and pedicled axial-pattern flaps as the preferred technique. This chapter discusses the history, preoperative considerations, surgical anatomy, and techniques of the most commonly used flaps in penile reconstruction: the radial forearm fasciocutaneous flap, the anterolateral thigh fasciocutaneous flap, the superficial circumflex iliac perforator flap, and the gracilis muscle flap. Information regarding postoperative management, including flap monitoring, catheter management, and local care are included. Knowledge of the surgical anatomy of the donor and recipient sites is crucial to achieving satisfactory results.
- Published
- 2021
21. Managing Common and Uncommon Complications in Gender-Affirming Masculinizing Chest Surgery
- Author
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Alexander R. Facque and Loren S. Schechter
- Subjects
Surgical results ,medicine.medical_specialty ,business.industry ,General surgery ,Gender Confirmation Surgery ,Transgender ,Medicine ,Complication rate ,Chest surgery ,business ,Subcutaneous Mastectomy - Abstract
Masculinizing chest surgery is one of the most commonly requested procedures in gender confirmation surgery. The World Professional Association of Transgender Health has established standards of care that offer recommendations for patients and surgeons prior to undergoing gender confirmation surgery. There have been many techniques described to perform masculinizing chest surgery, and the majority of patients are very satisfied with their surgical results. Overall, the complication rate in chest surgery is low. The following is a discussion of chest surgery with a focus on the potential cause, treatment, and some possible methods of prevention of the most common, and uncommon, complications that arise in chest surgery.
- Published
- 2021
22. A narrative review of outcomes following metoidioplasty: complications and satisfaction
- Author
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Alireza Hamidian Jahromi, Ari M. Spellman, Sydney Horen, Edward E. Cherullo, Amir H. Dorafshar, and Loren S. Schechter
- Subjects
General Medicine - Abstract
Metoidioplasty consists of lengthening and straightening the hormonally hypertrophied clitoris. The goals of the procedure include masculinizing the external genitalia and enabling standing micturition. Metoidioplasty may be performed as a stand-alone procedure or an interval procedure prior to phalloplasty. While most often performed with urethral lengthening, metoidioplasty may also be performed as a “simple release” (i.e., without urethral lengthening). Secondary procedures typically include scrotoplasty and placement of testicular implants. While satisfaction with this procedure is high, complications can occur. Complications are commonly categorized as either urologic (i.e., strictures and fistula) or wound healing (i.e., wound disruption, infection, bleeding, etc.). This narrative review discusses postoperative outcomes, including both satisfaction and complications. Published data on complications include fistula and stricture rates from 0%-50% and 0%-63%, respectively. Overall satisfaction with appearance ranges from 48%-100%, and patient ability to void while standing ranges from 67%-100%. Metoidioplasty is a safe and effective procedure for transgender men. Further research regarding surgical techniques and outcomes will help reduce complications and improve overall patient satisfaction.
- Published
- 2022
23. Discussion: Promoting Centers for Transgender Care
- Author
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Amir H. Dorafshar, Devin O’Brien-Coon, Rachel Bluebond-Langner, Joseph Lopez, Emily C. Sluiter, Jens U. Berli, Jordan C. Deschamps-Braly, William M. Kuzon, Loren S. Schechter, Hossein E. Jazayeri, and Stan Monstrey
- Subjects
medicine.medical_specialty ,business.industry ,Oral surgery ,MEDLINE ,Transgender Persons ,Otorhinolaryngology ,Family medicine ,Transgender ,medicine ,Humans ,Surgery ,Oral Surgery ,business - Published
- 2020
24. V07-01 URETHRAL RECONSTRUCTION IN GENDER AFFIRMING PHALLOPLASTY WITH RADIAL FOREARM FREE FLAP
- Author
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Ömer Acar, Susan Talamini, Loren S. Schechter, Luca Morgantini, and Ervin Kocjancic
- Subjects
medicine.medical_specialty ,Radial forearm free flap ,business.industry ,Urology ,education ,Medicine ,Context (language use) ,Phalloplasty ,business ,humanities ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Urethral reconstruction within the context of gender affirming phalloplasty is important as almost half of the patients suffer from some degree of urethral complication p...
