Friday, August 2, 2019

Trans surgery wiki

Introduction

These pages are a collection of links to to information about surgeons around the world. Originally it was only links containing photos of MTF SRS results based on my (HiddenStill) personal research into SRS, but has been expanded. There's a wide range of information here and some of it may be disturbing.

I've tried to avoid expressing my personal opinions on these pages but there is bias in what I've collected due to my interests at the time. I'm trying to round it out to include links of more general interest to everyone, but its a long term project. As a result what you see here is not necessarily representative of what's available on Internet. Further, links posted here are not an endorsement that the surgeons are good, or even competent. Please bear that in mind and do your own research.

Note that there's a fair number of negative posts about surgeons here as its one of the things I'm most interested in. All experienced surgeons have negative reviews and its not something that should rule automatically one out. I like to consider the number of negative vs positive reviews. There's also more links for some surgeons than others, again due to my personal focus. I'll continue to edit and add to these pages over time and if anyone knows of any results, links, corrections, or improvements please let me know.

I generally only list posts or video's where I can identify the surgeon.

If the original poster wants links removed from these pages please let me know.

Many of the links should be explored further. For example, I list only one YouTube video rather than all of them by the same person.

You can watch age restricted YouTube video's without signing in by changing the url to start with www.nsfwyoutube.com

Web pages in foreign languages can easily be translated using the Google Chrome browser.

This sub was created as the wiki for /r/Transgender_Surgeries/. Having a seperate sub allows the wiki to be made 18+ without making the parent sub 18+.

Male to Female (MTF) Surgery

Female to Male (FTM) Surgery

I don't know much about this, but there's a lot of photo's on transbucket and /r/ftm sub on reddit.

The book Management of gender dysphoria : a multidisciplinary approach contains chapters on FTM surgery.

Blogs

If anyone wants to create and maintain some FTM wiki pages, or creates a similar FTM wiki please let me know.

Bias on review sites

There are two major sources of information on transgender surgery, reddit and susans. While reddit doesn't appear to have any censorship susans sometimes removes or edits posts critical of surgeons. I believe this is due to legal concerns as they don't have the kind of money (lawyers) reddit does, but unfortunately it introduces significant bias.

I've seen a number of complaints about the medical review site realself that among other things it removes negative reviews for doctors that pay, and there's lots of fake reviews.

ABC News Investigates Top Doctor Awards: Are They Always Well Deserved? in 2012

Miami Herald in 2016 State moves to revoke license of Miami 'butt lift' surgeon accused of medical malpractice - "Florida health officials this week took steps to revoke the medical license of a Miami cosmetic surgeon accused of severely injuring at least four patients in May 2015 while performing liposuction and another procedure known as a “Brazilian butt lift." and "The Miami Herald contacted the women after they posted comments about the doctor on a cosmetic surgery referral website called RealSelf.com, where Omulepu has received high ratings."

Given that, I'd be concerned if there were a large discrepancy between the number or quality of reviews on a site like realself and susans/reddit. Some surgeons have a lot of self created material but very few independant reviews, which also concerns me.

I'd also be cautious where surgeons feature in articles in lots of magazines, newspapers and social media. There's a risk that they are really good at marketing and their reputation is influenced by that rather than their skills.

Malpractice Insurance in the USA

A number of states do not require doctors to carry malpractice insurance, and some of the surgeons listed in this wiki do not have it (I've not checked all of them).

Why doesn't a doctor carry malpractice insurance?

The huffpost article Patients, Beware When Doctors 'Go Bare' from 2013 makes some very clear points

  • Often, this means that a patient killed or injured by a careless, uninsured physician could potentially be left with little or no compensation for their damages, medical bills and lost wages.

  • Virtually every lawyer who sues doctors in Florida takes the case on a contingency fee basis, in my experience. That means they will only get paid if and when the case resolves. It also means that the lawyer is responsible for fronting the costs of the investigation and trial. Because uninsured doctors are undesirable defendants for most personal injury lawyers, when any Florida medical malpractice lawyer investigates a potential claim, one of the first questions asked is, "Does the doctor have malpractice insurance?"

  • *In addition to the sign, uninsured doctors have to obtain an irrevocable line of credit to pay a malpractice claim. The line must be made payable to the doctor upon presentation of a final judgment or settlement. The funds cannot be used for litigation costs or defense attorney's fee."

  • Doctors who do not operate or have staff privileges are only required to maintain a line of credit equal to $100,000 per claim or $300,000 per incident. Doctors who operate or have hospital privileges must have a line of $250,000 or $750,000 per incident.

Smoking and Recreational Drugs

Applies to all plastic surgeries.

reddit

https://420intel.com/articles/2018/07/25/can-you-smoke-cannabis-after-plastic-surgery - "Most well-regarded plastic surgeons recommend refraining from smoking cannabis for six weeks before and after any surgery. Medical experts believe that patients should protect their investment and give their bodies enough time to recover naturally and completely" and "If you get the okay, it is best to avoid smoking any substance and instead take cannabis in other forms."

