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Chest-wall contouring surgery in female-to-male transgender patients: A one-center retrospective analysis of applied surgical techniques and results
Background and Aims: Chest-wall contouring surgery is an important part of the gender reassignment process that contributes to strengthening the self-image and facilitating living in the new gender role. Here, we analyze the surgical techniques used in our clinic and report the results. Material and...
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| Published in: | Scandinavian journal of surgery 2017-03, Vol.106 (1), p.74-79 |
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| Language: | English |
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| container_end_page | 79 |
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| container_start_page | 74 |
| container_title | Scandinavian journal of surgery |
| container_volume | 106 |
| creator | Kääriäinen, M. Salonen, K. Helminen, M. Karhunen-Enckell, U. |
| description | Background and Aims:
Chest-wall contouring surgery is an important part of the gender reassignment process that contributes to strengthening the self-image and facilitating living in the new gender role. Here, we analyze the surgical techniques used in our clinic and report the results.
Material and Methods:
Female-to-male transgender patients (n = 57) undergoing chest-wall contouring surgery at Tampere University Hospital between January 2003 and April 2015 were enrolled in the study. Breast appearance was evaluated and either a concentric circular approach or a transverse incision technique was used for mastectomy. Patient characteristics and data regarding the technique and postoperative results were collected and analyzed retrospectively.
Results:
In addition to the transgender diagnosis, 40.4% of the patients had another psychiatric diagnosis. For mastectomy, a concentric circular approach was used in 50.9% and a transverse incision approach in 49.1% of the patients. In the transverse incision group, 21.4% of the patients underwent pedicled mammaplasty and 78.6% mastectomy with a free nipple–areola complex graft. Compared with the transverse incision group, breasts were smaller (p |
| doi_str_mv | 10.1177/1457496916645964 |
| format | article |
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Chest-wall contouring surgery is an important part of the gender reassignment process that contributes to strengthening the self-image and facilitating living in the new gender role. Here, we analyze the surgical techniques used in our clinic and report the results.
Material and Methods:
Female-to-male transgender patients (n = 57) undergoing chest-wall contouring surgery at Tampere University Hospital between January 2003 and April 2015 were enrolled in the study. Breast appearance was evaluated and either a concentric circular approach or a transverse incision technique was used for mastectomy. Patient characteristics and data regarding the technique and postoperative results were collected and analyzed retrospectively.
Results:
In addition to the transgender diagnosis, 40.4% of the patients had another psychiatric diagnosis. For mastectomy, a concentric circular approach was used in 50.9% and a transverse incision approach in 49.1% of the patients. In the transverse incision group, 21.4% of the patients underwent pedicled mammaplasty and 78.6% mastectomy with a free nipple–areola complex graft. Compared with the transverse incision group, breasts were smaller (p < 0.001) and body mass index value was lower in the concentric circular group (p = 0.001). One-third of the patients had complications (hematoma, infection, seroma, fistula, or partial necrosis of nipple–areola complex) and the reoperation rate was 8.8%. Hematoma was the most frequent reason for reoperation. Corrections were required for the scar in 14.0% of the patients, the contour in 28.0%, the areola in 15.8%, and the nipple in 5.3%. Secondary corrections were needed more often in the concentric circular (55.2%) than in the transverse incision group (25.0%; p = 0.031).
Conclusions:
The larger the breast, poorer the skin quality, and greater the amount of excess skin, the longer the required incision and resulting scar is for mastectomy of female-to-male patients. Hematoma is the most common reason for acute reoperation and secondary corrections are often needed.</description><identifier>ISSN: 1457-4969</identifier><identifier>EISSN: 1799-7267</identifier><identifier>DOI: 10.1177/1457496916645964</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><ispartof>Scandinavian journal of surgery, 2017-03, Vol.106 (1), p.74-79</ispartof><rights>The Finnish Surgical Society 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c332t-a208a5bb89458f086b251a3773cbe1993af3c7a2f3ea615357e170e19fc04db63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1457496916645964$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1457496916645964$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,783,787,21978,27865,27936,27937,44957,45345</link.rule.ids><linktorsrc>$$Uhttps://journals.sagepub.com/doi/full/10.1177/1457496916645964?utm_source=summon&utm_medium=discovery-provider$$EView_record_in_SAGE_Publications$$FView_record_in_$$GSAGE_Publications</linktorsrc></links><search><creatorcontrib>Kääriäinen, M.</creatorcontrib><creatorcontrib>Salonen, K.</creatorcontrib><creatorcontrib>Helminen, M.</creatorcontrib><creatorcontrib>Karhunen-Enckell, U.</creatorcontrib><title>Chest-wall contouring surgery in female-to-male transgender patients: A one-center retrospective analysis of applied surgical techniques and results</title><title>Scandinavian journal of surgery</title><description>Background and Aims:
Chest-wall contouring surgery is an important part of the gender reassignment process that contributes to strengthening the self-image and facilitating living in the new gender role. Here, we analyze the surgical techniques used in our clinic and report the results.
Material and Methods:
Female-to-male transgender patients (n = 57) undergoing chest-wall contouring surgery at Tampere University Hospital between January 2003 and April 2015 were enrolled in the study. Breast appearance was evaluated and either a concentric circular approach or a transverse incision technique was used for mastectomy. Patient characteristics and data regarding the technique and postoperative results were collected and analyzed retrospectively.