- Published
- 2020
25. Contributors
- Author
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Benjamin Abelson, Paurush Babbar, Stefan Baral, Marta R. Bizic, Marci Bowers, David Call, James Murphy, Luis Capitán, Fermín Capitán-Cañadas, Jeremi Carswell, Gene DeHaan, Miroslav L. Djordjevic, Cecile A. Ferrando, Dan H. Karasic, Gail Knudson, Juno Obedin-Maliver, Parisa A. Samimi, Cherie Quesenberry Marfori, Ray Qian, Sari L. Reisner, Audrey Rhee, Stephanie Roberts, Joshua D. Safer, Loren S. Schechter, Rebecca B. Schechter, Anup Shah, Matthew Siedhoff, Daniel Simon, Tonya N. Thomas, Carolyn Wolf-Gould, Christopher Wolf-Gould, Kevan Wylie, and Sam Winter
- Published
- 2020
26. Establishment of a Gender Confirmation Program
- Author
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Rebecca B. Schechter and Loren S. Schechter
- Subjects
Medical education ,media_common.quotation_subject ,education ,Gender Confirmation Surgery ,ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION ,ComputerApplications_COMPUTERSINOTHERSYSTEMS ,Surgical procedures ,Surgical training ,Multidisciplinary approach ,Vaginoplasty ,Quality (business) ,Phalloplasty ,Philosophy of education ,Psychology ,media_common - Abstract
Requests for gender-confirming surgical procedures have increased in recent years. As such, the demand for surgery has outpaced the number of qualified surgeons. This chapter highlights the need and importance of multidisciplinary training programs in gender confirmation surgery. In addition, we propose a framework for how these educational programs can be structured. Important aspects of training programs, including educational philosophy and the development of quality parameters, are explored.
- Published
- 2020
27. History of Gender Identity and Surgical Alteration of the Genitalia
- Author
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Loren S. Schechter and David M. Whitehead
- Subjects
Transsexual ,Medical education ,Documentation ,Gender identity ,Surgical procedures ,Psychology ,Surgical interventions - Abstract
As we continue to refine surgical procedures, medical professionals should not only be familiar with current literature and research but also understand the history of gender-related surgery. Like any historical survey, the history of gender surgery is limited by the documentation of historic examples and practices, the reliability of this documentation, and the ways that current thinking views the past. Nonetheless, the purpose is to present surgical interventions for gender identity as part of a longer continuum. The goal is to allow historical cases to assist today’s practitioners in serving their patients.
- Published
- 2020
28. Breast and Chest Surgery for Transgender Patients
- Author
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Loren S. Schechter and Rebecca B. Schechter
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Transgender ,medicine ,Chest surgery ,business - Published
- 2020
29. Normas de Atención para la salud de personas trans y con variabilidad de género
- Author
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Robert Garofalo, Heino F. L. Meyer-Bahlburg, G. Mayer, R. K. Adler, Sam Winter, Eli Coleman, Stephen Whittle, A. Vitale, Vin Tangpricha, Walter J. Meyer, Randall D. Ehrbar, Stanislas Monstrey, E. Eyler, Katherine Rachlin, A. I. Lev, Jamie L Feldman, B. P. Hall, M. van Trotsenburg, M. Botzer, Aaron Devor, Friedemann Pfäfflin, Lin Fraser, P. T. Cohen-Kettenis, Kenneth J. Zucker, George R. Brown, Kevan Wylie, Gail Knudson, Randi Ettner, Dan H. Karasic, Walter O. Bockting, G. De Cuypere, Beatrice 'Bean' E. Robinson, Jennifer B. Green, Loren S. Schechter, Medical psychology, and NCA - Brain mechanisms in health and disease
- Subjects
Gender Studies ,050103 clinical psychology ,03 medical and health sciences ,030505 public health ,05 social sciences ,0501 psychology and cognitive sciences ,0305 other medical science - Abstract
La Asociacion Profesional Mundial para la Salud Transgenero1 (WPATH) es una asociacion internacional profesional multidisciplinaria cuya mision es promover la atencion basada en la evidencia, la ed...
