Hey gang,
I am a 55 yr old Transman
I am 7 years on T
I live in central Fl
I have a company that is self insured, as of 2016 covers transgender health needs through FL Blue.
Top surgery was covered by insurance due to breast cancer at age 45
After much consideration and research, along with financial demand and time away from work.
I have decided to go with metoidioplasty over phallosplasty...with assurance I can opt to move forward with the phallosplasty at a later date.
Bay Shore Plastic Surgery / Dr. Greenwald
Tampa, Fl
I think in this way, the healing and pain level will be more manageable for me. After the Meta healing is done I will have plenty of time to evaluate my phallosplasty options.
My consultation with Dr Greenwald went better then the one last month. I do wished he would show more patience and bedside manner when addressing the procedures. I mean.. he was like in a rush, he had a lot of patients waiting. He has a very nonchalant approach, like he’s said these things a million times. But I understand getting this way, my line of work has be doing this a lot too... I just want my customers to trust me, “...I know what you need, just give me the basics, I’ll take care of the rest...”
However, in leu of this, I didn’t get a full understanding of his techniques and stages. I spoke to his office manager Jennifer about it and she said put them in email, that he will respond in more depth.
I got to see his result book and they looked very good, only a couple did look like revisions might be needed on a couple of the metas.
I sent him a word doc with question, this way I wasn’t rushed and could ask the question I need to know the answers to. I emailed it this morning so not sure when I will get the replies, I will post what I get when I do.
Until next update
I am a 55 yr old Transman
I am 7 years on T
I live in central Fl
I have a company that is self insured, as of 2016 covers transgender health needs through FL Blue.
Top surgery was covered by insurance due to breast cancer at age 45
After much consideration and research, along with financial demand and time away from work.
I have decided to go with metoidioplasty over phallosplasty...with assurance I can opt to move forward with the phallosplasty at a later date.
Bay Shore Plastic Surgery / Dr. Greenwald
Tampa, Fl
I think in this way, the healing and pain level will be more manageable for me. After the Meta healing is done I will have plenty of time to evaluate my phallosplasty options.
My consultation with Dr Greenwald went better then the one last month. I do wished he would show more patience and bedside manner when addressing the procedures. I mean.. he was like in a rush, he had a lot of patients waiting. He has a very nonchalant approach, like he’s said these things a million times. But I understand getting this way, my line of work has be doing this a lot too... I just want my customers to trust me, “...I know what you need, just give me the basics, I’ll take care of the rest...”
However, in leu of this, I didn’t get a full understanding of his techniques and stages. I spoke to his office manager Jennifer about it and she said put them in email, that he will respond in more depth.
I got to see his result book and they looked very good, only a couple did look like revisions might be needed on a couple of the metas.
I sent him a word doc with question, this way I wasn’t rushed and could ask the question I need to know the answers to. I emailed it this morning so not sure when I will get the replies, I will post what I get when I do.
Until next update
This post was last modified: 04-11-2018, 08:21 AM by Borneheld.
Christopher
Awesome you have insurance for this! I didn't know Dr. Greenwald works with insurance. Will he take it upfront or work with you to get a reimbursement? He has been doing trans surgeries for a long time now (which might explain his nonchalant attitude) but it's uncommon to hear from people who have been to him. Congratulations on getting another step further along!
Joshua
Update from Dr. Greenwald
Hi, Chris.
Answers follow.....
Q: In regards to the hysterectomy; what is the method you will use if you’re going to do a vaginectomy as well?
A: Hysterectomy is performed through a low transverse abdominal incision. The upper vagina is removed in continuity with the surgical specimen and the lower vagina is removed from below.
Q: Will you also do a Monsplasty to lift the formed penis up higher on my groin area?
A: Monsplasty can be performed at the same time.
Q: Will the scrotum position forward.
A:The scrotum is made after the urethra is healed and sealed. Swelling is the enemy of the urethra lengthening so in the first stage we will focus on the hysterectomy/ vaginectomy and urethra alone.
Q: For the urethra lengthening, will you use a graft from my mouth?
A: No grafts are used for the urethra. We use the local labia minora tissue.
Q: You stated there will be 2 stages. Can you go over the stages again with me please and what will be performed during each.
A: STAGE I: abdominal hysterectomy (with removal of tubes and ovaries as well) with vaginectomy and urethra lengthening.
A: STAGE II: scrotoplasty and metoidioplasty.
A: STAGE III: placement of testicular implants along with any needed scar revisions or cosmetic touch-ups.
--DG
In regards to the insurance, they are trying to renegotiate the contract with Florida Blue currently in order to be properly compensated. Dr. Greenwald will file for insurance only after they have a Letter of Agreement from FL Blue, with agreed upon payment terms...this is according to his office manager Jennifer, who does all the contract negotiations, these agreements are sometimes tough to get, so this could delay my surgery for a few months.
She said there is also the complication with a hysterectomy insurance claim on a [legal/official marker change] male patient; they always get denied. Once that happens it takes a while for it to get accepted.
On a personal note, I find this very perplexing because we cant even begin any transition without our therapist letters. and surgeries normally fall beyond name and marker changes which include informing all official offices ...doctors, insurance, drivers license, banks, schools, place of employment...etc.
So at some point in the last 6 years my insurance should have an ear mark on my account explaining things to come for my transition. They should be prepared regardless if i get any surgery, due to my status change and diagnosis...Insurance guidelines are really behind the times.
