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Related Experiment Videos

A Single Surgeon's Experience With Transgender Female-to-Male Chest Surgery.

David M Whitehead, Paul R Weiss1, Dina Podolsky1

  • 1Albert Einstein College of Medicine, Bronx, NY.

Annals of Plastic Surgery
|June 20, 2018
PubMed
Summary

Chest wall recontouring for gender dysphoria is safe. Advanced patient age and surgeon inexperience increase minor complication risk, while preoperative hormones may offer protection. Further follow-up is needed for late complications.

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Area of Science:

  • Plastic Surgery
  • Gender Affirming Care
  • Surgical Outcomes

Background:

  • Chest wall recontouring is a key surgical intervention for gender dysphoria in transgender men and nonbinary individuals assigned female at birth.
  • This study analyzes over two decades of surgical cases to identify factors influencing postoperative complications and nipple sensation preservation.

Purpose of the Study:

  • To identify risk factors for major and minor complications following chest wall recontouring surgery.
  • To assess the likelihood of preserving nipple sensation after different surgical techniques.

Main Methods:

  • A retrospective review of 137 female-to-male chest wall recontouring cases performed between 1994 and 2016.
  • Analysis of 99 cases using double-incision free nipple graft and double incision with nipple transposition on a pedicle techniques.

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  • Multivariate analysis to determine predictors of complications.

    • Main Results:

    • No significant risk factors identified for major postoperative complications.
    • Advanced patient age and less surgeon experience were associated with higher rates of minor complications.
    • Preoperative hormonal therapy showed a trend towards a protective effect against complications.

    Conclusions:

    • Chest wall recontouring techniques are generally safe, but a learning curve exists.
    • The double incision with nipple transposition on a pedicle technique may be preferred if nipple-areola complex depigmentation is a concern.
    • Longer follow-up is recommended to identify potential late complications.