Dr. Charles Garramone
Leading Authority on Top Surgery
Dr. Charles Garramone, DO, FACOS, is internationally recognized as one of the most experienced and trusted Top Surgery surgeons in the world. He made history as the first surgeon in the United States to dedicate his practice to Top Surgery. In 2005, when few surgeons offered gender-affirming procedures, Dr. Garramone was refining his surgical techniques to meet the unique needs of transgender and non-binary individuals seeking chest masculinization.
Dr. Garramone’s Top Surgery method uses a highly refined Double Incision technique. This prioritizes anatomical accuracy in nipple/areola size and placement, as well as superior chest contouring, resulting in consistently natural and aesthetically pleasing outcomes. Patients often refer to the distinctive results as the "Garramone Chest" due to the recognizable quality and symmetry of his work.
Additionally, Dr. Garramone offers ManSculpture®, a body masculinization procedure he pioneered that uses power-assisted liposuction to contour the abdomen, flanks, and outer hips. This surgery is frequently performed alongside Top Surgery to enhance masculine body shape and reduce overall procedural costs.
Education and Training
Dr. Garramone graduated cum laude from the University of Florida with a Bachelor of Science in Microbiology & Cell Science. He earned his medical degree from Nova Southeastern University College of Osteopathic Medicine. He completed a five-year General Surgery Residency at Michigan State University's Botsford General Hospital, where he served as Chief Resident in both the Department of General Surgery and Medical Education, as well as Associate Clinical Professor. He went on to complete a two-year Plastic & Reconstructive Surgery Fellowship at the Philadelphia College of Osteopathic Medicine, where he again served as Chief Resident and Associate Clinical Professor.
Dr. Garramone is board-certified in plastic and reconstructive surgery. He is a Fellow of the American College of Osteopathic Surgeons and holds membership in the American Osteopathic Association and the World Professional Association for Transgender Health (WPATH).
Recognized Excellence and Patient Trust
Dr. Garramone has performed thousands of Top Surgery procedures, earning the trust of patients from across the U.S. and around the world. His work is widely documented on social media, with patients enthusiastically sharing their post-operative results in what has come to be known on YouTube as "The Big Reveal" — a moment he encourages patients to capture at their first post-op appointment.
Surgical Facility and Travel
Surgeries are performed at Memorial Same Day Surgery Center, which features advanced medical equipment, experienced surgical teams, and board-certified anesthesiologists. Dr. Garramone also maintains privileges at Memorial Hospital West, Memorial Hospital Pembroke, and Memorial Hospital Miramar. Out-of-town patients are welcomed, and staff are available to offer lodging and travel recommendations.
Surgery Costs
- Top Surgery: $12,000 to $15,000
- ManSculpture® Body Masculinization: $6,000 to $18,000
Prices are approximate as of March 2024 and reflect the surgeon’s fee only. Financing is available through CareCredit. Dr. Garramone does not accept insurance, Medicare, or Medicaid.
Insurance Reimbursement Support
Although Dr. Garramone does not work directly with insurance companies, his office is committed to helping patients pursue potential out-of-network reimbursement. After your surgery, you will receive a comprehensive billing packet that includes:
- A detailed, itemized invoice (also known as a "superbill")
- A copy of your operative report
- Relevant CPT (procedure) and ICD-10 (diagnosis) codes
These documents are essential for submitting a claim to your insurance provider. With them, you can file for reimbursement directly, either through your insurance company’s patient portal or by mailing in a reimbursement request. While Dr. Garramone's office cannot guarantee reimbursement—since it depends on your specific plan and provider—many patients have successfully received partial or full reimbursement, especially those with out-of-network benefits.
For best results, it’s recommended that you contact your insurance company in advance to ask about their reimbursement policies for out-of-network gender-affirming surgery and what documentation is required.
Speaking with Dr. Garramone and Scheduling Surgery
Dr. Garramone offers both in-person and phone appointments at no charge. Wait times are typically one week, and surgeries can be scheduled within approximately three months. Patients consistently report a warm, supportive experience from the initial discussion to final follow-up.
Surgery Requirements
- Minimum age: 19
- Physician referral
- BMI under 45 (due to anesthesia guidelines)
- No smoking for at least one month pre-op
- Discontinuation of medications that interact with general anesthesia
- Mammogram required if over age 40
Advocacy and Community Support
Dr. Garramone has been a strong advocate for the transgender community since 2005. He is a proud Surgeon Sponsor of Point of Pride, a nonprofit organization that offers financial and logistical support to trans individuals seeking gender-affirming care.
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