Results:
In addition to the transgender diagnosis, 40.4% of the patients had another psychiatric diagnosis. For mastectomy, a concentric circular approach was used in 50.9% and a transverse incision approach in 49.1% of the patients. In the transverse incision group, 21.4% of the patients underwent pedicled mammaplasty and 78.6% mastectomy with a free nipple–areola complex graft. Compared with the transverse incision group, breasts were smaller (p < 0.001) and body mass index value was lower in the concentric circular group (p = 0.001). One-third of the patients had complications (hematoma, infection, seroma, fistula, or partial necrosis of nipple–areola complex) and the reoperation rate was 8.8%. Hematoma was the most frequent reason for reoperation. Corrections were required for the scar in 14.0% of the patients, the contour in 28.0%, the areola in 15.8%, and the nipple in 5.3%. Secondary corrections were needed more often in the concentric circular (55.2%) than in the transverse incision group (25.0%; p = 0.031).
Conclusions:
The larger the breast, poorer the skin quality, and greater the amount of excess skin, the longer the required incision and resulting scar is for mastectomy of female-to-male patients. Hematoma is the most common reason for acute reoperation and secondary corrections are often needed.</description><issn>1457-4969</issn><issn>1799-7267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp1UMtOwzAQjBBIVKV3jv4BQxwndsytqnhJlbjAOdo469RV6gTbBfU_-GBcygmJvexjdka7k2XXLL9hTMpbVlayVEIxIcpKifIsmzGpFJWFkOepTjA94pfZIoRtnqJUhSqKWfa12mCI9BOGgejRxXHvretJ2Pse_YFYRwzuYEAaR3rMJHpwoUfXoScTRIsuhjuyJKNDqlOTxh6jH8OEOtoPJOBgOAQbyGgITNNgsfuRtxoGElFvnH3fY0h7XWKG_RDDVXZhYAi4-M3z7O3h_nX1RNcvj8-r5ZpqzotIochrqNq2VmVVm7wWbVEx4FJy3SJTioPhWkJhOIJgFa8kMpknxOi87FrB51l-0tXp3uDRNJO3O_CHhuXN0djmr7GJQk-UAD0222RXei_8v_8N1sN8AA</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Kääriäinen, M.</creator><creator>Salonen, K.</creator><creator>Helminen, M.</creator><creator>Karhunen-Enckell, U.</creator><general>SAGE Publications</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201703</creationdate><title>Chest-wall contouring surgery in female-to-male transgender patients: A one-center retrospective analysis of applied surgical techniques and results</title><author>Kääriäinen, M. ; Salonen, K. ; Helminen, M. ; Karhunen-Enckell, U.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c332t-a208a5bb89458f086b251a3773cbe1993af3c7a2f3ea615357e170e19fc04db63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kääriäinen, M.</creatorcontrib><creatorcontrib>Salonen, K.</creatorcontrib><creatorcontrib>Helminen, M.</creatorcontrib><creatorcontrib>Karhunen-Enckell, U.</creatorcontrib><collection>CrossRef</collection><jtitle>Scandinavian journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Kääriäinen, M.</au><au>Salonen, K.</au><au>Helminen, M.</au><au>Karhunen-Enckell, U.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chest-wall contouring surgery in female-to-male transgender patients: A one-center retrospective analysis of applied surgical techniques and results</atitle><jtitle>Scandinavian journal of surgery</jtitle><date>2017-03</date><risdate>2017</risdate><volume>106</volume><issue>1</issue><spage>74</spage><epage>79</epage><pages>74-79</pages><issn>1457-4969</issn><eissn>1799-7267</eissn><abstract>Background and Aims:
Chest-wall contouring surgery is an important part of the gender reassignment process that contributes to strengthening the self-image and facilitating living in the new gender role. Here, we analyze the surgical techniques used in our clinic and report the results.
Material and Methods:
Female-to-male transgender patients (n = 57) undergoing chest-wall contouring surgery at Tampere University Hospital between January 2003 and April 2015 were enrolled in the study. Breast appearance was evaluated and either a concentric circular approach or a transverse incision technique was used for mastectomy. Patient characteristics and data regarding the technique and postoperative results were collected and analyzed retrospectively.
Results:
In addition to the transgender diagnosis, 40.4% of the patients had another psychiatric diagnosis. For mastectomy, a concentric circular approach was used in 50.9% and a transverse incision approach in 49.1% of the patients. In the transverse incision group, 21.4% of the patients underwent pedicled mammaplasty and 78.6% mastectomy with a free nipple–areola complex graft. Compared with the transverse incision group, breasts were smaller (p < 0.001) and body mass index value was lower in the concentric circular group (p = 0.001). One-third of the patients had complications (hematoma, infection, seroma, fistula, or partial necrosis of nipple–areola complex) and the reoperation rate was 8.8%. Hematoma was the most frequent reason for reoperation. Corrections were required for the scar in 14.0% of the patients, the contour in 28.0%, the areola in 15.8%, and the nipple in 5.3%. Secondary corrections were needed more often in the concentric circular (55.2%) than in the transverse incision group (25.0%; p = 0.031).
Conclusions:
The larger the breast, poorer the skin quality, and greater the amount of excess skin, the longer the required incision and resulting scar is for mastectomy of female-to-male patients. Hematoma is the most common reason for acute reoperation and secondary corrections are often needed.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><doi>10.1177/1457496916645964</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Sage Journals GOLD Open Access 2024 |
| title | Chest-wall contouring surgery in female-to-male transgender patients: A one-center retrospective analysis of applied surgical techniques and results |
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