- Published
- 2018
30. Tomboys Revisited: A Retrospective Comparison of Childhood Behavioral Patterns in Lesbians and Transmen
- Author
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Frederic M. Ettner, Randi Ettner, Tonya White, Loren S. Schechter, and Tanya Friese
- Subjects
Physics ,03 medical and health sciences ,0302 clinical medicine ,05 social sciences ,Transgender ,Behavioral pattern ,0501 psychology and cognitive sciences ,Lesbian ,030217 neurology & neurosurgery ,050104 developmental & child psychology ,Clinical psychology - Abstract
In 1979, a study conducted by Ehrhardt et al. retrospectively examined childhood behavioral patterns of 30 adults; 15 identified as lesbian women and 15 identified as transmen. All 30 adults had been assigned female at birth, and, as children, all were regarded as “tomboys.” The study found several key factors that distinguished the two cohorts. The goal of this study was to replicate and extend the 1979 study, utilizing a larger sample size and including a reference group of heterosexual women. Given the major social, technological, medical, and legal paradigm shifts that have occurred over the past four decades, we sought to determine if the previous findings still differentiate the cohorts. In light of the exponential rise in the number of gender diverse and dysphoric youth who request treatment, providing optimal, affirmative care and education is paramount, especially since many of these young people seek social and/or medical transition. Exploration of the early behavioral indices of the diverse trajectories may help to inform best practices for optimal care for these young people and their families.
- Published
- 2018
31. Training Surgeons in Gender Confirmation Surgery
- Author
-
Loren S. Schechter and Rebecca B. Schechter
- Subjects
Male ,Surgeons ,Gender dysphoria ,medicine.medical_specialty ,business.industry ,Gender Confirmation Surgery ,Sex reassignment surgery (female-to-male) ,MEDLINE ,030206 dentistry ,General Medicine ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,Multidisciplinary approach ,Family medicine ,Sex Reassignment Surgery ,medicine ,Humans ,Female ,Surgery ,030223 otorhinolaryngology ,Training program ,business - Abstract
Gender confirmation surgery can be an important component in helping individuals alleviate gender dysphoria. Increased advocacy, awareness, and acceptance of these medically necessary procedures have resulted in a greater demand for such procedures, exceeding the number of qualified surgeons able to perform them. It is recognized that formal training guidelines and fellowship programs are needed so as to assure that surgeons performing these procedures are adequately experienced. Here, the authors discuss a potential framework by which a multidisciplinary training program in gender confirmation surgery can be developed and implemented.
