Bekeny Jenna C, Zolper Elizabeth G, Manrique Oscar J, Fan Kenneth L, Del Corral Gabriel
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.
Department of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Ann Transl Med. 2021 Apr;9(7):611. doi: 10.21037/atm-20-5087.
Gender-affirming surgery (GAS) is often a crucial step during the journey to identity actualization for transgender patients. Surgical breast augmentation, or "top surgery", is frequently cited as the most important and sometimes only gender-affirming procedure sought by transfeminine patients. The breast augmentation process is remarkably similar in transgender and cisgender patients. However, there are unique guidelines, anatomic considerations, and contextual issues for the transgender patient population that must be taken into account by providers to achieve optimal outcomes. The aim of this review is to outline the current state of breast augmentation for transfeminine patients. We walk through our suggested pre-surgical evaluation, breast augmentation options, and post-surgical care. In the preoperative period, providers must establish a positive provider-patient relationship that allows for thorough history taking, physical examination, and goal setting. Providers must be able to select an appropriate implant, incision location, and operative plane to balance patient desires and pre-existing anatomic characteristics in transfeminine patients. Postoperatively, the provider must address acute and chronic needs to allow for continued satisfaction and safety. After reading this review, we aim for providers to be well-equipped to provide the highest quality breast augmentation care for their transfeminine patients. As research into best practices for breast augmentation in transfeminine patients continues to develop, we expect that surgical practice will continue to evolve.
性别肯定手术（GAS）通常是跨性别患者实现身份认同过程中的关键一步。手术隆胸，即“上半身手术”，经常被认为是跨性别女性患者寻求的最重要且有时是唯一的性别肯定手术。跨性别患者和顺性别患者的隆胸过程非常相似。然而，对于跨性别患者群体，有一些独特的指导方针、解剖学考量和背景问题，医疗服务提供者必须加以考虑，以实现最佳效果。本综述的目的是概述跨性别女性患者隆胸的现状。我们将介绍建议的术前评估、隆胸选择和术后护理。在术前阶段，医疗服务提供者必须建立良好的医患关系，以便进行全面的病史采集、体格检查和目标设定。医疗服务提供者必须能够选择合适的植入物、切口位置和手术层面，以平衡跨性别女性患者的需求和其现有的解剖特征。术后，医疗服务提供者必须满足患者的急性和慢性需求，以确保患者持续满意并保证安全。阅读本综述后，我们希望医疗服务提供者能够充分准备好为其跨性别女性患者提供最高质量的隆胸护理。随着对跨性别女性患者隆胸最佳实践的研究不断发展，我们预计手术实践也将不断演变。
