Gender Affirmation by Christopher Salgado Miroslav Djordjevic

Author:Christopher Salgado,Miroslav Djordjevic
Language: eng
Format: epub
Publisher: Thieme Medical Publishing Inc.
Published: 2017-03-08T16:00:00+00:00

Fig. 9-3 ALT phalloplasty with one-stage urethral reconstruction before glansplasty.

Fig. 9-4 Six months after glansplasty in a patient receiving ALT phalloplasty.

Fig. 9-5 A, ALT flap donor-site scar with the implanted tissue expander. B, Perioperatively, excision of the skin graft scar and advancement of expanded tissue. C, Postoperatively, excision of 50% of the skin graft scar and advancement of expanded tissue.

This 31-year-old FTM patient (Fig. 9-5) had right ALT phalloplasty. The patient disliked the appearance of his donor-site scar and was self-conscious wearing shorts above the knee. Approximately 3 years after his ALT phalloplasty, he desired tissue expansion and removal of as much skin graft scar as possible. His insurance only covered one 800 cc tissue expander, which was placed lateral to the skin graft scar. Intraoperatively the expander was filled to 250 cc and over the next 9 weeks was expanded to 850 cc of normal saline solution. On return, approximately 50% of his skin graft was removed, and his expanded skin was advanced over the defect. He will likely pursue additional expansion at a later date.

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