Gender Confirmation Surgery for the Endocrinologist

Narayan, Sasha K.; Morrison, Tessalyn; Dugi, Daniel; Mosser, Scott W.; Berli, Jens U.

doi:10.1016/j.ecl.2019.02.002

Cited by 12 publications

(17 citation statements)

References 20 publications

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“…The thought is that exogenous estrogen increases the risk of thromboembolic events. However, this practice is controversial due to low incidence of thromboembolic events coupled with the deleterious effects of stopping hormone use in the transgender population (16). In our practice, we no longer stop exogenous hormone use, and we have not documented any changes in thromboembolic event frequency.…”

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 87%

“…As previously mentioned, exogenous hormones should be taken for at least a year to prepare for surgical augmentation by maximizing growth of native tissues (15). Some groups advocate for stopping exogenous hormone use approximately two to four weeks prior to surgery (16). The thought is that exogenous estrogen increases the risk of thromboembolic events.…”

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

“…For all patients, systemic illnesses and medications must be assessed preoperatively to ensure risk of complications is reduced. Breast surgery impairs tissue vascularity, so any agents that cause vasoconstriction, such as nicotine, cocaine, and methamphetamines, must be stopped preoperatively (16). 40.5% of our transfeminine patients have some degree of tobacco history, highlighting the prevalence of tobacco use and the importance of screening for its use.…”

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

“…Wound healing capabilities are maximized with smoking cessation as well (15). In patients with diabetes, HbA1c should be below 7.0% to minimize cardiovascular and infectious complications (16).…”

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

“…Fat grafting is rarely used as the sole method of transfeminine breast augmentation. However, this procedure is especially useful for reducing implant visibility and palpability and it offers a more natural appearing counter (16,27). Take rates for fat grafting range from 50-60%, so multiple procedures are often needed to achieve the desired outcome (15,27).…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Breast augmentation in the transgender patient: narrative review of current techniques and complications

et al. 2021

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Gender-affirming surgery (GAS) is often a crucial step during the journey to identity actualization for transgender patients. Surgical breast augmentation, or "top surgery", is frequently cited as the most important and sometimes only gender-affirming procedure sought by transfeminine patients. The breast augmentation process is remarkably similar in transgender and cisgender patients. However, there are unique guidelines, anatomic considerations, and contextual issues for the transgender patient population that must be taken into account by providers to achieve optimal outcomes. The aim of this review is to outline the current state of breast augmentation for transfeminine patients. We walk through our suggested pre-surgical evaluation, breast augmentation options, and post-surgical care. In the preoperative period, providers must establish a positive provider-patient relationship that allows for thorough history taking, physical examination, and goal setting. Providers must be able to select an appropriate implant, incision location, and operative plane to balance patient desires and pre-existing anatomic characteristics in transfeminine patients.Postoperatively, the provider must address acute and chronic needs to allow for continued satisfaction and safety. After reading this review, we aim for providers to be well-equipped to provide the highest quality breast augmentation care for their transfeminine patients. As research into best practices for breast augmentation in transfeminine patients continues to develop, we expect that surgical practice will continue to evolve.

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Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 87%

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

Section: Surgical Techniquesmentioning

confidence: 99%

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Breast augmentation in the transgender patient: narrative review of current techniques and complications

et al. 2021

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A Single-Center 10-Year Experience of 180 Transmasculine Patients Undergoing Gender-Affirming Mastectomy While Continuing Masculinizing Hormone Replacement Therapy

et al. 2022

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Gender Affirming Surgeries of the Trunk

Park,

Stranix

2024

Curr Surg Rep

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Purpose of Review This review aims to explore the current concept, techniques, outcomes and safety of gender affirming surgeries of the trunk for transgender and gender non-conforming individuals. Recent Findings Gender affirming surgery is increasingly becoming more accessible to patients with gender dysphoria. Chest surgery is the most popular form with various surgical techniques that one can utilize. It is critical for operating surgeons to understand the nuances of these procedures when compared to cis-gender body contouring procedures. Recent outcome data show that these procedures are safe and well tolerated with high patient satisfaction and mental health benefits. Further long-term outcome data are needed. Summary Gender affirming surgery of the trunk is a safe and well-tolerated treatment for patients with gender dysphoria with high patient satisfaction and mental health benefits. Graphical Abstract

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Gender Confirmation Surgery for the Endocrinologist

Cited by 12 publications

References 20 publications

Breast augmentation in the transgender patient: narrative review of current techniques and complications

Breast augmentation in the transgender patient: narrative review of current techniques and complications

A Single-Center 10-Year Experience of 180 Transmasculine Patients Undergoing Gender-Affirming Mastectomy While Continuing Masculinizing Hormone Replacement Therapy

Gender Affirming Surgeries of the Trunk

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