This gender affirmation patient contacted Dr. Medalie for a top surgery procedure. He was scheduled for a peri-areolar incision double mastectomy. The procedure was performed through a keyhole incision and the patient is shown 6 months post op. He is very pleased with his FtM top surgery results.
This pleaseant 51 year old came to see Dr. Medalie in his Beachwood office. She complained of difficulty with exercise and sexual activity due to the large size of her inner labia and desired vaginal rejuvenation by reducing her labia minora . She underwent the labiaplasty and clitoral hood reduction under local anesthesia and mild oral sedation at Dr. Medalie’s Beachwood office, and the pictures show her three month after her vagina rejuvenation surgery. She has excellent reduction in the size of her labia minora with no protrusion of the labial tissue beyond the labia majora. Her clitoral hood is also more streamlined with less central excess. She is very pleased with her outcome.
Dr. Medalie of Cleveland Plastic Surgery is an expert in labia minora reduction and vagina rejuvenation. He also performs clitoral hood reduction and fat injection to the labia majora. He has presented his techniques and results at national meetings and in book chapters. His labiaplasty and vaginoplasty patients travel from all over Ohio, the midwest and east coast. Please visit his photo gallery to see examples of his work!
Labiaplasty for central hypertrophy. Before and three months after the labial reduction procedure.
This pleaseant 49 year old came to see Dr. Medalie in his Beachwood office. She complained of difficulty with exercise and sexual activity due to the large size of her inner labia and desired vaginal rejuvenation by reducing her labia minora . She underwent the labiaplasty and clitoral hood reduction under local anesthesia and mild oral sedation at Dr. Medalie’s Beachwood office, and the pictures show her three month after her vagina rejuvenation surgery. She has excellent reduction in the size of her labia minora with no protrusion of the labial tissue beyond the labia majora. Her clitoral hood is also more streamlined with less central excess. She is very pleased with her outcome.
Dr. Medalie of Cleveland Plastic Surgery is an expert in labia minora reduction and vagina rejuvenation. He also performs clitoral hood reduction and fat injection to the labia majora. He has presented his techniques and results at national meetings and in book chapters. His labiaplasty and vaginoplasty patients travel from all over Ohio, the midwest and east coast. Please visit his photo gallery to see examples of his work!
This 30 year old patient came to see Dr. Medalie at his Beachwood, Ohio clinic to discuss mommy makeover surgery. She elected to have a full abdominoplasty (also known as a tummy tuck) with liposuction of the abdomen, flanks and sides as well as a full breast lift (also known as a mastopexy). She also had excess tissue in the armpit region (axillary ectopic breast tissue) which she wanted to be removed. The surgery was performed as an outpatient and the patient is shown 9 months after her body contouring procedure. She is extremely happy with her new abdominal contour and her rounder and perkier breasts. Her armpit region is also much smoother with minimal bulging. Below is information from the American Society of Plastic Surgery. Plastic Surgery results can vary
The goal of a mommy makeover is to restore the shape and appearance of a woman’s body after childbearing. Many women notice changes in their bodies post-pregnancy. There are many areas of the body that can be addressed, most commonly the breasts, abdomen, waist, genitalia and buttocks. A mommy makeover is typically performed as a single stage procedure. There are many techniques used to perform a mommy makeover, and many factors should be taken into consideration when choosing which techniques are best:
This pleasant 28 year old trans man came to see Dr. Medalie in regards to FtM “top surgery”. He had too much tissue for the peri-areolar approach and was scheduled for a double incision mastectomy with free nipple grafting and chest contouring by limited liposuction. His gender confirming surgery was performed as an outpatient and took approximately 90 minutes to perform. In his after picture he is shown 1 year post DI and is very pleased with his contour. He also has had good hair growth from testosterone therapy. *Results may vary
Below I have attached some information from my main web page that discussed the surgical options for top surgery. Here is a link to that page:
The procedure is based on the following:
PERI: In general, patients who have smaller breasts can have the entire surgery performed by having a small incision at the outer edge of the areola from 12:00 to 6:00 o’clock. A lighted retractor and surgical scissors are used to perform a complete sub-cutaneous mastectomy. Liposuction of the chest is also performed as needed.This provides the most optimal results and can be almost invisible after it heals. If the skin appears a little looser at the start of the case then a complete peri-areolar incision is made. A small amount of skin is removed (in a doughnut pattern , also known as-“peri-areolar or “purse-string” mastopexy”). A subcutaneous mastectomy is performed and then the outer edge of the skin is closed with a purse-string to the newly down-sized areola. By necessity, the edges of the incision around the nipple will be “scalloped” or bunched up initially. This settles down to a great degree over time. If the patient understands that scar revision may be necessary, this is a very reasonable approach. The nipple may experience compromise of its blood supply and also have sensation or erectile capacity changes.
