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FTM Phalloplasty » Surgeons

Dr. Christopher Salgado

Experienced Phalloplasty Surgeon in Florida

Dr. Christopher Salgado, MD is a board-certified plastic surgeon in Miami who has more than a decade of experience performing Phalloplasty surgery. Dr. Salgado has committed his career to gender-affirming surgery and transgender people represent more than 3/4 of the patients he sees in his practice. After many years or working in an academic setting, Dr. Salgado launched his private practice, Constructive Surgery, in 2019. All of Dr. Salgado's staff have completed comprehensive training in trans surgical care and follow WPATH guidelines.

Dr. Salgado performs RFF, ALT, and MLD Phalloplasty. His Phalloplasty technique is unique in the United States, as he uses urethral prelamination. The first stage involves Hysterectomy (if required) and Vaginectomy (only required if urethral lengthening is also to be performed.) Vaginal lining (or tissue from the mouth or uterus) is harvested and used to form the penile urethra, which is tubularized around a catheter and placed in the donor site. This urethral prelamination with mucosal tissue may reduce urethral complications.

"Our goal was to decrease urinary fistulas and urethral strictures with our modification of technique. Our operative fistula rate was 14% and urethral stricture rate was 19%. The fistula rate is smaller than previously published. Urethral strictures were not uncommon in this series with a rate of 19% of which three of four cases were managed conservatively with dilation only. Although there have not been any blinded, randomized controlled trials comparing single-stage to two-stage phalloplasty, we believe that prelamination using vaginal mucosa for the construction of the transmale phallus urethra is a worthwhile technique that has demonstrated a reduction in the prevalence of complications with this already very challenging procedure."2

Additionally, Dr. Salgado's technique uses a smaller radial forearm flap than what is used in a tube-within-a-tube RFF Phalloplasty, and because the urethra isn't made from hair bearing skin, hair removal isn't required (though some may choose to have hair removal on their donor site for cosmetic reasons.)

Stage 2 takes place three months later. During this stage, the phallus is created from the donor site tissue and transferred to the groin. To further support the point of urethral connection, Dr. Salgado incorporates a gracilis muscle flap. If desired, he can also use the gracilis to augment the scrotum, avoiding the use of testicular implants. To provide sensation, Dr. Salgado connects the donor site nerves to the ilioinguinal or genitofemoral nerve and one of the dorsal clitoral nerves. (The exception to this is the MLD procedure, in which the dorsal clitoral nerve is not used.) Glansplasty is also done in this stage. Dr. Salgado uses the Norfolk technique, using either a skin graft or labial graft. Patients stay in hospital for 2-3 weeks after Stage 2. The use of Integra to improve the appearance of the donor site is optional (and adds an additional surgery.) To provide rigidity, Dr. Salgado uses either a penile implant or in some cases, as section of bone from the forearm.

Dr. Salgado is affiliated with Palmetto General Hospital and Coral Gables Hospital, in Miami, Florida. He also performs outpatient procedures at Sky Surgery Center in Miami.

Latest Phalloplasty Studies by Dr. Salgado:

1. Vaginal and reproductive organ preservation in trans men undergoing gender-affirming phalloplasty: technical considerations [FULL TEXT]
Christopher J Salgado, Kerstin Yu, and Maria J Lalama. J Surg Case Rep. 2021 Dec; 2021(12).
Preservation of the vaginal canal with reproductive organs is uncommon though becoming increasingly discussed in trans men. In cases where the vagina is preserved, the method with least complications is to maintain the native urethral orifice. Urethral lengthening requires modification of the anterior wall of the vagina, which may narrow the vaginal canal and risk urethral sequelae. In cases where the reproductive organs or vaginal canal with the cervix have been preserved, screening for cancer is best followed by both a urologist and gynecologist so that surveillance is adequately maintained by physicians knowledgeable of this particular anatomy.

2. Two-Stage Prelaminated Mucosal Neourethra Radial Forearm Flap Phalloplasty for Transgender Men [FULL TEXT]
Christopher J. Salgado MD, Ajani Nugent MD, Josef Hadeed MD, Maria Lalama BS, Jorge Rey MD & Carlos Medina MD. Global Journal of Medical Research: I Surgeries and Cardiovascular System, Volume 21, Issue 1, 2021.
A retrospective review of transmen patients from June 2016 to June 2018 was performed on patients undergoing a two- stage mucosa only prelaminated neourethra radial forearm flap phalloplasty. Using a two-stage approach for the construction of the transman phalloplasty, we have been able to show acceptable complication rates while accomplishing the goals in our surgical endeavor.

Education, Training and Experience:

  • Bachelors in Anatomy and Physiology, Boston University
  • Medical Degree and General Surgery training, Georgetown University in Washington D.C.
  • Plastic Surgery residency, University of Rochester
  • Fellowship in Microsurgery, I-Shou University, Taiwan
  • Served as a reconstructive surgeon in the U.S. Army for 4 years
  • Assistant Professor of Plastic Surgery at Cooper University Hospital in New Jersey, 2005-2007.
  • Assistant Professor of Surgery in Department of Plastic Surgery at Case Western Reserve University in Cleveland, 2008-2010.
  • Associate Professor of Surgery at the University of Miami, 2010-2013.
  • Professor of Surgery and Interim Chief of Division of Plastic Surgery at the University of Miami, 2013-2019.
  • Board-certified by the American Board of Plastic Surgeons and a member of the American Society of Plastic Surgeons.

Insurance
Dr. Salgado's staff are committed to helping patients get insurance coverage for their surgeries and will work on insurance authorization on your behalf. Dr. Salgado accepts Blue Cross Blue Shield, Florida Blue, United Healthcare, Cigna, Aetna, Molina, AvMed and Medicare.

Surgery Requirements

  • Two support letters from a qualified mental health professional.
  • Medical clearance if there are significant health issues.

Booking a Consultation
Dr. Salgado offers virtual and in-person consultations for a fee of $200. The wait time for a consult is 2 months, with surgery dates booked 4-8 months after consultation. To book your consult, please contact Dr. Salgado here. Se habla Español. Falando português.

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