Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis
Background Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods Recorded data were collected and analyzed for all male transgender patients...
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Korean Society of Plastic and Reconstructive Surgeons
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doaj-685b1f68b1fd48539ec1bad26943180a2020-11-25T01:29:10ZengKorean Society of Plastic and Reconstructive SurgeonsArchives of Plastic Surgery2234-61632234-61712019-09-0146543344010.5999/aps.2018.012143673Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysisShafreena Kühn0Seirah Keval1Robert Sader2Lara Küenzlen3Marcus Kiehlmann4Gabriel Djedovic5Ahmet Bozkurt6Ulrich Michael Rieger7 Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany Rhein-Main Working Group on Transsexualism and Transidentity, Frankfurt am Main, Germany Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany Department of Plastic Surgery, Helios Clinic Wuppertal, Wuppertal, Germany Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, GermanyBackground Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department. Results In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients’ habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%). Conclusions Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions.http://www.e-aps.org/upload/pdf/aps-2018-01214.pdfTransgenderMastectomyGender reassigning surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shafreena Kühn Seirah Keval Robert Sader Lara Küenzlen Marcus Kiehlmann Gabriel Djedovic Ahmet Bozkurt Ulrich Michael Rieger |
spellingShingle |
Shafreena Kühn Seirah Keval Robert Sader Lara Küenzlen Marcus Kiehlmann Gabriel Djedovic Ahmet Bozkurt Ulrich Michael Rieger Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis Archives of Plastic Surgery Transgender Mastectomy Gender reassigning surgery |
author_facet |
Shafreena Kühn Seirah Keval Robert Sader Lara Küenzlen Marcus Kiehlmann Gabriel Djedovic Ahmet Bozkurt Ulrich Michael Rieger |
author_sort |
Shafreena Kühn |
title |
Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis |
title_short |
Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis |
title_full |
Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis |
title_fullStr |
Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis |
title_full_unstemmed |
Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis |
title_sort |
mastectomy in female-to-male transgender patients: a single-center 24-year retrospective analysis |
publisher |
Korean Society of Plastic and Reconstructive Surgeons |
series |
Archives of Plastic Surgery |
issn |
2234-6163 2234-6171 |
publishDate |
2019-09-01 |
description |
Background Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department. Results In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients’ habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%). Conclusions Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions. |
topic |
Transgender Mastectomy Gender reassigning surgery |
url |
http://www.e-aps.org/upload/pdf/aps-2018-01214.pdf |
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