Refinements in Gender-Affirming Feminizing Chest Surgery

Area of Science:

• Plastic Surgery
• Gender-Affirming Care

Background:

• Feminizing top surgery (mammaplasty augmentation) involves surgical adjustments for gender dysphoria.
• Surgeons must consider unique anatomy in transgender and gender diverse patients.

Purpose of the Study:

• To evaluate the outcomes of a specific subfascial surgical approach for feminizing top surgery.
• To assess complication rates and aesthetic results in gender-diverse individuals.

Main Methods:

• Retrospective chart review (December 2019 - May 2023) of 140 gender-diverse patients.
• Inclusion of transgender women and nonbinary individuals undergoing feminizing top surgery.
• Analysis of complication rates (hematoma, infection, seroma, etc.) and cosmetic outcomes.

Main Results:

• The subfascial approach yielded low complication rates: hematoma (4.29%), infection (2.86%), seroma (1.42%).
• Good cosmetic outcomes observed with low rates of contour abnormalities (5.71%) and asymmetry (1.43%).
• Only 3.57% of patients required revision surgery.

Conclusions:

• A reproducible subfascial technique using calculated dissection pockets and concealed incisions achieves favorable aesthetic results.
• This method effectively minimizes complications in feminizing top surgery for gender-diverse patients.
• Bilateral breast augmentation with round implants in the subfascial plane is a safe and effective procedure.