Salim Ali, Metz Erica, Constant James S, Gurjala Anandev, Yokoo Karen, Tong Winnie M Y
From the Department of Surgery, Kaiser Permanente Medical Center, San Francisco, CA.
Ann Plast Surg. 2018 May;80(5S Suppl 5):S279-S284. doi: 10.1097/SAP.0000000000001414.
INTRODUCTION: Despite the rising popularity of subcutaneous mastectomy (top surgery) in patients born female and identifying as male or nonbinary, there are limited studies on how prior breast surgeries affect subcutaneous mastectomy. This study evaluates if previous breast reduction affected subcutaneous mastectomy in this patient population. METHODS: The case series consists of 5 patients who, having had prior breast reductions, elected to have subcutaneous mastectomy. The data were collected retrospectively for mastectomy conducted from 2015 to 2016. Demographic data collected included age at surgery, body mass index, smoking status, medical comorbidity, and use of hormone medication. Outcome data included postoperative complications and need for operative revision. Postoperative follow-up was at 1 week and at 1, 3, 6, and 12 months. RESULTS: Patients' ages were between 29 and 46 years with body mass index from 24 to 33 kg/m. They underwent breast reduction approximately 9 to 26 months prior to subcutaneous mastectomy. All 5 patients successfully underwent subcutaneous mastectomy via double incision and free nipple grafts. Blood loss was estimated to be approximately 42 mL. All patients were discharged on the same day of surgery. The last follow-up averaged at 13 months after surgery and no major complication was reported. However, 1 patient required revision of the nipple graft and chest scars. CONCLUSIONS: This small case series suggests that subcutaneous mastectomy could be safely performed in transmasculine or nonbinary patients who had previous breast reduction.
引言:尽管皮下乳房切除术(胸部手术)在出生时为女性且自我认同为男性或非二元性别的患者中越来越受欢迎,但关于既往乳房手术如何影响皮下乳房切除术的研究有限。本研究评估既往乳房缩小术是否会影响该患者群体的皮下乳房切除术。 方法:该病例系列包括5例曾接受过乳房缩小术并选择进行皮下乳房切除术的患者。回顾性收集了2015年至2016年进行乳房切除术的数据。收集的人口统计学数据包括手术年龄、体重指数、吸烟状况、合并症以及激素药物的使用情况。结果数据包括术后并发症和手术修复的需求。术后随访时间为1周以及1、3、6和12个月。 结果:患者年龄在29至46岁之间,体重指数为24至33kg/m²。他们在皮下乳房切除术之前约9至26个月接受了乳房缩小术。所有5例患者均通过双切口和游离乳头移植成功进行了皮下乳房切除术。估计失血量约为42mL。所有患者均在手术当天出院。最后一次随访平均在术后13个月,未报告重大并发症。然而,1例患者需要对乳头移植和胸部瘢痕进行修复。 结论:这个小病例系列表明,对于既往接受过乳房缩小术的跨性别男性或非二元性别患者,可以安全地进行皮下乳房切除术。
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