- Published
- 2019
32. Guiding the conversation—types of regret after gender-affirming surgery and their associated etiologies
- Author
-
Asa Radix, Sasha K. Narayan, Rachel Bluebond-Langner, Angela Carter, Jess Guerriero, Randi Ettner, Sara Danker, Jens U. Berli, Gaines Blasdel, Loren S. Schechter, and Rayisa Hontscharuk
- Subjects
Original Article on Transgender Surgery ,medicine.medical_specialty ,Descriptive statistics ,media_common.quotation_subject ,030232 urology & nephrology ,Regret ,General Medicine ,Terminology ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Patient experience ,Transgender ,medicine ,Etiology ,Conversation ,Professional association ,Psychology ,media_common - Abstract
Background A rare, but consequential, risk of gender affirming surgery (GAS) is post-operative regret resulting in a request for surgical reversal. Studies on regret and surgical reversal are scarce, and there is no standard terminology regarding either etiology and/or classification of the various forms of regret. This study includes a survey of surgeons' experience with patient regret and requests for reversal surgery, a literature review on the topic of regret, and expert, consensus opinion designed to establish a classification system for the etiology and types of regret experienced by some patients. Methods This anonymous survey was sent to the 154 surgeons who registered for the 2016 World Professional Association for Transgender Health (WPATH) conference and the 2017 USPATH conference. Responses were analyzed using descriptive statistics. A MeSH search of the gender-affirming outcomes literature was performed on PubMed for relevant studies pertaining to regret. Original research and review studies that were thought to discuss regret were included for full text review. Results The literature is inconsistent regarding etiology and classification of regret following GAS. Of the 154 surgeons queried, 30% responded to our survey. Cumulatively, these respondents treated between 18,125 and 27,325 individuals. Fifty-seven percent of surgeons encountered at least one patient who expressed regret, with a total of 62 patients expressing regret (0.2-0.3%). Etiologies of regret were varied and classified as either: (I) true gender-related regret (42%), (II) social regret (37%), and (III) medical regret (8%). The surgeons' experience with patient regret and request for reversal was consistent with the existing literature. Conclusions In this study, regret following GAS was rare and was consistent with the existing literature. Regret can be classified as true gender-related regret, social regret and medical regret resulting from complications, function, pre-intervention decision making. Guidelines in transgender health should offer preventive strategies as well as treatment recommendations, should a patient experience regret. Future studies and scientific discourse are encouraged on this important topic.
- Published
- 2021
33. Common characteristics of functional and adverse outcomes in acute lower-extremity trauma reconstruction
- Author
-
Loren S. Schechter, Matthew L. Jimenez, Manoj Shah, Varun Shah, Iris A. Seitz, Justine C. Lee, and Suela Sulo
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Trauma center ,030208 emergency & critical care medicine ,030230 surgery ,Microsurgery ,Asepsis ,Surgery ,03 medical and health sciences ,Plastic surgery ,0302 clinical medicine ,Traumatic injury ,Amputation ,Ambulatory ,medicine ,Range of motion ,business - Abstract
Injury to the lower extremity is one of the most common traumatic injuries encountered in both combat and civilian situations. Improvements in sterile technique, the use of antibiotics, bony fixation, and microvascular reconstruction have shifted the management paradigm from predominantly amputation to limb salvage. We reviewed acute lower-extremity reconstruction in a single suburban trauma center and identified common characteristics of functional and adverse outcomes. The records of patients treated at a level I trauma center for lower-extremity injuries and requiring plastic surgery consultation or intervention were reviewed. Common demographic and clinical characteristics for three functional outcomes (range of motion, return to work, and ambulation) and three adverse outcomes (venous thromboembolism, rehospitalization, and operative revision) were compared. Of the 4039 patients treated for a lower-extremity traumatic injury over a 6-year period, 92 (2.3%) patients met the inclusion criteria. Severity of injury was a common determinant of outcome. On long-term follow-up, the majority of patients were ambulatory (n = 50), albeit frequently with some deficit in range of motion or gait disturbance. When modifiable characteristics were evaluated, an increased length of time to soft-tissue coverage was associated with both an increased incidence of venous thromboembolism and range-of-motion deficit. Delayed definitive soft-tissue coverage of lower-extremity traumatic wounds is associated with thromboembolic events and range-of-motion deficits. Involvement of a plastic surgeon in a multi-disciplinary trauma team could expedite definitive wound coverage and improve clinical outcomes of lower-extremity trauma. Future research evaluating the impact of early plastic surgery involvement on outcome measures is necessary. Level of Evidence: Level IV, risk/prognostic study
