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Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

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A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
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Tracheostomy Care II: Procedure01:25

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Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
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Related Experiment Video

Updated: Dec 19, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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A Three-Step Technique for Optimal Nipple Position in Transgender Chest Masculinization.

Haripriya S Ayyala1, Thayer J Mukherjee1, Thuy-My Le1

  • 1Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ.

Aesthetic Surgery Journal
|June 6, 2020
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Summary

This study introduces a triple confirmation technique for precise nipple-areola complex (NAC) positioning in female-to-male chest masculinization surgery, achieving high patient satisfaction with aesthetic outcomes.

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Area of Science:

  • Plastic Surgery
  • Gender Affirmation Surgery
  • Aesthetic Reconstruction

Background:

  • Determining the ideal nipple-areola complex (NAC) position is a significant challenge in transgender chest masculinization.
  • Standardized methods are needed to ensure optimal aesthetic and functional outcomes for female-to-male chest reconstruction.

Purpose of the Study:

  • To establish the best location and aesthetic parameters for the nipple-areola complex (NAC) in female-to-male chest masculinization.
  • To evaluate patient satisfaction with NAC placement and overall surgical results.

Main Methods:

  • A cohort of patients undergoing female-to-male mastectomy with free nipple grafting was analyzed.
  • A novel triple confirmation technique using vertical and horizontal coordinates was employed for NAC positioning.
  • Postoperative patient satisfaction was assessed using a 24-question Likert scale survey.

Main Results:

  • All 18 surveyed patients reported high satisfaction with the aesthetic results of their chest masculinization.
  • 100% of patients expressed satisfaction with the nipple location (mean Likert score 4.72).
  • Patients reported high satisfaction with nipple size (mean 4.17) and shape (mean 3.89).

Conclusions:

  • The triple confirmation technique provides an effective, reproducible method for guiding NAC relocation during gender affirmation surgery.
  • This technique contributes to achieving excellent aesthetic results and high patient satisfaction in female-to-male chest masculinization.