Surgical indications and outcomes of mastectomy in transmen: A prospective study of technical and self-reported outcome measures

Although transgender surgery constitutes a growing field within plastic surgery, prospective studies on masculinizing mastectomies are lacking [ view full abstract ]

Although transgender surgery constitutes a growing field within plastic surgery, prospective studies on masculinizing mastectomies are lacking

The objective of the present study was to prospectively follow a cohort of transmen undergoing mastectomy and assessing technical and self-reported outcomes, as well as to evaluate surgical decision-making. [ view full abstract ]

The objective of the present study was to prospectively follow a cohort of transmen undergoing mastectomy and assessing technical and self-reported outcomes, as well as to evaluate surgical decision-making.

Fifty-four transmen were recruited during a 10-month period at the Department of Plastic Surgery of a Centre of Expertise on Gender Dysphoria. Preoperative assessment included standardized chest examination. Six months... [ view full abstract ]

Fifty-four transmen were recruited during a 10-month period at the Department of Plastic Surgery of a Centre of Expertise on Gender Dysphoria. Preoperative assessment included standardized chest examination. Six months postoperatively, participants rated their satisfaction with surgery, and 12 months postoperative surgical outcomes were reviewed independently.

Surgical decision-making was evaluated by comparing indications and outcomes per technique, and assessing the clinical validity of the most-used decision-aid (using Cohen’s kappa). [ view full abstract ]

Surgical decision-making was evaluated by comparing indications and outcomes per technique, and assessing the clinical validity of the most-used decision-aid (using Cohen’s kappa).

One periareolar mastectomy, 26 concentric circular mastectomies and 22 inframammary skin resections with free nipple graft were performed in our cohort. Five participants were still to be operated. Concentric circular... [ view full abstract ]

One periareolar mastectomy, 26 concentric circular mastectomies and 22 inframammary skin resections with free nipple graft were performed in our cohort. Five participants were still to be operated. Concentric circular mastectomy was performed in smaller or medium-size breasts with low ptosis-grade and good elasticity, whereas the inframammary skin resection group showed a wider range of physical characteristics. Despite being performed in better-quality breasts, concentric circular mastectomy was associated with more secondary corrections (38.5%), dehiscence, seroma, and lower postoperative satisfaction compared to inframammary skin resections. Clinical decision-making was generally in line with the published decision-aid.

Compared to inframammary skin resections, concentric circular mastectomy – despite being performed in favourable breast types – appears to produce poorer technical and self-reported outcomes. Surgical indications and... [ view full abstract ]

Compared to inframammary skin resections, concentric circular mastectomy – despite being performed in favourable breast types – appears to produce poorer technical and self-reported outcomes. Surgical indications and preoperative counselling regarding secondary corrections may therefore be subject to improvement.