Dr. Gabriel Del Corral, MD, FACS is a double board-certified plastic and reconstructive surgeon who specializes in gender-affirming procedures at the MedStar Center for Gender Affirmation in Washington D.C. and Baltimore, Maryland. Dr. Del Corral’s latest research focuses on advancing surgical techniques and improving outcomes in gender-affirming vaginoplasty, facial and chest surgeries.
Latest Research
Vaginoplasty
A comparative analysis of peritoneal flap and intestinal vaginoplasty for management of vaginal stenosis.
Lava CX, Berger LE, Li KR, et al. J Plast Reconstr Aesthet Surg. 2024;98:55-63.
This study looked at two surgical options—peritoneal flap vaginoplasty (PFV) and intestinal segment vaginoplasty (ISV)—for transgender or non-binary patients who had complications after an earlier surgery called penile inversion vaginoplasty (PIV). The focus was on restoring vaginal depth and function in patients with vaginal narrowing (stenosis). Overall, while both surgeries had similar short-term complications, ISV showed a lower rate of recurring vaginal narrowing. This information can help guide decisions on which surgery to choose for future patients.
The robotic-assisted free jejunal flap for neovaginal canal creation in gender-affirming vaginoplasties.
Del Corral GA, Chang BL, Lava CX, Li KR, Lisle DM. Microsurgery. 2024;44(5):e31202.
A major challenge in gender-affirming vaginoplasty is creating a vagina that is long-lasting, self-lubricating, and allows for comfortable sexual intercourse. The jejunum, part of the small intestine, was suggested as a good option because it can reduce some complications associated with other surgical methods. The study involved six transgender women, with an average age of about 36 years. The surgery was robotic-assisted, and involved creating the vagina using a segment of jejunum. After about 8 months of follow-up, the average depth of the new vagina was 7 cm, with a diameter of 1.3 cm. Two patients experienced complications: one had a hematoma (a collection of blood) and another needed additional surgery to fix an issue with the flap.
Minimizing opioid consumption by eliminating patient-controlled analgesia after penile inversion vaginoplasty with enhanced recovery after surgery (ERAS) protocol. [FULL TEXT]
Tirrell AR, Abu El Hawa AA, Bekeny JC, Fan KL, Del Corral G. Andrology. 2022;10(2):232-240.
This study looked at pain management after penile inversion vaginoplasty (PIV). It focused on comparing two methods of pain control: intravenous patient-controlled analgesia (PCA), where patients can self-administer pain relief, and non-PCA (NCA) methods, which use different pain management strategies. The study concluded that using NCA pain management protocols can significantly reduce opioid consumption and shorten hospital stays after PIV, benefiting patients’ overall well-being.
A Novel Application of Magnetic Resonance Imaging to Surgical Planning of Penile Inversion Vaginoplasty. [FULL TEXT]
Abu El Hawa AA, Orra S, Bekeny JC, Dekker PK, Georges NP, Del Corral G. Plast Reconstr Surg Glob Open. 2021;9(8):e3733.
This study focused on transfeminine patients who often need additional surgeries after vaginoplasty because they are unhappy with the depth of their new vagina. Researchers aimed to see how using magnetic resonance imaging (MRI) before surgery could help set realistic expectations for patients and improve surgical planning. Unlike traditional methods, MRI gives a more accurate measurement of vaginal depth. The authors suggest that future research should involve more patients and examine how preoperative imaging affects patient satisfaction and surgical outcomes.
Top Surgery
Perioperative Patient-Initiated Communication in Gender-Affirming Mastectomy. [FULL TEXT]
Lava CX, Snee IA, Li KR, et al. J Clin Med. 2024;13(12):3368.
This study looked at how often transgender and non-binary (TGNB) patients undergoing gender-affirming Top Surgery reach out for help or information before and after their surgery. Researchers found that common reasons for reaching out included administrative issues, preoperative requirements, costs, and wound care after surgery. Older patients and those with a history of anxiety or depression tended to communicate more frequently. Patients who didn’t have postoperative drains also reached out more often.
