Long-term Results of Breast Reduction in Female-to-Male Transsexuals

Abstract

Transsexualism is considered to be an extreme end in a large group of gender identity disorders. Two main types of transsexualism are identified: male-to-female (MtF) and female-to-male (FtM). Transsexual persons have a feeling of being incarcerated in a foreign body and therefore they wish to change their sex by hormone therapy and surgical treatment. Breast reduction usually is the first procedure in the process of surgical reassignment in FtM transsexual persons. the aim of this study was to evaluate the long-term results of breast reduction in FtM transsexual persons, taking into account breast size and surgical technique. The doctors' and patients' opinions about the results were also compared. material and methods. The study was carried out in a group of 98 FtM transsexual persons treated at the Department of Plastic, Reconstructive and Aesthetic Surgery. Evaluation of the long-term results of breast reduction was performed based on clinical examination done by the doctors and a questionnaire filled in by the patients and the surgeons. Results. Good results of breast reduction were achieved in more than 60% of the examined patients operated on mainly by Webster technique. conclusions. Clinical examination of the long-term results of breast reduction in FtM transsexual persons revealed good aesthetic effects. The doctors' and the patients' opinions were similar. key words: breast reduction, transsexualism female-to-male POLSKI PRZEGLĄD CHIRURGICZNY

Transsexual Mastectomy: Selection of Appropriate Technique According to Breast Characteristics

“…Breast binding also negatively affects both skin excess and skin elasticity (6). Although various techniques have been published in the literature, describing how to perform an ideal chest contouring in FtM transsexual persons (1,2,3,4,5,6,7,8,9,10,11), there are only a few articles proposing an algorithmic surgical approach for subcutaneous mastectomy (4,6,10). In 1995, Hage et al (4) published their algorithmic approach as the “Amsterdam experience” with three surgical options.…”

“…Webster first described this technique in 1946 for low-grade gynecomastia cases (13). As a FtM subcutaneous mastectomy technique, many authors have adopted this approach (3,4,5,6,7,8,9,10). The most important advantage of this technique is small and good concealed infraareolar scar.…”

“…Breast amputation with NAC graft technique has been proposed for very large breasts in FtM transsexuals (1,4,6,8,9,10). So far, apron flap technique has never been used to define this technique.…”

“…The key determinants for choice of best technique are grade of skin excess and ptosis, breast size, and skin quality. To date, various mastectomy procedures in FtM transsexuals have been reported, including transareolar, semicircular, concentric circular, extended concentric circular, and nipple- areolar graft techniques (6,7,8,9,10,11). However, none of them has proposed the vertical pedicled subcutaneous mastectomy in FtM transsexuals.…”

Barriers to Gender-affirming Surgery Consultations in a Sample of Transmasculine Patients in Boston, Mass.

“…To date, most research on the surgical experiences of gender diverse patients involved exclusively adult 6 – 11 and/or transfeminine 7 , 8 , 10 , 11 samples. Preliminary research with transmasculine patients has demonstrated that gender-affirming surgery is associated with better quality of life, 12 , 13 including decreased chest-related dysphoria after top surgery 13 , 14 and better perceived gender congruence after bottom surgery. 15 This is not to say surgical intervention is a “cure” for gender dysphoria, but an important component of care for gender diverse patients experiencing dysphoria related to primary and secondary sex characteristics.…”