Dr. Loren Schechter, MD is one of the country’s foremost experts on transgender surgery. He is the Medical Director of the Gender Affirmation Surgery Program at Rush University Medical Center in Chicago. Dr. Schechter has been performing gender-affirming surgeries for more than 20 years. Since 2013, he has performed approximately 100-150 gender-affirming procedures every year. Currently, approximately 85-90% of his patients are transgender individuals seeking surgery. He offers the full spectrum of gender-affirming procedures, including Vaginoplasty, FFS, Metoidioplasty and Phalloplasty. Dr. Schechter’s outstanding surgical skills and extensive experience have made him a popular choice for those seeking Gender Affirming Surgery.
A narrative review of outcomes following metoidioplasty: complications and satisfaction. [FULL TEXT]
Alireza Hamidian Jahromi, Ari M. Spellman, Sydney Horen, Edward E. Cherullo, Amir H. Dorafshar, Loren S. Schechter. Plast Aesthet Res, Special Issue Gender Confirmation Surgery: Risk Factors and Complications, June 2022;9:41.
While satisfaction with this procedure is high, complications can occur. This narrative review discusses postoperative outcomes, including both satisfaction and complications. Published data on complications include fistula and stricture rates from 0%-50% and 0%-63%, respectively. Overall satisfaction with appearance ranges from 48%-100%, and patient ability to void while standing ranges from 67%-100%. Metoidioplasty is a safe and effective procedure for transgender men.
Strategic Planning and Essential Steps for Establishing a Uterine Transplant and Rehabilitation Program: From Idea to Reality.
Dorafshar AH, Jahromi AH, Horen SR, Schechter LS, Johannesson L, Testa G, Hertl M, Dewdney S, Aschkenasy J, Molo MW, Brincat C, Cherullo E, Behel JM, Hebert C, Shulman R, Bassi S, Alecci AT, Konety B. Ann Surg. 2021 Nov 18.
Uterine transplant (UTx) is performed to address absolute uterine infertility in the presence of uterine agenesis, a non-functional uterus, or following a prior hysterectomy. Following the initial success of UTx resulting in a livebirth (2014) in Sweden, there are over 70 reported UTx surgeries resulting in more than 40 livebirths worldwide. Currently, UTx has been performed in over 10 countries. As UTx is transitioning from an “experimental procedure” to a clinical option, an increasing number of centers may contemplate a UTx program. This article discusses essential steps for establishment of a successful UTx program. These principles may be implemented in cis- and transgender UTx candidates.
Guiding the conversation-types of regret after gender-affirming surgery and their associated etiologies.
Narayan SK, Hontscharuk R, Danker S, Guerriero J, Carter A, Blasdel G, Bluebond-Langner R, Ettner R, Radix A, Schechter L, Berli JU. Ann Transl Med. 2021 Apr;9(7):605.
In this study, regret following GAS was rare and was consistent with the existing literature. Regret can be classified as true gender-related regret, social regret and medical regret resulting from complications, function, pre-intervention decision making. Guidelines in transgender health should offer preventive strategies as well as treatment recommendations, should a patient experience regret. Future studies and scientific discourse are encouraged on this important topic.
Managing Common and Uncommon Complications in Gender-Affirming Masculinizing Chest Surgery.
In: Kim, J.Y. (eds) Managing Common and Uncommon Complications of Aesthetic Breast Surgery, pp 205–211, Springer, Cham. Schechter, L.S., Facque, A.R. (March 2021).
There have been many techniques described to perform masculinizing chest surgery, and the majority of patients are very satisfied with their surgical results. Overall, the complication rate in chest surgery is low. The following is a discussion of chest surgery with a focus on the potential cause, treatment, and some possible methods of prevention of the most common, and uncommon, complications that arise in chest surgery.
The Affordable Care Act and Its Impact on Plastic and Gender-Affirmation Surgery.
Plast Reconstr Surg. 2021 Jan 1;147(1):135e-153e.
Gender-affirmation surgery has seen exponential growth, largely because of expanded insurance coverage through the protections afforded to transgender individuals by the Affordable Care Act. As gender-affirming surgery continues to grow, plastic surgeons have the opportunity to adapt and diversify their practices.