- Published
- 2017
34. Comment on: Suprapubic pedicled phalloplasty in transgender men: multicentric retrospective cohort analysis
- Author
-
Brandon Alba, Loren S. Schechter, and Rayisa Hontscharuk
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,General surgery ,Transgender ,Medicine ,Retrospective cohort study ,Phalloplasty ,business - Published
- 2020
35. Commentary on: Gender Surgery Beyond Chest and Genitals: Current Insurance Landscape
- Author
-
Aaron L. Wiegmann and Loren S. Schechter
- Subjects
medicine.medical_specialty ,business.industry ,Family medicine ,medicine ,MEDLINE ,Humans ,Surgery ,Genitalia ,General Medicine ,Current (fluid) ,Transgender Person ,business ,Transgender Persons - Published
- 2019
36. Anatomical Basis and Surgical Techniques Employed in Facial Feminization and Masculinization
- Author
-
Loren S. Schechter, Daniela Atencio, and Alexander R. Facque
- Subjects
Gender dysphoria ,Male ,Transgender Persons ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Transgender ,medicine ,Feminization (sociology) ,Humans ,Feminization ,030223 otorhinolaryngology ,business.industry ,Skull ,Skeletal structures ,Heart ,030206 dentistry ,General Medicine ,medicine.disease ,stomatognathic diseases ,Face surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Face ,Surgery ,Female ,Transgender Person ,business ,Transsexualism - Abstract
Increasingly, facial feminization and masculinization techniques are being employed in the treatment of gender dysphoria. For the facial surgeon, knowledge of the anatomical differences between masculine and feminine facial skeletal structures is of utmost importance. Combining this knowledge with the various surgical and non-techniques that may be employed in order to achieve each patient's goals will allow the facial surgeon to greatly impact the lives of persons of transgender and gender diverse experience. Below, this article discusses these anatomical differences as well as current surgical practices employed in order to masculinize or feminize the face.
- Published
- 2019
37. Gender Confirmation Surgery: Moving Forward
- Author
-
Loren S. Schechter and Mimis Cohen
- Subjects
Gender dysphoria ,Male ,medicine.medical_specialty ,MEDLINE ,Social transition ,Transgender Persons ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Transgender ,Sex Reassignment Surgery ,Medicine ,Humans ,Craniofacial skeleton ,030223 otorhinolaryngology ,business.industry ,Gender Confirmation Surgery ,Sex reassignment surgery (female-to-male) ,030206 dentistry ,General Medicine ,medicine.disease ,Otorhinolaryngology ,Family medicine ,Surgery ,Female ,business ,Transsexualism - Abstract
Facial surgery can help facilitate an individual's social transition and alleviate gender dysphoria. As such, surgical requests for feminizing and masculinizing procedures continue to increase. Surgical management requires knowledge of anatomy and anatomic differences as well as an understanding of social challenges faced by transgender and gender diverse individuals. Here, the authors provide a brief overview of gender confirmation surgery specific to the head and neck and craniofacial skeleton. In addition, the authors explore barriers to accessing healthcare for transgender and gender diverse individuals throughout the world.
- Published
- 2019
38. Inflatable penile prosthesis implantation after gender affirming phalloplasty with radial forearm free flap
- Author
-
Ervin Kocjancic, Jorge Jaunarena, Ömer Acar, and Loren S. Schechter
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Penile Implantation ,Prosthesis ,Free Tissue Flaps ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Sex Reassignment Surgery ,Humans ,Fixation (histology) ,030219 obstetrics & reproductive medicine ,business.industry ,Penile Erection ,Penile prosthesis ,Surgery ,medicine.anatomical_structure ,Inflatable ,Radial forearm free flap ,Inflatable penile prosthesis ,Patient Satisfaction ,Female ,Phalloplasty ,Penile Prosthesis ,business ,Penis - Abstract
We aimed to review all information on penile prosthetic surgery in patients with prior phalloplasty and give a detailed description of the authors's preferred technique. A nonsytematic review of the articles that were published in English and indexed on Pubmed, Google Scholar, and Embase databases was conducted. The relevant literature reports mainly on the outcomes of penile prosthesis (PP) implantation following gender affirming phalloplasty with the radial forearm free flap technique. Three-piece inflatable penile prostheses (IPP) have been the most commonly utilized hardware in this setting. PP implantation in a neophallus is a complex procedure and contains some technical nuances. Creation of spaces within the neophallus for the cylinder(s), wrapping the cylinder(s) with synthetic materials or allografts, and fixation of the prosthesis to the pubic bony structures can be considered as the most important steps of this procedure. Five-year IPP retention rates in flap phalloplasty range between 42 and 78% which is lower than the rate observed in anatomic phallus. In addition, complication and mechanical failure rates are higher in flap phalloplasty. However, satisfaction rates after PP implantations in anatomic penis versus neophallus seem to be similarly high. Infection, migration, and mechanical failure are the most frequent complications.