Double Incision: In those patients with a large amount of breast tissue with excessive skin of poor quality and droop, it is usually recommend to remove the excess skin and breast tissue in the crease of the pectoralis muscles (elliptical or double incision mastectomy) and put the nipples and areolae back on as grafts. This surgery has the advantage of immediate and predictable results. I can contour the skin flaps and place the nipples where I want to. It has the disadvantage of permanently altering the sensation and erectile capacity of the nipples (and sometimes the pigmentation), and it leaves larger scars on the chest. Over time they fade and flatten out. At each end of the scar, “dog-ears” may form. These are small bunches of tissue created by the closing of the ellipse as a straight line. They tend to settle down over time, but may need to be revised. I always try and address the dog ears at the time of surgery but this may extend the length of the scar. Dog ears are more likely in patients who are heavier and have more tissue to start with. I always perform liposuction of the central and lateral chest (to flatten the dog ears) as well as the area in front of the armpit. I have been asked why a scar may meet in the center of the chest on some top surgery results but not on others. This is dependent on pre-existing anatomy. If the tissue meets in the middle (such as in the example right below) then the scar by necessity will meet in the middle (this can’t be seen in the example because of the patient’s chest hair.)
FtM DI top surgery and body contouring for gender affirmation
Before Top Surgery and lower abdominoplasty After Top Surgery and lower abdominoplasty
This pleasant 27 year old trans man came to see Dr. Medalie in regards to FtM “top surgery”. He had too much loose skin for the peri-areolar approach and was scheduled for a double incision mastectomy with free nipple grafting and chest contouring by limited liposuction. He was also interested in contouring his lower abdomen and decided on a lower abdominoplasty with liposuction. His gender confirming surgery was performed as an outpatient and took approximately 2 hours to perform. In his after picture he is shown 1 year post DI and body contouring and is very pleased with his contour. He has begun an extensive work out regimen and in combination with his lower abdominoplasty and testosterone, his newly contoured body demonstrates excellent musculature and chest contour.*Results may vary
Below I have attached some information from my main web page that discussed the surgical options for top surgery. Here is a link to that page:
The procedure is based on the following:
PERI: In general, patients who have smaller breasts can have the entire surgery performed by having a small incision at the outer edge of the areola from 12:00 to 6:00 o’clock. A lighted retractor and surgical scissors are used to perform a complete sub-cutaneous mastectomy. Liposuction of the chest is also performed as needed.This provides the most optimal results and can be almost invisible after it heals. If the skin appears a little looser at the start of the case then a complete peri-areolar incision is made. A small amount of skin is removed (in a doughnut pattern , also known as-“peri-areolar or “purse-string” mastopexy”). A subcutaneous mastectomy is performed and then the outer edge of the skin is closed with a purse-string to the newly down-sized areola. By necessity, the edges of the incision around the nipple will be “scalloped” or bunched up initially. This settles down to a great degree over time. If the patient understands that scar revision may be necessary, this is a very reasonable approach. The nipple may experience compromise of its blood supply and also have sensation or erectile capacity changes.
Double Incision: In those patients with a large amount of breast tissue with excessive skin of poor quality and droop, it is usually recommend to remove the excess skin and breast tissue in the crease of the pectoralis muscles (elliptical or double incision mastectomy) and put the nipples and areolae back on as grafts. This surgery has the advantage of immediate and predictable results. I can contour the skin flaps and place the nipples where I want to. It has the disadvantage of permanently altering the sensation and erectile capacity of the nipples (and sometimes the pigmentation), and it leaves larger scars on the chest. Over time they fade and flatten out. At each end of the scar, “dog-ears” may form. These are small bunches of tissue created by the closing of the ellipse as a straight line. They tend to settle down over time, but may need to be revised. I always try and address the dog ears at the time of surgery but this may extend the length of the scar. Dog ears are more likely in patients who are heavier and have more tissue to start with. I always perform liposuction of the central and lateral chest (to flatten the dog ears) as well as the area in front of the armpit. I have been asked why a scar may meet in the center of the chest on some top surgery results but not on others. This is dependent on pre-existing anatomy. If the tissue meets in the middle (such as in the example right below) then the scar by necessity will meet in the middle (this can’t be seen in the example because of the patient’s chest hair.)
Before After
Before After
This patient came to see Dr. Medalie complaining of severe gynecomastia and lateral excess skin and fatty tissue as well as excess skin of the abdomen. He had lost a great deal of weight and was concerned about the displaced nipple/areolar complex, excess breast tissue and lateral excess skin and fatty tissue. His male breast reduction surgery was performed on an outpatient basis.He had a complete double mastectomy with nipple areolar reconstruction by grafting and side and chest liposuction. His incisions were extended quite far on his sides in order to remove the excess lateral skin as well. The patient is shown 4 months after his procedure. His chest contour is much improved and his nipples are smaller and in a better position. His abdomen is much tighter ands the excess lower skin is gone. He is working out and lifting weights and has excellent body aesthetics from his body contouring procedure.He is extremely pleased with his outcome. The tattoos are temporary to see how they would look in the future.*Plastic Surgery results are not guaranteed
Below is information provided by the American Society of Plastic Surgery:
Gynecomastia surgery reduces breast size in men, flattening and enhancing the chest contours.
In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.
Plastic surgery to correct gynecomastia is technically called reduction mammaplasty.
