Episode Details

Episode Notes:

• How it started: Dr. Blechman trained at NYU and did a fellowship at MD Anderson Cancer Center, where he focused on breast reconstruction for cancer patients. In 2016, a trans patient came in seeking a mastectomy — and everything shifted.
• Top surgery isn't one thing: The term is often used to mean chest masculinization, but Dr. Blechman walks through the full range — from complete chest masculinization to gender-affirming radical breast reductions for non-binary patients, to breast augmentation for trans women. Every patient is different, and he starts every consult by asking patients to tell him about their journey with gender.
• Narcotic-free pain management: Dr. Blechman has developed a protocol using a pre-surgical nerve block (long-acting numbing medicine injected into the rib cage), combined with Advil and Tylenol post-op. Only about 10% of patients need anything beyond that. He draws on his experience running the NYC Marathon to put post-op discomfort in perspective for patients — and credits the psychological framing as part of why it works.
• Nipple tattooing: Some top surgery patients choose not to keep their nipples. For those who later want one, or for patients who experience asymmetry or color variation after surgery, Dr. Blechman's PAs perform nipple and areola tattooing right in the office.
• Building a safe space: Dr. Blechman talks about the well-documented reality that many trans people have had negative experiences in healthcare settings. His practice is designed to counter that — respectful care, inclusive intake, and a staff trained to meet patients where they are.
• Advocacy beyond the OR: Dr. Blechman travels to Albany and Washington twice a year with medical organizations to meet with legislators on gender-affirming care issues. He notes that New York State has written gender identity protections directly into the state constitution.
• NYC Pride March: For the past three to four years, Dr. Blechman and his team have marched in NYC Pride with a pickup truck and a group of patients they've operated on — sometimes 20–30 people. One former patient is now shadowing in his office, inspired to go to medical school.
• Grayson: Dr. Blechman mentions operating on Grayson, a trans fitness influencer with hundreds of thousands of followers, whose dressing-removal video got 14 million views on TikTok.

Connect with Dr. Blechman: 🌐 blechmanplasticsurgery.com

https://www.blechmanplasticsurgery.com/dr-keith-blechman-upper-east-side-plastic-surgeon

https://www.instagram.com/dr.blechman/

https://www.instagram.com/breastsurgerygroup/

Podcast song by SIXFOOT 5: https://www.sixfoot5prod.com 

Apple: https://music.apple.com/us/artist/sixfoot-5/1551774977 

Spotify: https://open.spotify.com/artist/5rHMzoU0G0fLhaBsrQiOOY?si=laSZ5hiKTYubJJyhrzf2JQ

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.