Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery
Background:. The purpose of mastectomy for the female-to-male transgender patient is to produce a masculine appearance of the chest. A number of algorithms have been proposed for selecting the surgical technique; these have generally been based on the degree of breast ptosis and the quality and elas...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003363 |
| _version_ | 1818439330156249088 |
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| author | Yoram Wolf, MD Samuel Kwartin, MD |
| author_facet | Yoram Wolf, MD Samuel Kwartin, MD |
| author_sort | Yoram Wolf, MD |
| collection | DOAJ |
| description | Background:. The purpose of mastectomy for the female-to-male transgender patient is to produce a masculine appearance of the chest. A number of algorithms have been proposed for selecting the surgical technique; these have generally been based on the degree of breast ptosis and the quality and elasticity of the skin. We present a series of subcutaneous mastectomies operated on by 1 surgeon during the last 2 decades. Based on our experience, we suggest a classification system for selecting surgical technique.
Methods:. Data were collected from the files of female-to-male transgender persons who underwent surgery during 2003–2019. The data included background and surgery information. Pictures from the clinic’s archive of the patients before, during, and after surgery were collected and analyzed.
Results:. In total, 220 mastectomies were performed on 110 patients aged 13.5–50 years (mean 22.5 ±6.1). The excision averaged 443 g per breast (range: 85–2550). A periareolar approach was performed in 14 (12.7%), omega-shaped resection (nipple–areola complex on scar) in 2 (1.8%), spindle-shaped mastectomy with a dermal nipple–areola complex flap approach in 38 (34.5%), and a complete mastectomy with a free nipple–areola complex graft in 56 (50.9%). Complications included 2 hypertrophic scars, 6 hematomas requiring revision surgery, 3 wound dehiscences, and 3 cases of partial nipple necrosis.
Conclusions:. Analysis of the data led to a proposed classification for female-to-male transgender mastectomy (Wolf’s classification), based on skin excess and the distance between the original and the planned position of the nipple–areola complex. |
| first_indexed | 2024-12-14T17:54:45Z |
| format | Article |
| id | doaj.art-776a94c3369149218c715d8cffb87a95 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-14T17:54:45Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-776a94c3369149218c715d8cffb87a952022-12-21T22:52:35ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742021-01-0191e336310.1097/GOX.0000000000003363202101000-00006Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming SurgeryYoram Wolf, MD0Samuel Kwartin, MD1From the * Plastic Surgery Unit, Hillel Yaffe Medical Center, The Technion, Rappaport Faculty of Medicine, Haifa, IsraelFrom the * Plastic Surgery Unit, Hillel Yaffe Medical Center, The Technion, Rappaport Faculty of Medicine, Haifa, IsraelBackground:. The purpose of mastectomy for the female-to-male transgender patient is to produce a masculine appearance of the chest. A number of algorithms have been proposed for selecting the surgical technique; these have generally been based on the degree of breast ptosis and the quality and elasticity of the skin. We present a series of subcutaneous mastectomies operated on by 1 surgeon during the last 2 decades. Based on our experience, we suggest a classification system for selecting surgical technique. Methods:. Data were collected from the files of female-to-male transgender persons who underwent surgery during 2003–2019. The data included background and surgery information. Pictures from the clinic’s archive of the patients before, during, and after surgery were collected and analyzed. Results:. In total, 220 mastectomies were performed on 110 patients aged 13.5–50 years (mean 22.5 ±6.1). The excision averaged 443 g per breast (range: 85–2550). A periareolar approach was performed in 14 (12.7%), omega-shaped resection (nipple–areola complex on scar) in 2 (1.8%), spindle-shaped mastectomy with a dermal nipple–areola complex flap approach in 38 (34.5%), and a complete mastectomy with a free nipple–areola complex graft in 56 (50.9%). Complications included 2 hypertrophic scars, 6 hematomas requiring revision surgery, 3 wound dehiscences, and 3 cases of partial nipple necrosis. Conclusions:. Analysis of the data led to a proposed classification for female-to-male transgender mastectomy (Wolf’s classification), based on skin excess and the distance between the original and the planned position of the nipple–areola complex.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003363 |
| spellingShingle | Yoram Wolf, MD Samuel Kwartin, MD Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery Plastic and Reconstructive Surgery, Global Open |
| title | Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery |
| title_full | Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery |
| title_fullStr | Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery |
| title_full_unstemmed | Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery |
| title_short | Classification of Transgender Man’s Breast for Optimizing Chest Masculinizing Gender-affirming Surgery |
| title_sort | classification of transgender man s breast for optimizing chest masculinizing gender affirming surgery |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003363 |
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