Gynecomastia is a condition of overdeveloped or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity or the use of certain drugs.
Gynecomastia can cause emotional discomfort and impair your self-confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.
Gynecomastia is characterized by:
A male breast reduction procedure includes the following steps:
Medications are administered for your comfort during the surgical procedures. The options include intravenous sedation and general anesthesia. Your doctor will recommend the best option for you.
In cases where the chest tissue is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions.
The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.
There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference. I find that almost always a patient will need a small incision to remove glandular tissue under the nipple. I try to make the incision at the areolar skin junction on the lateral border of the areola from 6-12 o’clock.
Sometimes gynecomastia is treated with both liposuction and excision. This is the case in the example above when there is both excess fatty tissue and glandular tissue present.
A tummy tuck procedure includes the following steps:
Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and belly button.
The shape and length of the incision will be determined by the amount of excess skin. Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired.
A second incision around the navel may be necessary to remove excess skin in the upper abdomen.
The upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position.
Sutures, skin adhesives, tapes or clips close the skin incisions.
Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Get more information about tummy tuck results.
Liposuction of flanks Before picture
Liposuction of flanks After picture
This cosmetic surgery patient desired body contouring by liposuction. She discussed treatment of her flanks, sides and abdomen with Dr. Medalie at his Beachwood office. Surgery was performed and 4 liters of fatty tissue was removed from her flanks, sides and abdomen in an outpatient surgery at the Brainard Surgery Center. Her post-operative results were excellent and she was very happy with her new contour after her body contouring procedure.
*Plastic Surgery results can vary from patient to patient and are not guaranteed
The liposuction procedure includes the following steps:
Medications are administered for your comfort during the surgical procedure. The choices include local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Liposuction is performed through small, inconspicuous incisions.
First, diluted local anesthesia is infused to reduce bleeding and trauma. Then a thin hollow tube, or cannula, is inserted through the incisions to loosen excess fat using a controlled back and forth motion. The dislodged fat is then suctioned out of the body using a surgical vacuum or syringe attached to the cannula.
Your improved body contour will be apparent once the swelling and fluid retention commonly experienced following liposuction subside. Get more information about liposuction results.
This 29 year old patient from Cleveland, Ohio came to see Dr. Daniel A. Medalie of Cleveland Plastic Surgery at his Beachwood office to discuss a mommy makeover by tummy tuck surgery and liposuction as well as breast enhancement. She had two pregnancies and also lost around 75 lbs. She is 5’5″ and 145 lbs . On exam she has a great deal of loose skin and muscle of the abdomen as well as some extra fatty tissue. Dr. Medalie proposed an abdominoplasty procedure with muscle plication (tightening) and side and flank liposuction as an outpatient. She agreed and is shown 3 months after her body contouring surgery. She also desired bilateral breast augmentation to help correct her deflated breast appearance. She chose 405 cc silicone implants to be placed in a dual plane technique. In her post op photos, she has excellent reduction of loose skin and stretch marks as well as good tightening of the abdominal wall and is very happy with her body contouring results. Her breasts are fuller and more symmetric and complement her new abdomen.
The goal of a mommy makeover is to restore the shape and appearance of a woman’s body after childbearing. Many women notice changes in their bodies post-pregnancy. There are many areas of the body that can be addressed, most commonly the breasts, abdomen, waist, genitalia, and buttocks. A mommy makeover is typically performed as a single stage procedure. There are many techniques used to perform a mommy makeover, and many factors should be taken into consideration when choosing which techniques are best:
Abdominoplasty
Liposuction
Breast Augmentation
Breast Lift
Vaginoplasty
Labiaplasty
Thigh Lift
Arm Lift
This 36 year old patient from Cleveland, Ohio came to see Dr. Daniel A. Medalie of Cleveland Plastic Surgery at his Beachwood office to discuss a mommy makeover by tummy tuck surgery and liposuction as well as breast enhancement. On exam she has a great deal of loose skin and muscle of the abdomen as well as some extra fatty tissue. Dr. Medalie proposed an abdominoplasty procedure with muscle plication (tightening) and side and flank liposuction as an outpatient. She agreed and is shown 6 months after her body contouring surgery. She also desired a breast lift on the right side with more volume on the left to match the right. She underwent a full right breast lift (mastopexy) and a small silicone breast implant on the left. She has excellent reduction of loose skin and stretch marks as well as good tightening of the abdominal wall and is very happy with her body contouring results. Her breasts are much more symmetric and complement her new abdomen.
The goal of a mommy makeover is to restore the shape and appearance of a woman’s body after childbearing. Many women notice changes in their bodies post-pregnancy. There are many areas of the body that can be addressed, most commonly the breasts, abdomen, waist, genitalia, and buttocks. A mommy makeover is typically performed as a single stage procedure. There are many techniques used to perform a mommy makeover, and many factors should be taken into consideration when choosing which techniques are best:
Abdominoplasty
Liposuction
Breast Augmentation
Breast Lift
Vaginoplasty
Labiaplasty
Thigh Lift
Arm Lift