Utility of Negative Pressure Wound Therapy: Raising the Bar in Chest Masculinization Surgery. [FULL TEXT]
Abu El Hawa AA, Dekker PK, Mizher R, Orra S, Fan KL, Del Corral G. Plast Reconstr Surg Glob Open. 2022;10(2):e4096.
This study looks at the benefits of using negative pressure wound therapy (NPWT) in 131 patients who had chest masculinization surgery with free nipple grafting (FNG). The researchers compared those who received NPWT after surgery to those who received standard wound care (SWC). The group using NPWT had significantly fewer complications (18%) compared to the standard care group (42%). More specifically, there were lower rates of nipple graft loss (12.5% vs. 24.7%), fewer cases of fluid buildup (seromas) (1.4% vs. 7.9%), and reduced nipple color changes (8.3% vs. 18.9%). Patients using NPWT also had their drainage tubes removed sooner (7 days vs. 9 days).
Analysis of Chest Masculinization Surgery Results in Female-to-Male Transgender Patients: Demonstrating High Satisfaction beyond Aesthetic Outcomes Using Advanced Linguistic Analyzer Technology and Social Media. [FULL TEXT]
Black CK, Fan KL, Economides JM, Camden RC, Del Corral GA. Plast Reconstr Surg Glob Open. 2020;8(1):e2356.
This study looked at how satisfied patients are after subcutaneous mastectomy for chest masculinization, focusing on social media posts and comparisons to plastic surgeons’ assessments of the results. Researchers analyzed 50 images of postoperative results from Instagram, along with the accompanying comments. They used a tool to measure the level of joy expressed in these posts, and three plastic surgeons rated the aesthetic quality of the surgeries. Overall, the study indicated that while patients are generally satisfied and supported by their community, there is a significant gap between their happiness and the surgeons’ ratings of the surgical outcomes. This suggests that while patients find meaning in their results, there is room for improvement in surgical techniques to enhance both appearance and satisfaction.
Facial Feminization
Applications of three-dimensional surgical planning in facial feminization surgery: A systematic review.
Escandón JM, Morrison CS, Langstein HN, Ciudad P, Del Corral G, Manrique OJ. J Plast Reconstr Aesthet Surg. 2022;75(7):e1-e14.
This study examined the use of three-dimensional (3D) technology in facial feminization surgery (FFS) to see if it improves safety, efficiency, and accuracy. Researchers reviewed existing studies that reported on 3D surgical planning in FFS, analyzing data from various sources. The conclusion suggests that 3D technology in surgical planning shows promising results, but more studies are needed to fully understand its benefits.
Breast Augmentation
Breast augmentation in the transgender patient: narrative review of current techniques and complications. [FULL TEXT]
Bekeny JC, Zolper EG, Manrique OJ, Fan KL, Del Corral G. Ann Transl Med. 2021;9(7):611.
The review aims to equip healthcare providers with the knowledge to deliver high-quality breast augmentation care for transgender women, with the expectation that practices will continue to improve as more research becomes available.
Outcomes in chest feminization patients with a history of illicit hormone use and silicone injections.
Tirrell AR, Abu El Hawa A, Bekeny JC, Del Corral G. The Breast Journal. 2021;27(4):352-358.
This study looked at transfeminine patients who had undergone illegal feminization procedures, like using unregulated hormones and silicone injections, before getting breast augmentation surgery. These illicit treatments can cause complications and concerns for surgeons. The researchers found that most patients who used silicone injections were asymptomatic, but two did have symptoms related to the injections. They also determined that most of the patients who had undergone illicit treatments still successfully received surgical procedures, including breast augmentations and reductions. Only one patient experienced a complication, which healed on its own.
Breast augmentation for transfeminine patients: methods, complications, and outcomes. [FULL TEXT]
Bekeny JC, Zolper EG, Fan KL, Del Corral G. Gland Surg. 2020;9(3):788-796.
Breast augmentation for transgender women is similar to the procedure for cisgender women but requires special attention to anatomical differences to achieve the best results. The most common method involves using breast implants, as other options like fat grafting may not provide satisfactory outcomes. Complications from these surgeries are rare and comparable to those experienced by cisgender women.