I`ll update once I get any info from Jennifer about what my insurance tells them.
Hi, Chris.
Answers follow.....
Q: In regards to the hysterectomy; what is the method you will use if you’re going to do a vaginectomy as well?
A: Hysterectomy is performed through a low transverse abdominal incision. The upper vagina is removed in continuity with the surgical specimen and the lower vagina is removed from below.
Q: Will you also do a Monsplasty to lift the formed penis up higher on my groin area?
A: Monsplasty can be performed at the same time.
Q: Will the scrotum position forward.
A:The scrotum is made after the urethra is healed and sealed. Swelling is the enemy of the urethra lengthening so in the first stage we will focus on the hysterectomy/ vaginectomy and urethra alone.
Q: For the urethra lengthening, will you use a graft from my mouth?
A: No grafts are used for the urethra. We use the local labia minora tissue.
Q: You stated there will be 2 stages. Can you go over the stages again with me please and what will be performed during each.
A: STAGE I: abdominal hysterectomy (with removal of tubes and ovaries as well) with vaginectomy and urethra lengthening.
A: STAGE II: scrotoplasty and metoidioplasty.
A: STAGE III: placement of testicular implants along with any needed scar revisions or cosmetic touch-ups.
--DG
In regards to the insurance, they are trying to renegotiate the contract with Florida Blue currently in order to be properly compensated. Dr. Greenwald will file for insurance only after they have a Letter of Agreement from FL Blue, with agreed upon payment terms...this is according to his office manager Jennifer, who does all the contract negotiations, these agreements are sometimes tough to get, so this could delay my surgery for a few months.
She said there is also the complication with a hysterectomy insurance claim on a [legal/official marker change] male patient; they always get denied. Once that happens it takes a while for it to get accepted.
On a personal note, I find this very perplexing because we cant even begin any transition without our therapist letters. and surgeries normally fall beyond name and marker changes which include informing all official offices ...doctors, insurance, drivers license, banks, schools, place of employment...etc.
So at some point in the last 6 years my insurance should have an ear mark on my account explaining things to come for my transition. They should be prepared regardless if i get any surgery, due to my status change and diagnosis...Insurance guidelines are really behind the times.
I`ll update once I get any info from Jennifer about what my insurance tells them.
Christopher
Thank you for the detailed update! There's not a lot of recent information available about Dr. Greenwald so I'm sure others will find this helpful.
Do you know if you're a candidate for laparoscopic hysterectomy? Abdominal hysterectomy is the most invasive type of this surgery and carries higher risks and has a longer recovery time. My understanding is that Dr. Greenwald is not trained as a OB/GYN but as a plastic surgeon. Does he have a OB/GYN on staff?
Robotic lap hysto and metoidioplasty are also available at the University of Miami. Have you considered this program?
http://surgery.med.miami.edu/plastic-and...ffirmation
Do you know if you're a candidate for laparoscopic hysterectomy? Abdominal hysterectomy is the most invasive type of this surgery and carries higher risks and has a longer recovery time. My understanding is that Dr. Greenwald is not trained as a OB/GYN but as a plastic surgeon. Does he have a OB/GYN on staff?
Robotic lap hysto and metoidioplasty are also available at the University of Miami. Have you considered this program?
http://surgery.med.miami.edu/plastic-and...ffirmation
Joshua
Thank you Josh for the Miami info, i will defiantly check it out.
I am at the point of moving away from Dr. Greenwald, The insurance contract negotiations have stopped my momentum with this office and I will not be deterred by bureaucracy and Dr Greed.
As for the Hysto, Dr Greenwald did say he has a whole team that does their own part...what they were was not really clear.
For now, I will pursue a new surgeon, maybe down in Miami or up in Atlanta...i`ll make a new thread for what i find out, or add to any existing ones.
I am at the point of moving away from Dr. Greenwald, The insurance contract negotiations have stopped my momentum with this office and I will not be deterred by bureaucracy and Dr Greed.
As for the Hysto, Dr Greenwald did say he has a whole team that does their own part...what they were was not really clear.
For now, I will pursue a new surgeon, maybe down in Miami or up in Atlanta...i`ll make a new thread for what i find out, or add to any existing ones.
Christopher
I'm sorry to hear that your surgeon search continues but it's best to follow your instincts!
Do you have a lead on a surgeon in Georgia? Dr. Fara Movagharnia is in Atlanta and received some training from Dr. Bowers but I don't believe that included Metoidioplasty. Other options would be Dr. Brad Figler in Chapel Hill NC, or Dr. Dulin and Dr. Crane in Texas.
Do you have a lead on a surgeon in Georgia? Dr. Fara Movagharnia is in Atlanta and received some training from Dr. Bowers but I don't believe that included Metoidioplasty. Other options would be Dr. Brad Figler in Chapel Hill NC, or Dr. Dulin and Dr. Crane in Texas.
Joshua
Joshua,
Sad news about Dr Greenwald, I was really floored when i found this out.
There was a tragic accident on Oct 5,2019, Dr. Daniel Greenwald died in a plane crash.
https://www.tampabay.com/news/hillsborou...ntsb-says/
He was listed for upper and lower Trans surgeon for Tampa FL
Sad news about Dr Greenwald, I was really floored when i found this out.
There was a tragic accident on Oct 5,2019, Dr. Daniel Greenwald died in a plane crash.
https://www.tampabay.com/news/hillsborou...ntsb-says/
He was listed for upper and lower Trans surgeon for Tampa FL
Christopher
