Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Division of Urology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Aesthet Surg J. 2019 Mar 14;39(4):381-390. doi: 10.1093/asj/sjy143.
Breast augmentation in trans-women requires special consideration and thorough preoperative planning.
This study aimed to present our long-term outcome and experience gained over the past 21 years.
Trans-women who have undergone breast augmentation since 1995 were reviewed for primary surgery, type of incision, implant site, implant size and shape, and revisions.
A total of 138 patients with a follow-up of 4.6 years (range, 2.0-13.3) were included. In 112 patients (82.4%), the inframammary incision was chosen. Subpectoral implantation was performed in 70 patients (51.5%). Round breast implants (91 patients, 66.9%, P = 0.010) with low projection (103 patients, 75.7%, P < 0.001) were favored. The implant size used during 2011-2016 of 363.3 ± 97.3 cc was significantly increased as compared to the implant size reported during 1995-1999 (mean difference, +142.1 cc, P < 0.001) and 2000-2004 (mean difference, +113.5 cc, P < 0.001). Simultaneously, revision rates dropped significantly over time (52.9% during 1995-1999 as compared to 6.9% during 2011-2016, P < 0.001). Overall, request for larger implants was the most common indication for revision (13 patients, 9.4%) after 6 months (range, 4.0-18.7). At revision, implant volume was 355.4 ± 132.8 cc, showing significant increase of 107.0 ± 48.1 cc as compared to primary implants (+30.0%, P = 0.048).
Request for larger breast implants was the most common reason for revision. Depending on the various degrees of breast tissue growth due to hormonal therapy, whenever applicable, we recommend round, low projection implants with a mean size of 360 cc in the prepectoral pocket.
跨性别女性的乳房增大需要特殊考虑和充分的术前规划。
本研究旨在介绍我们过去 21 年的长期结果和经验。
回顾了自 1995 年以来接受过乳房增大手术的跨性别女性，包括初次手术、切口类型、植入部位、植入物大小和形状以及修正手术。
共纳入 138 例患者，随访时间为 4.6 年（范围 2.0-13.3）。在 112 例患者（82.4%）中，选择了乳晕下切口。70 例患者（51.5%）采用了胸大肌下植入。更喜欢使用圆形乳房植入物（91 例，66.9%，P=0.010），低突度（103 例，75.7%，P<0.001）。2011-2016 年使用的植入物大小为 363.3±97.3cc，与 1995-1999 年（平均差异，+142.1cc，P<0.001）和 2000-2004 年（平均差异，+113.5cc，P<0.001）报告的植入物大小相比显著增加。同时，随着时间的推移，修复率显著下降（1995-1999 年为 52.9%，2011-2016 年为 6.9%，P<0.001）。总体而言，在 6 个月（范围 4.0-18.7）后，要求更大的植入物是最常见的修复指征（13 例，9.4%）。在修复时，植入物体积为 355.4±132.8cc，与初次植入物相比，显著增加了 107.0±48.1cc（+30.0%，P=0.048）。
要求更大的乳房植入物是最常见的修复原因。根据激素治疗引起的不同程度的乳房组织生长，只要适用，我们建议在前胸肌口袋中使用圆形、低突度、平均大小为 360cc 的植入物。
