[OUR EXPERIENCE IN MASTECTOMY FOR TRANSGENDERS FEMALE TO MALE - A 90 CASES COHORT STUDY]

We present our experience in mastectomies for masculine chest contouring, including discussion of techniques, complications and decision-making processes.

Creating a masculine chest is an important component in the process of gender reassignment, in female to male transgenders. This surgery may be performed using various techniques and the main complication is acute hematoma requiring surgical revision.

The study population included all the patients operated on during 2013-2018. Data was collected from the medical files and clinical photos.

A total of 180 mastectomies were performed on 90 patients, 67 of which were performed in the past 5 years; average age was 22.4 years; average tissue weight was 467 grams per breast and operation length was 2.5 hours; 13 (14%) were operated on with the periareolar approach, 3 (3.3%) using a Nipple Areolar Complex (NAC) on scar approach, 37 (41.1%) using a dermal NAC flap approach and 37 (41.1%) using a free NAC graft (41.1%). Complications included two hypertrophic scars, five hematomas requiring revision surgery, three wound dehiscence and two cases of nipple necrosis.

We will present a series of 90 cases of female to male transgenders operated on by the senior author over the past two decades.

The choice of technique changed over the years as did the operation length. The two main approaches are dermal NAC flap and a free NAC graft. Future studies will compare these techniques. There is a need for a clinical classification for choosing the tailored type of operation according to the characteristics of the breast.