Abstract
Purpose:
Masculinizing chest surgery is the most common surgical procedure for transgender and gender-diverse patients. This study outlines technical improvements by associating torsoplasty double-incision with a free nipple-areola complex grafting and conceals the future scar in the natural chest crease. The main purpose of this work was to assess surgical outcomes and patient satisfaction regarding this improved transgender torsoplasty technique.
Methods:
A pilot study of transgender patients' follow-up was conducted following chest masculinizing surgery. Patient breast characteristics, complications, and cosmetic revision surgery were assessed. Anonymous quality of life and satisfaction self-report questionnaires made up of the breast questionnaire (BREAST-Q) breast reduction questionnaire and the body questionnaire chest module were collected pre- and postoperatively.
Results:
Between July 2017 and December 2019, the improved double-incision masculinizing torsoplasty (IDIMT) was performed on 50 breasts in 25 transgender patients. Postoperative hematoma requiring urgent surgical revision occurred in four patients (8% of chest surgery patients). Postoperative BREAST-Q reduction module scores indicated greater satisfaction with chest outcomes (mean score 18.4 vs. 39.7), sexual well-being (mean score 6.4 vs. 17.4), and psychosocial well-being (mean score 30.4 vs. 41.2). The importance of male chest appearance in gender affirmation was considerable for almost all patients (n=20, 95.3%).
Conclusion:
Herein, we report that the above-described IDIMT appears safe with a low postoperative complication rate. We show that this improved technique enhances the patient quality of life, aesthetic/sexual satisfaction, and psychosocial well-being. This procedure is also crucial to gender affirmation for patients.
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