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"Speaker 0: A phalloplasty is a procedure to basically create a penis or a phallus for an individual who was born biological female and who seeks transition to, a male, gender." "Speaker 0: The procedure is done with plastic surgeons and urologists." "Speaker 0: The urologists manipulate the tissues in the surrounding area to lengthen the urethra." "Speaker 0: A new scrotum is created and, some of the anatomical parts of, the female anatomy are removed." "Speaker 0: We typically utilize tissue from elsewhere." "Speaker 0: For example, the forearm or the thigh is used." "Speaker 0: The plastic surgeons are also responsible for, providing sensation by doing the nerve coaptation so that the new phallus will have sensation, and also responsible for reestablishing the blood supply, and also to shape it in a way that appears more physiologically and anatomically like a natural one."

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Speaker 1 had gynecomastia surgery because he was tired of worrying about what clothes to wear. During a follow-up appointment, he tells Dr. Duffer that one nipple seems to get more erect than the other and sticks out a little more. Dr. Duffer says that Speaker 1 looks really good and natural and that one side of his chest is firmer, possibly due to more scar tissue. Speaker 1 says he noticed tissue when he was 13 and it never went away with working out or dieting. He researched plastic surgeons and was nervous at first due to swelling, but the results were priceless. He doesn't have to obsess over what to wear anymore. Later, Speaker 1, who is Officer Sewell, offers the doctor and another person a ride to a gay bar. He then invites a cop to hang out with them later at the gay bar.

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Chest reconstruction is a procedure that we perform to patients who identify as non binary or transmasculine or interested in, having their breast removed and to reconstruct a more masculine appearance of their chest. Most of the times it includes a mastectomy, which is the medical term to describe a removal of the breast tissue, but also, building a more masculine appearance to the chest, eliminating the inframammary fold and reconstructing the nipples in a more masculine position and appearance.

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Dr. Potter is speaking with an unnamed doctor from United Healthcare to discuss a patient's breast reconstruction. Dr. Potter wants to understand why United is denying coverage for a procedure to preserve sensation, involving dissection of the fourth intercostal nerve and grafting it to dermatosensory elements on the nipple. Dr. Potter requests the evaluation and reasoning behind United's decision, including the data and literature they reviewed. The unnamed doctor states that they cannot provide their name due to security reasons and that the information Dr. Potter is requesting is an internal resource and cannot be emailed. Dr. Potter expresses concern that United is making a medical determination, questions how that process works, and states that recent data from 2023 and 2024 supports the procedure's effectiveness. Dr. Potter will file an internal appeal.

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Speaker 0: In the immediate recovery after chest reconstruction, the patients are going home the same day or the following day. In the majority of the cases, they go home with a drain in each breast pocket and they have some dressings. They also have a foam to cover their chest to help with reducing the swelling and the risk for bleeding and a surgical vest. The majority of the patients describe that their pain is between two to four out of 10, and most of them don't take any narcotics and need a few medications just to control the pain.

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I want to address why I’ve chosen not to get a mammogram. In nursing school, I learned not to deeply palpate a mass due to the risk of spreading infection or causing a cancerous mass to rupture and metastasize. It doesn’t make sense to compress a lump between plates, as that could lead to further issues. Research shows that people often die from metastasis rather than the primary tumor, and cancer treatments can cause metastasis. Additionally, I’m concerned about the radiation exposure from mammograms, as breast tissue is sensitive. I prefer to live a toxic-free lifestyle and remain hopeful, despite the rising cancer rates and reports of aggressive cancers. I encourage everyone to do their own research on this topic.

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I decided to have gynecomastia surgery because I was tired of worrying about my appearance. After the surgery, my chest is healing well, although one nipple is healing better than the other. I noticed some firmness on one side compared to the other, but overall, I look natural and feel great. I struggled with excess tissue since I was 13, and despite my efforts to work out and diet, it never went away. After researching surgeons, I took the plunge, and the results have been life-changing. I no longer obsess over what to wear, which has given me a sense of freedom. Later, we chatted with an officer while heading to a gay bar, and he gave us a warning but declined our invitation to join us.

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There is not one surgery that every transgender person wants. Many transgender people have no interest in having surgery. For other people, they undergo medical transition involving use of gender affirming hormone treatments. And for others, they may have one or more surgeries. They may have top surgery, which is surgery on the chest or breasts. They may have bottom surgery, surgery on the genitals. They may have facial feminization. Trans women may have a tracheal shave to reduce their Adam's apple. No two trans people have the same needs to resolve their gender dysphoria. So you can never make an assumption that any trans person wants any particular surgery or any surgery at all.

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For bottom surgery, hair removal is extremely important. For hair removal for a vaginoplasty, you can use laser. And because we're usually using penile inversion vaginoplasty, we need that hair to be removed because that's going to be the inside of the new lining of the cavity. Not only do we not want hair in there, it also can cause a lot of complications. So we go through that with you before, and then we do many hair checks as well to make sure that you're on the right path.