Strategies for innervation of the neophallus [FULL TEXT]
Rayisa Hontscharuk , Charalampos Siotos, Loren S. Schechter. Plast Aesthet Res 2020;7:65.
A fundamental goal of phalloplasty includes the construction of a sensate neophallus. Both tactile and erogenous sensation are important for protective sensation (including retention of implantable penile prosthesis) as well as sexual satisfaction. This article describes the sensory innervation of flaps commonly used for phalloplasty including the radial forearm flap, anterolateral thigh flap, and musculocutaneous latissimus dorsi flap. The sensory innervation of the perineum and external genitalia will be reviewed as a basis for selecting recipient nerves.
Inflatable penile prosthesis implantation after gender affirming phalloplasty with radial forearm free flap.
Kocjancic E, Jaunarena JH, Schechter L, Acar Ö. Int J Impot Res. 2020 Jan;32(1):99-106.
PP implantation in a neophallus is a complex procedure and contains some technical nuances. Creation of spaces within the neophallus for the cylinder(s), wrapping the cylinder(s) with synthetic materials or allografts, and fixation of the prosthesis to the pubic bony structures can be considered as the most important steps of this procedure. Five-year IPP retention rates in flap phalloplasty range between 42 and 78% which is lower than the rate observed in anatomic phallus. In addition, complication and mechanical failure rates are higher in flap phalloplasty. However, satisfaction rates after PP implantations in anatomic penis versus neophallus seem to be similarly high. Infection, migration, and mechanical failure are the most frequent complications.
Training Surgeons in Gender Confirmation Surgery.
J Craniofac Surg. 2019 Jul;30(5):1380-1382
Gender confirmation surgery can be an important component in helping individuals alleviate gender dysphoria. Increased advocacy, awareness, and acceptance of these medically necessary procedures have resulted in a greater demand for such procedures, exceeding the number of qualified surgeons able to perform them. It is recognized that formal training guidelines and fellowship programs are needed so as to assure that surgeons performing these procedures are adequately experienced. Here, the authors discuss a potential framework by which a multidisciplinary training program in gender confirmation surgery can be developed and implemented.
Introduction to Phalloplasty.
Schechter LS, Safa B. Clin Plast Surg. 2018 Jul;45(3):387-389.
Phalloplasty represents the most complete genitoperineal transformation. Because it requires complex, staged procedures as well as the use of tissue from remote sites, patients must be well informed as to the nature of surgery. Surgical techniques for phalloplasty continue to evolve. Although many surgeons prefer the radial forearm free flap technique, a visible flap donor site makes this procedure less desirable for some patients. Other surgical options are available and include the anterolateral thigh flap, sometimes in conjunction with secondary flaps, and the musculocutaneous latissimus dorsi flap.
Surgery for gender identity disorder.
Plastic Surgery, 3rd Edition, Volume 4: Trunk and Lower Extremity. Loren S. Schechter, 2017. (Series Editor Peter C. Neligan, MD)
Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7
E. Coleman, W. Bockting, M. Botzer, P. Cohen-Kettenis, G. DeCuypere, J. Feldman, L. Fraser, J. Green, G. Knudson, W. J. Meyer, S. Monstrey, R. K. Adler, G. R. Brown, A. H. Devor, R. Ehrbar, R. Ettner, E. Eyler, R. Garofalo, D. H. Karasic, A. I. Lev, G. Mayer, H. Meyer-Bahlburg, B. P. Hall, F. Pfaefflin, K. Rachlin, B. Robinson, L. S. Schechter, V. Tangpricha, M. van Trotsenburg, A. Vitale, S. Winter, S. Whittle, K. R. Wylie & K. Zucker
International Journal of Transgenderism, Volume 13, Issue 4, August 2012, pages 165-232.
The Surgeon’s Relationship with the Physician Prescribing Hormones and the Mental Health Professional: Review for Version 7 of the World Professional Association for Transgender Health’s Standards of Care
Loren S. Schechter
International Journal of Transgenderism, Volume 11, Issue 4, November 2009, pages 222-225
Published online: 19 Dec 2009