Breast Augmentation in Transwomen: Can We have a Formula?

Area of Science:

• Plastic Surgery
• Gender Affirming Care
• Surgical Outcomes

Background:

• Breast augmentation in transwomen lacks specific preoperative guidelines for implant size selection.
• Existing methods may lead to subjective assessments, increasing operative time, costs, and revision rates.
• A standardized approach is needed to improve predictability and patient satisfaction.

Purpose of the Study:

• To derive a novel formula for preoperative breast implant size estimation in transwomen.
• To minimize surgeon bias and enhance patient-physician communication regarding expected outcomes.
• To reduce operative time, financial costs, and the incidence of revision surgeries.

Main Methods:

• Retrospective study of 51 transwomen patients from October 2018 to December 2020.
• Utilized a routine measurement protocol including chest circumference at inframammary fold (CC), circumference at point of maximum projection (POMP), and nipple-to-IMF distance difference (LOWERDIFF).
• Applied linear multivariate regression to develop the predictive formula.

Main Results:

• A formula for preoperative breast implant size calculation was successfully derived.
• The mean implant volume used was 354.51 mL.
• Complications included pain, delayed healing, and wound dehiscence, with a correlation found between complications and exceeding the calculated implant size by over 9%.

Conclusions:

• A simple formula based on four anthropometric measurements enables preoperative breast implant size estimation for transwomen.
• The derived equation serves as a valuable tool for surgeons and patient education, potentially improving surgical planning.
• Prospective studies are recommended to validate the formula's efficacy; exceeding the calculated size by 9% appears inadvisable.