Masculinization of the Chest in Transmen with Large Breasts

Area of Science:

• Plastic Surgery
• Gender Affirming Care
• Transgender Health

Background:

• Chest masculinization surgery is a key procedure for transgender men (transmen) seeking to align their physical appearance with their gender identity.
• This study focuses on a specific surgical technique for chest masculinization in transmen with large breasts and hypertrophied nipples/areolae.

Purpose of the Study:

• To analyze the outcomes of a comprehensive, single-staged surgical masculinization procedure for the chest in transmen.
• To evaluate patient satisfaction and aesthetic results using a validated scoring system.

Main Methods:

• A prospective cohort study involving 32 transmen with large breasts.
• Surgical technique included modified elliptical incision subcutaneous mastectomy, liposuction, reduced nipple-areola grafting, and quilting stitches.
• Outcomes were assessed using the institutional aesthetic outcome assessment score (IAOAS) after an average follow-up of 24.5 months.

Main Results:

• The average final IAOAS was 23.1.
• A high rate of excellent (68.75%) and good (31.25%) outcomes was observed.
• Complication rates were associated with the use of breast binders.

Conclusions:

• Top surgery is essential for transmasculine individuals to affirm their male gender identity.
• The described single-staged approach combining subcutaneous mastectomy and liposuction yields high patient satisfaction and excellent aesthetic results.
• This procedure is considered a prerequisite for subsequent gender-affirming surgeries at the institute.