Dr. Christopher Salgado, MD is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. In practice for more than 20 years, Dr. Salgado performs all aspects of transgender surgeries, from Facial Feminization and Top Surgery, to complex genital reconstruction. He is an active researcher who has authored over 120 peer-reviewed scientific articles. Dr. Salgado is on the editorial board of the Journal of Plastic, Reconstructive and Aesthetic Surgery and is a reviewer for Seminars in Plastic Surgery among others. He has edited three books, including the essential Gender Affirmation: Medical and Surgical Perspectives, published by Thieme in 2017. His latest research is focused on Phalloplasty, Vaginoplasty and Facial Feminization.
Phalloplasty in Transgender Men With and Without Urethral Lengthening
Christopher Salgado, Kerstin Yu, Stefan Kenel-Pierre, Edward Gheiler and Tony Shao. Transgender Health Advances and New Perspectives, edited by Carlos Miguel Rios-González, February 25, 2022.
The decision to undergo urethral lengthening is considered early in this surgical process. However, urethral complications are among the most common problems we see in phalloplasty, and surgical techniques have evolved to decrease these complications. We have developed an advanced two-stage mucosa-only prelaminated neourethra phalloplasty technique to address these issues. We also discuss the perineal urethroplasty in patients opting for no urethral lengthening in phalloplasty.
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.
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.
Supersonic Transporter Deformity in Transgender Men following Phalloplasty
Christopher J Salgado, Lydia A Fein , Eva A Williams, Rachita Sood. Plast Reconstr Surg. 2019 Jul;144(1):225-227.
Phalloplasty is often the final stage of gender-affirmation surgery for transgender men. Obtaining penile rigidity is important for sexual function, but may also bring complications, including supersonic transporter deformity, in which the glans becomes ventrally displaced and flaccid. Two cases of supersonic transporter deformity are presented here, one with a hydraulic penile implant and one with an autologous bone transplant. Attempt at surgical correction was performed in both. Careful attention must be paid to the unique anatomy of the neophallus and type of penile prosthesis to prevent or correct supersonic transporter deformity in transgender men.
Evaluation of BMI as a Risk Factor for Complications following Gender-affirming Penile Inversion Vaginoplasty [FULL TEXT]
Graham C. Ives, MD, Lydia A. Fein, MD, MPH, Lindsey Finch, JD, Emily C. Sluiter, BS, Megan Lane, MD, William M. Kuzon, MD, PhD, and Christopher J. Salgado, MD. Plast Reconstr Surg Glob Open. 2019 Mar; 7(3): e2097.
Gender affirmation surgery (GAS) has a positive impact on the health of transgender patients; however, some centers employ body mass index (BMI) as a strict selection criterion for surgical candidacy. Several single-center studies have found no clear correlation between BMI and complication rates. We conducted a retrospective multicenter study at 2 university-based centers to test the null hypothesis: obesity is not a significant determinant of the risk of acute surgical complications in patients undergoing penile inversion vaginoplasty (PIV).
Feminization and Masculinization of the Neck
Salgado CJ, Nugent AG, Satterwhite T, Carruthers K, Joumblat NR. Clinics in Plastic Surgery. Volume 45, ISSUE 4, P635-645, October 01, 2018.
Facial stigmata associated with one’s assigned gender can be very distressing for the gender dysphoric patient. The lower face and neck contain several structures that play a significant role in their ability to “pass” as their desired gender. Clinical recognition and modification of these structures will allow the patient to have facial and neck features that are consistent with their desired gender. This article reviews the techniques of mandibular angle contouring, genioplasty, chondrolaryngoplasty, facelift, and neck lift as they pertain to the feminization and masculinization of the face and neck of the patient with gender dysphoria.
Feminizing the Face: Combination of Frontal Bone Reduction and Reduction Rhinoplasty [FULL TEXT]
C. J. Salgado, H. AlQattan, A. Nugent, D. Gerth, W. Kassira, C. S. McGee, and L. Wo. Case Rep Surg. 2018; 2018: 1947807.
FFS improves mental health and quality of life in transgender patients. The nose and forehead are critical in facial attractiveness and gender identity; thus, frontal brow reduction and rhinoplasty are a mainstay of FFS. The open approach to reduction of the frontal brow is very successful in the feminization of the face; however, risks include alopecia and scarring. Endoscopic brow reduction, in properly selected patients, is minimally invasive with excellent outcomes avoiding these risks. Since both reduction rhinoplasty and frontal brow reduction are routinely performed in FFS, a combined approach provides superior control over the nasal radix and profile when performing surgery on the frontal bone region first followed by nose reduction.
Primary Sigmoid Vaginoplasty in Transwomen: Technique and Outcomes [FULL TEXT]
Christopher J Salgado, Ajani Nugent, Joseph Kuhn, Meghan Janette, Heidi Bahna. Biomed Res Int. 2018 May 10; 2018:4907208.
Most often, inverted phallus skin is used to create the neovagina in transwomen. However, not all patients have sufficient tissue to achieve satisfactory depth and those that do must endure cumbersome postoperative dilation routines to prevent contracture. In selected patients, the sigmoid colon can be used to harvest ample tissue while avoiding the limitations of penile inversion techniques It is now our standard of care to offer this surgery to our transfemale patients with phallus length of less than 4.5 inches or 11.4 centimeters.