Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Heinrich-Zille-Str. 13, 01445, Radebeul, Germany.
Department of Women's Health, University of Tübingen, Tübingen, Germany.
Aesthetic Plast Surg. 2024 Mar;48(6):1126-1132. doi: 10.1007/s00266-022-02945-0. Epub 2022 Jun 14.
The surgical goals of gender reassignment surgery of the breast in female-to male transsexuals (FMT) is the aesthetic shaping of a male thoracic wall with minimal scarring, while preserving the sensitivity of the nipple-areola complex (NAC). For large and ptotic breasts, we perform a mastectomy over an inframammary access with inferior pedicled NAC under color Doppler visualization of the perforators. This paper presents the technique, including complications and assessment of quality of life, as part of a unicentric analysis.
This was a retrospective analysis of 23 patients (46 mastectomies) performed between September 2014 and September 2020. The complication rate and the number of corrective surgeries were recorded for quality assessment. A semiquantitative score was used to evaluate aesthetic outcome, nipple sensitivity, quality of life, and sexuality.
A total of 46 mastectomies were performed in 23 patients. The patient survey showed high patient satisfaction. Loss of nipple sensitivity was observed after one mastectomy (2.17%). In 91.67% of cases, patients reported that their appearance reflected how they feel on the inside. In 75% of cases, patients reported feeling equal to other men. The overall complication rate was 10.87%. Shape correction due to persistent excess of volume was rare (2.17%, equivalent to one mastectomy).
Subcutaneous mastectomy with inferior nipple pedicle can be performed with a high degree of safety and satisfaction in FMT. Color Doppler-guided visualization of the perforator vessels is helpful in allowing a thin pedicle preparation, thus reducing the need for secondary surgeries to optimize the shape.
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女性变男性跨性别者（FMT）乳房再造手术的外科目标是通过最小化疤痕来塑造男性胸壁的美感，同时保留乳晕复合体（NAC）的敏感性。对于大而下垂的乳房，我们通过乳晕下的下蒂 NAC 进行乳房切除术，并在穿支血管的彩色多普勒可视化下进行。本文介绍了该技术，包括并发症和生活质量评估，作为单中心分析的一部分。
这是对 2014 年 9 月至 2020 年 9 月期间进行的 23 例患者（46 例乳房切除术）的回顾性分析。记录并发症发生率和需要矫正手术的数量，以评估质量。使用半定量评分评估美学效果、乳头敏感性、生活质量和性生活。
共对 23 例患者进行了 46 例乳房切除术。患者调查显示患者满意度高。一例乳房切除术后出现乳头敏感性丧失（2.17%）。91.67%的患者报告说，他们的外表反映了他们的内在感受。75%的患者报告说，他们感觉与其他男性平等。总的并发症发生率为 10.87%。由于持续存在的多余体积而需要进行形状矫正的情况很少见（2.17%，相当于一例乳房切除术）。
在 FMT 中，带下方乳头蒂的皮下乳房切除术具有高度的安全性和满意度。穿支血管的彩色多普勒引导可视化有助于准备薄蒂，从而减少优化形状的二次手术需求。
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