Augmentation Mammoplasty, an Indispensable Complement of Feminization in Gender Identity Disorder
Keywords:
augmentation mammoplasty, gender reassignment, transgender.Abstract
Introduction: The breast is one of the main external indicators of femininity, a reason why augmentation mastoplasty is a significant step in the transition to womanhood and improves symptoms of gender dysphoria.
Objective: To present the results of breast augmentation with implants in transgender patients.
Methods: A descriptive, longitudinal and prospective study was carried out in patients cared at the plastic surgery service of Hospital Clínico Quirúrgico Hermanos Ameijeiras, referred from the National Center for Sexual Education to complete the gender reassignment treatment with breast augmentation surgery, in the period between January and June 2022.
Results: The sample consisted of five patients, whose mean age was 45.2 years. One hundred percent received hormone therapy, 80 % were apparently healthy and 20 % were carriers of human immunodeficiency virus. Preoperatively, 80 % had absent breast tissue; the diameter of the nipple-areola complex was less than 3 cm and the length of segment three in profile view of the breast was less than 4 cm. 100 % were implanted with round cohesive silicone gel breast implants with microtextured surface. The implant volume was 255 cm3 in 80 % and 285 cm3 in 20 %. 100 % were approached through the submammary sulcus and the implant placement plane was retromuscular. No complications arose; all were satisfied with the good outcomes.
Conclusions: Augmentation mastoplasty with appropriate implants and technique in transgender patients offers good outcomes. It guarantees satisfaction to patients with male phenotype and female gender identity, whose breasts are the maximum expression of femininity.
Downloads
References
Layt C. Augmentation Mastopexy: Planning and Performance for Predictability: Management of Complications. Clin Plast Surg. 2021;48(1):45-57. DOI: https://doi.org/10.1016/j.cps.2020.09.002
Littman L. Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. 2021;50(8):3353-69. DOI: https://doi.org/10.1007/s10508-021-02163-w
Bekeny J, Zolper E, Fan K, Del Corral G. Breast augmentation for transfeminine patients: methods, complications, and outcomes. Gland Surg. 2020;9(3):788-96. DOI: https://doi.org/10.21037/gs.2020.03.18
Chatterjee S, Khanna M. Hundred and Eleven Cases of Subfascial Breast Augmentation in Trans Women-A Single-Center Experience. Indian J Plast Surg. 2020;53(1):51-8. DOI: https://doi.org/10.1055/s-0040-1708227
Claes K, D'Arpa S, Monstrey S. Chest Surgery for Transgender and Gender Nonconforming Individuals. Clin Plast Surg. 2018;45(3):369-80. DOI: https://doi.org/10.1016/j.cps.2018.03.010
de Blok C, Klaver M, Wiepjes C, Nota N, Heijboer A, Fisher A, et al. Breast Development in Transwomen After 1 Year of Cross-Sex Hormone Therapy: Results of a Prospective Multicenter Study. J Clin Endocrinol Metab. 2018;103(2):532-8. DOI: https://doi.org/10.1210/jc.2017-01927
Weigert R, Frison E, Sessiecq Q, Al Mutairi K, Casoli V. Patient satisfaction with breasts and psychosocial, sexual, and physical well-being after breast augmentation in male-to-female transsexuals. Plast Reconstr Surg. 2013;132(6):1421-9. DOI: https://doi.org/10.1097/01.prs.0000434415.70711.49
Simpson J, Bao X, Agarwala A. Pain Management in Enhanced Recovery after Surgery (ERAS) Protocols. Clin Colon Rectal Surg. 2019;32(2):121-8. DOI: https://doi.org/10.1055/s-0038-1676477
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. DOI: https://doi.org/10.1001/jama.2013.281053
Gabrick K, Chouiari F, Park K, Allam O, Mozaffari M, Persing J, et al. A comparison of perioperative safety for breast augmentation in cis- vs. trans patients. Ann Transl Med. 2021;9(7):601. DOI: https://doi.org/10.21037/atm-20-3355
de Blok C, Staphorsius A, Wiepjes C, Smit J, Nanayakkara P, den Heijer M. Frequency, Determinants, and Satisfaction of Breast Augmentation in Trans Women Receiving Hormone Treatment. J Sex Med. 2020;17(2):342-8. DOI: https://doi.org/10.1016/j.jsxm.2019.10.021
Fakin R, Zimmermann S, Kaye K, Lunger L, Weinforth G, Giovanoli P. Long-Term Outcomes in Breast Augmentation in Trans-Women: A 20-Year Experience. Aesthet Surg J. 2019;39(4):381-90. DOI: https://doi.org/10.1093/asj/sjy143
Namnoum J, Largent J, Kaplan H, Oefelein M, Brown M. Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type. J Plast Reconstr Aesthet Surg. 2013;66(9):1165-72. DOI: https://doi.org/10.1016/j.bjps.2013.04.046
Yu X, Kang C, Guttery D, Kadry S, Chen Y, Zhang Y. ResNet-SCDA-50 for Breast Abnormality Classification. IEEE/ACM Trans Comput Biol Bioinform. 2021;18(1):94-102. DOI: https://doi.org/10.1109/TCBB.2020.2986544
Yalanis G, Liu E, Cheng H. Efficacy and Safety of Povidone-Iodine Irrigation in Reducing the Risk of Capsular Contracture in Aesthetic Breast Augmentation: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2015;136(4):687-98. DOI: https://doi.org/10.1097/PRS.0000000000001576
Schoffer A, Bittner A, Hess J, Kimmig R, Hoffmann O. Complications and satisfaction in transwomen receiving breast augmentation: short- and long-term outcomes. Arch Gynecol Obstet. 2022;305(6):1517-24. DOI: https://doi.org/10.1007/s00404-022-06603-3
Coroneos C, Selber J, Offodile A, Butler C, Clemens M. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients. Ann Surg. 2019;269(1):30-6. DOI: https://doi.org/ 10.1097/SLA.0000000000002990
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
