Sara Danker, M.D., assistant professor in the Division of Plastic Surgery at the University of Miami Miller School of Medicine, traveled a long way before finally coming home to South Florida. As an undergraduate, the Miami native attended the University of Florida and was valedictorian. She earned her medical degree at the University of Central Florida College of Medicine and completed her plastic surgery residency at Oregon Health & Science University in Portland. Her next stop was a microvascular reconstructive surgery fellowship at MD Anderson Cancer Center in Houston.
“Dr. Sara Danker is an outstanding addition to the plastic surgery program at University of Miami Health System,” said Devinder Singh, M.D., chief of plastic surgery and interim professor of clinical surgery. “She brings subspecialty training in microvascular surgery from one of the best fellowships in the world, has unique expertise in gender affirming surgery, and is passionate about education and research.”
Helping transgender patients
Dr. Danker’s primary expertise is microvascular and complex reconstructive surgery. She cares for patients who need breast reconstruction after mastectomy, and other intensive procedures, as well as sharing her skills with medical residents. But gender affirmation — changing a person’s physical characteristics to reflect their actual identity — is her passion and will be a major part of her role at UHealth. Her homecoming is helping reactivate the health system’s Gender Affirmation Surgery Program.
“This is an incredible way to help people realize their potential and feel whole,” Dr. Danker said. “These patients go to great lengths and risk a lot to get these procedures, but they don't see any other way. There’s nothing else I know that is this powerful for patients.”
These complex surgeries require all the microsurgical skills she acquired during her many years of training. While performing a phalloplasty, she creates a penis with tissue from the patient’s forearm. In a later surgery, she will connect the patient’s urethra, a procedure called urethral lengthening, to make the new penis as functional as possible.
Though there are different protocols, patients must often return for several surgeries, over a year or longer, before the journey is complete. Dr. Danker’s unique set of skills make her one of the few surgeons in Florida qualified to perform phalloplasties and other rigorous, gender affirming procedures.
Dr. Danker is impressed by the gender-diverse patients who come to her for these procedures. They are profoundly upset by their birth gender and are willing to do whatever they can to complete this intensive series of surgeries. Her patients recognize the long road they travel to achieve full gender affirmation, but they are also living in bodies that feel completely alien to them. For Dr. Danker, their determination can be quite moving.
“When you spend time with these patients, it soon becomes apparent that these parts of their body can feel disgusting to them,” she said. “My mentor, Dr. Jens Berli, was doing a phalloplasty, and when he was talking to the patient in pre-op, they told him: ‘If I die on the table, please finish the operation so I can be buried as a man.’”
Assembling a team
Dr. Danker returned to South Florida, in part, to help reactivate the gender affirmation program. Comprehensive transgender patient care unites numerous specialties: plastic surgeons, urologists, OB/Gyns, endocrinologists, voice therapists, social workers, psychologists and others.
“The Miami LGBTQ community has been waiting for a gender surgeon like Dr, Danker,” said Lauren Foster, director of LGBTQ+ Services. “Our chief nursing executive, Maureen Fagan, and I are thrilled to be in partnership with her and applaud the Division of Plastic Surgery on her recruitment. We look forward to introducing her to the community and forging an impressive gender clinic here at UHealth.”
The University of Miami Health System has been repeatedly honored for the quality health care it provides the LGBTQ community, and was previously recognized as a leader in gender affirmation surgery. Dr. Danker is a key addition and is looking forward to making a major impact on trans patients’ lives.
“These are the most grateful patients I have ever encountered,” Dr. Danker said. “I can see how happy they are, their sense of relief and self-actualization. It’s just the most rewarding thing I do as a surgeon.”