- Published
- 2019
39. List of Contributors
- Author
-
Jeremi M. Carswell, Diane Chen, Erica Eugster, Joel E. Frader, Anisha Gohil, Rebecca M. Harris, Marco A. Hidalgo, Janet Y. Lee, Maja Marinkovic, Leena Nahata, Liat Perl, Stephanie A. Roberts, Stephen M. Rosenthal, Loren S. Schechter, Rebecca B. Schechter, Daniel Evan Shumer, Lisa Simons, Norman Spack, Dennis M. Styne, Amy C. Tishelman, Anna Valentine, and J. Whitehead
- Published
- 2019
40. Surgical Side Effects of GnRHa
- Author
-
Rebecca B. Schechter and Loren S. Schechter
- Published
- 2019
41. Gender Confirmation Surgery : Principles and Techniques for an Emerging Field
- Author
-
Loren S. Schechter and Loren S. Schechter
- Subjects
- Gender reassignment surgery
- Abstract
Gender confirming surgery represents one of many therapies for individuals with gender dysphoria and can be pivotal in allowing individuals to become their true selves. An emerging field, this text represents a continuing evolution of surgical techniques, as well as a framework around which surgical therapies are based. Providing a fundamental understanding of the surgical principles while also recognizing the fast-paced nature of the advances in technique, Gender Confirmation Surgery touches upon the challenges and complexities in the surgical care of transgender individuals, featuring detailed sections for transwomen and transmen surgeries, non-surgical options, and establishing educational programs.Written as a guide primarily for surgeons in plastics, urology, and gynecology, this book can also appeal to primary care practitioners, mental health professionals, and endocrinologists. By representing an evolution of technique and advances in the field, Gender Confirmation Surgery offers a framework around which practitioners can familiarize themselves with gender surgery.
- Published
- 2020
42. Assessing Patient Expectations in Gender-Affirming Surgery
- Author
-
Randi Ettner, Loren S. Schechter, Brandon Alba, and Rayisa Hontscharuk
- Subjects
medicine.medical_specialty ,business.industry ,Family medicine ,medicine ,Surgery ,business - Published
- 2020
43. Gender Confirmation Surgery: An Update for the Primary Care Provider
- Author
-
Loren S. Schechter
- Subjects
medicine.medical_specialty ,vaginoplasty ,media_common.quotation_subject ,lcsh:Special situations and conditions ,Medicine (miscellaneous) ,Metoidioplasty ,Review Article ,Primary care ,Gender Studies ,gender nonconforming ,Nursing ,Multidisciplinary approach ,phalloplasty ,Health care ,Transgender ,Medicine ,Quality (business) ,media_common ,gender confirmation surgery ,business.industry ,lcsh:RC952-1245 ,Gender Confirmation Surgery ,transgender ,Mental health ,Surgery ,metoidioplasty ,business - Abstract
Increased advocacy efforts and expanded third-party insurance coverage have improved access to healthcare for transgender individuals. In conjunction with mental health and medical professionals, gender surgeries offer an important step in allowing individuals to realize their true selves. To provide quality multidisciplinary care, primary care doctors need to understand challenges facing transgender individuals and treatment options available to them. In this article, we will review the role of the surgeon and the goals of various gender confirming surgeries. In addition, we will provide an overview of the available surgical options.
