Arch Plast Surg.  2019 May;46(3):262-266. 10.5999/aps.2018.00108.

Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar

• Cely AM
• Triana CE
• Triana LM

• KMID: 2450937
• DOI: http://doi.org/10.5999/aps.2018.00108

Abstract

Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.

Keyword

Transsexualism; Gender dysphoria; Gynecomastia; Mastectomy

MeSH Terms

Body Image
Breast
Cicatrix*
Feminization
Gender Dysphoria
Gender Identity
Gynecomastia
Humans
Hypopigmentation
Male
Mastectomy*
Prevalence
Thorax*
Transplants
Transsexualism