These days, Dr. Juliana Hansen is something of a superstar in both the transgender and plastic surgery communities.



But until a few years ago, the Oregon Health & Science University doctor didn't perform gender reassignment surgeries. Hansen, the division chief of plastic and reconstructive surgery at OHSU, specialized in operating on breast cancer patients.



Her career began shifting in 2011 when a transgender man and his mother came from Central Oregon to ask for help. The patient, who had been designated female at birth, wanted Hansen to remove his breasts.



Hansen didn't hesitate. Though she had not performed what's called "top surgery" for a transgender patient, she had the plastic surgery skills.



Top surgery involves removing a patient's breasts, but the procedure is more than a typical a mastectomy, Hansen said. Transgender patients don't want a completely flat chest.



Instead she performs something close to what's called gynecomastia -- an operation for men who have too much breast tissue -- removing most of the breast tissue, but leaving some to give her patients a masculine-looking chest.



The patient loved the look Hansen created for him, and soon word spread of Hansen's work.



She performed five top surgeries in 2013. The next year, she did 16. Last year, she operated on 51 patients. This year, she expects to do more than 80.



Last year, Hansen spoke on the first transgender surgery panel at the annual, premier plastic surgery conference in Boston.



Patients chronicle their visits, with photographs and glowing reviews, on Reddit and transgender forums.



"More than anything else, for my transmale patients, their breasts represent femaleness," Hansen said. "They hate them. Hate them. Hate them. Top surgery allows them to move on and focus on other aspects of their life."



Five years after that first surgery, Hansen's first transgender patient came back to visit her. His life had only become happier after Hansen helped shape his body to match his identity.



This time, he brought his fiance. He wanted her to meet the surgeon who made his free, happy life possible. They even invited Hansen to the wedding.



"Getting to see my patients participate in life events that reflect their happiness and confidence is extremely rewarding," Hansen said. "As a surgeon who has helped in that journey, you couldn't ask for anything more."





-- Casey Parks

503-221-8271

cparks@oregonian.com; @caseyparks