- Published
- 2016
44. Strategies for innervation of the neophallus
- Author
-
Rayisa Hontscharuk, Loren S. Schechter, and Charalampos Siotos
- Subjects
Radial forearm flap ,business.industry ,Sensation ,Medicine ,General Medicine ,Phalloplasty ,Anatomy ,business - Abstract
A fundamental goal of phalloplasty includes the construction of a sensate neophallus. Both tactile and erogenous sensation are important for protective sensation (including retention of implantable penile prosthesis) as well as sexual satisfaction. This article will describe the sensory innervation of flaps commonly used for phalloplasty including the radial forearm flap, anterolateral thigh flap, and musculocutaneous latissimus dorsi flap. The sensory innervation of the perineum and external genitalia will be reviewed as a basis for selecting recipient nerves. Additionally, surgical techniques, such as neurorrhaphy, will be discussed. Finally, outcome data, although limited, will be assessed.
- Published
- 2020
45. Gender Surgery: A Truly Multidisciplinary Field
- Author
-
Bauback Safa and Loren S. Schechter
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,Multidisciplinary approach ,030220 oncology & carcinogenesis ,Field (Bourdieu) ,MEDLINE ,Medicine ,Surgery ,Medical physics ,030230 surgery ,business - Published
- 2018
46. Introduction to Phalloplasty
- Author
-
Bauback Safa and Loren S. Schechter
- Subjects
Male ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,030232 urology & nephrology ,Surgical Flaps ,03 medical and health sciences ,0302 clinical medicine ,Urethra ,medicine ,Humans ,Latissimus dorsi flap ,business.industry ,Gender Confirmation Surgery ,Anterolateral thigh ,Plastic Surgery Procedures ,eye diseases ,Surgery ,body regions ,Radial forearm free flap ,030220 oncology & carcinogenesis ,Female ,Phalloplasty ,business ,Transsexualism ,Penis - Abstract
Phalloplasty represents the most complete genitoperineal transformation. Because it requires complex, staged procedures as well as the use of tissue from remote sites, patients must be well informed as to the nature of surgery. Surgical techniques for phalloplasty continue to evolve. Although many surgeons prefer the radial forearm free flap technique, a visible flap donor site makes this procedure less desirable for some patients. Other surgical options are available and include the anterolateral thigh flap, sometimes in conjunction with secondary flaps, and the musculocutaneous latissimus dorsi flap.
- Published
- 2018
47. V11-04 INFLATABLE PENILE PROSTHESIS IMPLANTATION POST PHALLOPLASTY
- Author
-
Jorge Jaunarena, Ervin Kocjancic, Luca Morgantini, Laurel Sofer, and Loren S. Schechter
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,Inflatable penile prosthesis ,business.industry ,Urology ,030232 urology & nephrology ,Medicine ,Phalloplasty ,business ,Surgery - Published
- 2018
48. V10-01 NOVEL VAGINOPLASTY TECHNIQUE: INVERSION OF PENILE SKIN AND USE OF SCROTAL GRAFT WITHOUT SACROSPINAL FIXATION
- Author
-
Hari T. Vigneswaran, Ervin Kocjancic, David M. Whitehead, Jorge Jaunarena, Luca Morgantini, Loren S. Schechter, and Laurel Sofer
- Subjects
03 medical and health sciences ,Fixation (surgical) ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Urology ,Penile skin ,030232 urology & nephrology ,medicine ,Vaginoplasty ,business ,Surgery - Published
- 2018
49. Gender Affirmation: MedicalSurgical Perspectives
- Author
-
Loren S. Schechter
- Subjects
medicine.medical_specialty ,business.industry ,Gender affirmation ,Family medicine ,medicine ,MEDLINE ,Surgery ,business - Published
- 2017
50. Pursuing Gender Transitioning Surgeries
- Author
-
Loren S. Schechter and Rebecca B. Schechter
- Subjects
business.industry ,Medicine ,business - Published
- 2017
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