New York Times

  • Want a Face-Lift? First, Better Stop Smoking uin 2008 - "For the last 5 to 10 years, many plastic and cosmetic surgeons have refused to operate on smokers, especially those seeking a face-lift, tummy tuck, or breast-lift — procedures that require skin to be shifted." and "“Nowadays if a doctor knew a patient was smoking and they did flap surgery,” he said, referring to an operation where shifting skin is required, “many of us would say that’s malpractice.”"

Science News

Can quitting smoking before surgery prevent complications?, last update 2018, "Quitting smoking one or two months before planned surgery can significantly lower the risk of complications like poor wound healing. "

Papers

Order of Surgeries

After SRS you have to dilate regularly, so it may be best to leave a gap before other surgeries that could interfere with that schedule.

Ideally VFS is the last procedure under general anesthetic as intubation can damage the results of VFS, even with an experienced anesthetist

BA and BBL should probably not be done at the same time as during recovery you're supposed to lie on your back/front respectivly.

Facial Team

Scars

reddit

  • 30 plus years on hormones. What effects did I notice? in 2018 - "The scars on my vulva faded away after more than 10 years. 28 years post-op you couldn’t find them if you searched for it. I still dilate once a month. The estrogens help to keep the tissue elastic. For the early era Biber did a great job."

Papers

Pediatric Pearls, Clinical Practice, Vitamin E for treating children’s scars, Does it help reduce scarring? - "ANSWER. Vitamin E is the main lipid-soluble antioxidant in the skin. Several anecdotal reports have suggested that topical use of vitamin E cream can reduce scar formation. Current evidence from the literature, however, does not support that proposition. In fact, studies report some adverse effects with use of vitamin E. Further research is needed before application of vitamin E cream becomes the standard of care."

Loss of Sensation

https://www.hotoctopuss.com/guest-post-leandra-vane-on-orgasm-hunting-with-nerve-damage/ - "I was born with nerve damage. I grew up in a body that was mostly numb, and when I was 24 years old, I had a spine surgery after which I lost even more sensation. Today, I don’t have feeling in over half of my body. But I still love having orgasms." by Leandra Vane in 2018

Other

reddit

YouTube

  • Management of post vaginoplasty prolapse in transgender patientPOP by Prof. Palma in 2019 - "This is a case of a transgender female that presented prolapse after 14 years after surgery for gender confirmation. The glans penis prolapsed on straining through the neovagina. Glandoplasty, corpus cavernosa ressection and proper fixation of the neovagina resulult in great satisfaction for "

Silicone Injections

Very dangerous. Have been used in face, breast, body.

fda

YouTube

Papers

CBS News

People

realself

University of California, San Francisco

Travel

reddit

  • reply to [PSA] Avoid Dubai & Abu Dhabi (and Emirates and Etihad Airways) by PennyLisa in 2019 - "Yeh... No don't go there. Even on a stop-over. Someone I know got detained in the airport for 24hrs due to being trans on the way for FFS in Spain when they were supposed to be there for 4 hours. They had to change the surgery dates because of it (facial team sorted it out in the end). "

Researching on Internet

I'lll add some information here about how to search for surgery information. TBA.

reddit

Making Useful Surgery Posts

If you're making a post on reddit or elsewhere it would help if you did these things

  • Give the name of the name of the surgeon, and if its someone who's not well known provide enough information that its easy to find them. I generally won't list them in this wiki without knowing who they are. If its on YouTube make it in the text so its easy to find without watching the entire video.
  • Photo posts on imgur should ideally have captions with the name of the surgeon, year of surgery, time post-op (days, weeks, etc), and any interesting points about the photo that the view should take note of. Not everyone will see the photo from a link on reddit. This post Hana's Recovery (up to 6 months) shows an example of captions, but who is the surgeon and what year was it? The year is important because an older photo may not be representative of the surgeons current skill or technique.
  • If you make multiple related posts add a link back to the older posts so that people can easily go back to them. Edit the posts in the older ones to refer forwards to the next. An index would be even better. Some people don't know how to use reddit and find related posts, and even if you do it can be very difficult after a few years and thousands of posts.
  • Let me know if you make or see a post that you think should be in the wiki - I don't find all of them by myself. I normally link posts that I think will be of interest to people researching a surgeon. Either send me a pm or add my reddit user name to the post somewhere - i.e. just type /u/HiddenStill/

Questions that tend to be of interest to others include

  • Pictures?
  • Who was the surgeon?
  • Why did you choose them?
  • Would you reccomend them to others?
  • What did it cost?
  • How long was the wait list?
  • How was the pain?
  • Any complications?
  • How does it look?
  • For SRS, what was your depth?
  • For SRS with surgeons that are not well known, how many surgeries have they done?
  • What would you like to have known before having surgery?

It can be helpful to know how to format posts on reddit to make it easier to read.

Here's a really good example of post of the above suggestions

If you make a very negative post about a surgeon on susans there's a good chance it will get removed.

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