Dr. Pang is a double board-certified plastic and reconstructive surgeon who performs gender-affirming genital, face and chest reconstruction surgeries. In 2019, Dr. Pang completed the intensive Transgender Surgery Fellowship training program at Mount Sinai. Now an associate surgeon at Align Surgical in San Francisco, Dr. Pang’s practice is dedicated to providing specialized care to the transgender and gender-nonconforming communities. His latest research is focused on Vaginoplasty revisions and insurance coverage for Facial Feminization surgeries.
Latest Research
Considerations for Secondary Vaginoplasty – FULL TEXT
Maia Shoham, John Henry Pang, Thomas Satterwhite. Transl Androl Urol. 2022 Nov.
In this single-institution, retrospective cohort study of patients who required revision after undergoing penile inversion vaginoplasty, Abboud et al. describe their technique for secondary vaginoplasty with a meshed skin graft to re-line the vaginal canal. An abdominal skin graft is harvested through an elliptical incision and meshed to expand its surface area. The graft is shaped around a dilator and placed into the neovaginal space to line the re-established cavity. The resulting donor scar is aesthetically favorable, resembling that of an abdominoplasty.
Insurance Coverage of Facial Gender Affirmation Surgery: A Review of Medicaid and Commercial Insurance
Enrique Gorbea, Sunder Gidumal, Aki Kozato, John Henry Pang, Joshua D. Safer, Joshua Rosenberg. Otolaryngol Head Neck Surg, 2021 Dec.
Medicaid policy reviews found that 18 states offer some level of gender-affirming coverage for their patients, but only 3 include Facial Gender Affirmation Surgery (17%). Ninety-three percent discussed coverage of FGAS, but 51% considered these procedures cosmetic. Thyroid chondroplasty (20%) was the most commonly covered FGAS procedure. Mandibular and frontal bone contouring, rhinoplasty, blepharoplasty, and facial rhytidectomy were each covered by 13% of the medical policies reviewed.
No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery – FULL TEXT
Aki Kozato, G W Conner Fox, Patrick C Yong, Sangyoon J Shin, Bella K Avanessian, Jess Ting, Yiwei Ling, Subha Karim, Joshua D. Safer, John Henry Pang. J Clin Endocrinol Metab, 2021 Mar 25.
A total of 919 TGNB patients underwent 1858 surgical procedures representing 1396 unique cases, of which 407 cases were transfeminine patients undergoing primary vaginoplasty. Of the latter, 190 cases were performed with estrogen suspended for 1 week prior to surgery, and 212 cases were performed with HT continued throughout. Of all cases, 1 patient presented with VTE, from the cohort of transfeminine patients whose estrogen HT was suspended prior to surgery. No VTE events were noted among those who continued HT. Mean postoperative follow-up was 285 days.
An Opportunity to Better Assess Breast Development in Transgender Women
John Henry Pang, Joshua D. Safer. The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 3, March 2021.
Some studies suggest that more than 50% of trans feminine people desire breast augmentation surgery to supplement breast growth achieved with hormone therapy alone. Where previous reported limitations of breast volume assessment in the plastic surgery literature include human error and ethnocentric determinants that limited generalizability, the current investigators addressed the former with the novel use of anthropomorphic landmarks and VECTRA 3D imaging to track breast volume changes. Further, they reported 3 years of follow-up, the longest study to date regarding the impact of hormone therapy on breast development in transgender women. The authors suggest that their findings may be cause to rethink guidelines that recommend a 1-year period of hormone therapy prior to surgical augmentation to allow for a majority of breast growth to have occurred.