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In this video, the speaker shares their top surgery results, which they had three years ago with Dr. Katharine Gast. They show their faded scars and mention that they don't do much scar care because they like how they look. The speaker emphasizes the importance of their decision to have top surgery at 16, which involved removing excess chest tissue and masculinizing the shape.

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A gender affirming hysterectomy is very similar to most hysterectomies that occur. Hysterectomy itself is the removal of the uterus, the cervix, which is the opening of the uterus, and the fallopian tubes, which are attached to the sides of the uterus. Some gender affirming hysterectomies will also include the removal of the ovaries, but that's technically a separate procedure called a bilateral oophorectomy. And not every gender affirming hysterectomy includes that, and people who are getting gender affirming hysterectomies do not have to have their ovaries removed.

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Transitioning carries risks, including potential sterility, loss of breastfeeding ability, and changes in sexual function. It may also impact bone health and height. Despite these risks, the most crucial aspect is to accept and love your child for who they are, regardless of their gender identity.

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"The eligibility for getting gender affirming surgeries at Boston Children's Hospital is basically the same as it would be for most other hospitals or surgeons in The United States." "And that's the case because we all follow the World Professional Association for Transgender Health or WPATH standards of care." "For top surgery, you are requested, but not required to have been on gender affirming hormones for at least a year." "If you're a trans woman, it's really encouraged that you be on estrogen for at least a year because you want to maximize your natural breast growth." "Many surgical centers require you to be 18." "At Boston Children's Hospital for top surgeries, we'll see people as young as age 15 if they've been affirmed in their gender for a long period of time and don't really have any other life complications that make surgery inappropriate."

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Dr. Potter is speaking with an unnamed doctor at United Healthcare to discuss a patient's breast reconstruction. Dr. Potter wants to understand why the procedure is not covered, particularly the nerve graft to preserve sensation, stating it's the patient's only chance. Dr. Potter requests the evaluation and reasoning behind United's decision, including the literature reviewed. The unnamed doctor cannot provide their name or email the information, citing security and internal resource policies. Dr. Potter expresses concern that United is making a medical determination, not just a coverage decision. Dr. Potter cites data from 2023 and 2024 supporting the procedure's effectiveness and wants to see the data United is using to deny coverage. Dr. Potter will file an internal appeal.

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Gender affirming hysterectomy is similar to a regular hysterectomy, involving the removal of the uterus, cervix, and fallopian tubes. Sometimes, the ovaries are also removed in a separate procedure called bilateral oophorectomy, but this is not always necessary for gender affirming hysterectomies. People undergoing this surgery do not have to have their ovaries removed.

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Mammograms can produce cancer because they involve squashing the breasts, which are very sensitive. This squashing causes pain, which indicates inflammation. Inflammation involves increased blood flow and leaking blood vessels to bring in white blood cells and oxygen. The signs of inflammation are that the area is red, hot, painful, and swollen. Mammograms irradiate inflamed, acutely injured tissue with ionizing radiation. This process is not done with prostates or testicles, only breasts. The speaker believes this is a male-dominated madness.

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Binding is essentially when someone who's assigned female wears something on their chest to make it appear flatter. And a lot of my patients who identify as transgender male or non binary or male leaning like to do that. The top three tips I have for safe binding are to first make sure you're measuring correctly. And sometimes it might take the assistance of like a parent or a trusted friend to do it right. Second, making sure that you're buying not only the correct size for your chest measurements, but for your shoulder measurements too. Cause a lot of people make mistakes there. And then the third tip is definitely not wearing it for more than ten hours a day.

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This boy just had top surgery, and I want to share our journey. After the surgery, I was called to the Recovery Room. The surgeon was working on him, and there was a lot of blood coming from his scars. They informed me that they needed to take him back for more surgery because a blood vessel had popped. Unfortunately, we lost his right armpit hair during the process, but the left one remained untouched.

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Speaker 0 confirms that the person is currently taking 6 milligrams of estrogen per day. Speaker 1 clarifies that they take it twice a day. Speaker 0 reviews the person's history and asks about the surgery they are seeking. They discuss the irreversible effects of estrogen therapy, such as breast development and shrinkage of the testicles. Speaker 0 mentions that hair growth and redistribution may be affected by estrogen. Speaker 1 mentions that they are not complaining about taking daily pills, but rather wondering if it accelerates the process. The conversation ends.

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- "Vaginoplasty is a relatively big procedure." - "It takes about between four to six hours in the Operating Room and therefore there is some swelling involved, there's some pain involved." - "But most of the times we actually administer epidural anesthesia as well, which helps a lot with the pain management for the patient." - "A very big component of the vaginoplasty procedure is the post op care." - "Seven to ten days after the procedure, the patient is required to start doing dilations." - "In the dilations, they are using different sizes of dilators gradually, and they need to do that several times a day for minutes a day." - "The reason for that is because otherwise the cavity will not be maintained and the old reconstruction can be lost."

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Breast augmentation for transfeminine patients is augmenting or increasing the volume of the breast tissue. And when we do that, we're trying to reconstruct a more feminine appearance to the chest. We typically do that with silicone implants that can either sit under the muscle or under the breast tissue itself. To the majority of the patients, they have this surgery several years after being on estrogen because estrogen itself can cause a building of breast tissue. It's very typical that we will need to increase the distance between the nipple to the fold underneath the breast and we are able to do that in the same procedure as well.

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Karen Selva, pediatric endocrinologist and medical director of Randall Children's Hospital T Clinic, discusses puberty blockers for transgender and gender expansive youth. Puberty blockers work at the level of the pituitary gland and they actually suppress the release of the LH and the FSH so that the sex organs are no longer stimulated; The signs are blocked and don't progress. The main benefit is that they prevent the unwanted permanent effects of puberty, and thus future surgeries can be avoided as an adult. We can prevent chest reconstruction in affirm trans males or facial feminization surgery in transfemales. They are reversible; if stopped, endogenous puberty resumes. They can alleviate depression or worsening gender dysphoria. The Pediatric Endocrine Society recommends puberty suppression in clinical guidelines for transgender and gender diverse youth. The practice is new; first guidelines were published in 02/2009, and long-term data are not yet available.

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Dr. Potter is speaking with an unnamed doctor from United Healthcare to discuss a patient's breast reconstruction. Dr. Potter wants to understand why United is denying coverage for a procedure to preserve sensation, involving dissecting the fourth intercostal nerve and grafting it to dermatosensory elements on the nipple. Dr. Potter requests the evaluation and reasoning behind United's decision, wanting to review the data and references used, but is told it's an internal resource and cannot be emailed. Dr. Potter cites data from 2023 and 2024 supporting the procedure's effectiveness and emphasizes that this is the patient's only chance for sensation preservation. Dr. Potter expresses concern that United is practicing medicine by making medical determinations and states they will file an internal appeal. Dr. Potter voices frustration at not being able to speak with the United doctor as a peer.

Genius Life

Breast Implant Illness and Explant Surgery Explained - Dr. Robert Whitfield
Guests: Robert Whitfield
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Breast implant illness (BII) is characterized by a range of symptoms including neurological issues like brain fog, ENT problems, muscle and joint pain, gastrointestinal disturbances, and reproductive tract symptoms. Chronic inflammation is a key component, with implants contributing to this condition. In 2016, a case involving a cancer patient revealed an E. coli infection around an implant, leading to increased awareness of BII. Recent studies indicate a 29% incidence of bacterial contamination in scar capsules from implants. Detoxification ability varies among individuals, and those with poor detoxification may be more susceptible to BII. Factors like genetics, lifestyle, and environmental exposures contribute to chronic inflammation. Explant surgery, which involves removing both the implant and the surrounding capsule, is often necessary for symptom relief, as leaving the capsule can retain biofilm and bacteria. Fat transfer is considered a safer reconstruction option compared to implants, as it uses the patient's own tissue. The size and texture of implants do not significantly correlate with BII symptoms; rather, bacterial contamination is a more critical factor. Patients often experience symptoms years after implantation, complicating diagnosis. Maintaining breast health involves avoiding processed foods, managing oral health, and ensuring quality sleep. The relationship between implants and breast cancer remains unproven, and while BII is gaining recognition, a formal diagnosis code does not exist. Education and informed decision-making are essential for those considering implants.

Mind Pump Show

Grow Your Lagging Body Parts with this Method | Mind Pump 2319
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If you've been strength training for a while and have a lagging body part, consider going lighter instead of heavier. This approach helps improve the connection to the specific muscle that isn't developing as quickly. For example, if your chest is lagging while your shoulders and triceps are strong, focus on lighter weights and slow down to feel the chest engage during exercises like the bench press. Incorporating isometric holds at both the stretch and squeeze positions can enhance muscle recruitment. Many people overlook the neurological aspect of strength training, focusing solely on movement and load. However, the central nervous system plays a crucial role in muscle activation. Clients may perform exercises correctly but still fail to feel the targeted muscle working due to improper movement patterns. As you progress in training, it's essential to adjust your approach to ensure that lagging muscles are adequately engaged. For instance, if squats primarily develop your quads without engaging your glutes, reduce the weight and focus on connecting with the glutes during the movement. This may require a temporary decrease in load to retrain your body to recruit the correct muscles effectively. When working with clients who have been lifting for years, it can be challenging to shift their ingrained movement patterns. They may need to unlearn inefficient techniques that have become habitual. This is similar to learning to type correctly after years of using only a few fingers; initially, it may feel slower, but it ultimately leads to better results. Incorporating lighter weights and focusing on proper muscle engagement can lead to improved development in lagging body parts. This strategy is often more effective than simply increasing weight, which can reinforce existing movement patterns that do not target the desired muscles. Additionally, when training clients with breast implants, it's important to avoid heavy pressing movements that could shift the implants. Instead, focus on shoulder mobility and upper back strength to prevent issues like frozen shoulder. After explant surgery, prioritize shoulder and scapular mobility to aid recovery and prevent complications. Using peptides may also help with healing and scar tissue management post-surgery.
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