The analysis try authorized by the integrity committee from Trakya University

Out of , i performed 52 bilateral subcutaneous mastectomies at the Company off Plastic, Reconstructive and you can Graphic Businesses, Trakya College or university Hospital, Edirne, Turkey ( Desk step one ). An average diligent ages was twenty eight.2 (a long time, 18-47). The weights of patients was basically ranging from forty and 100 kg and you may average bmi (BMI) try 23.cuatro (Bmi range, 15.6-36.7). 30 clients got a track record of finding testosterone hormonal medication ahead of operation. Hormone medication is actually left behind four weeks prior to medical input. Together with, for each diligent underwent a whole psychiatric, endocrinological, urologic and you will gynecological investigations, and that greeting brand new diagnosis of “FtM transsexualism” to-be made. An enthusiastic ultrasound test try did to check the presence of glandular muscle and ban people pathologic size in every circumstances. ‘Patient Told Consent Form‘ is actually obtained from all of the anybody.

Desk step 1

Preoperatively, the choice of techniques is actually according to nipple proportions and you can degree off body excessively, surface suppleness, NAC size and updates. A several level nipple class was did considering breast dimensions and you will skin too-much:

All clients was informed regarding compatible technique of incisions and you may you’ll postoperative scars. For those people who does not take on postoperative scars not in the subpectoral trace, this problem try indexed. Then, particular subcutaneous mastectomy was selected according to research by the algorithm exhibited when you look at the Shape 1 . Compatible antibiotics had been applied one hour up until the procedure and the five months immediately following. A patient fulfillment survey are did 1 year after the functions to evaluate the general graphic consequence of subcutaneous mastectomy. Patient pleasure was ranked given that “decent” (5), “good” (4), “satisfactory” (3), “shorter high enough” (2) and you may “unsatisfactory” (1).

Medical techniques

All subcutaneous mastectomies have been did below general anesthesia. On the patient in the vulnerable position, particular body cuts were made according to preoperative marks. From inside the elevation out-of flaps, very cautious dissection try performed to preserve every subcutaneous fat more than new mammary gland. For this reason, enough thickness body supplies a great looking breasts wall appearance in place of strictly adhered and you may disheartened elements between the body and you will chest wall.

Regarding cases of boobs with just minimal dimensions and you may surface too-much, new Webster method was utilized ( Contour dos ). The fresh incision begins regarding ‘three‘ status within the areola-body combination and you can ends in the ‘nine‘ standing. It may be expanded laterally and medially by no less than step one cm, to possess most useful exposure of subcutaneous dissection urban area. Through the level regarding NAC state-of-the-art, a little bit of mammary muscle can be included below that it flap to quit depression deformity. Following, subcutaneous mastectomy is performed. After this process, to form a great looking male chest shape, the required amount of subcutaneous weight tissues will likely be excised out of over the amount of the fresh submammary fold, if necessary. Whilst the technique is more difficult, because of the brief publicity screen by which dissection and you will hemostasis are carried out, it brief incision causes a highly-concealed infra-areolar scar. As well, nipple avoidance can be carried out, when needed. A sucking sink is put on subcutaneous dissection area. But not, should your diligent comes with the interest in a smaller sized areola, this process are modified so you’re able to a beneficial concentric periareolar means.

The concentric periareolar technique can be used for boobs having modest epidermis too much and you can good epidermis suppleness (B glass) or for breasts with minimal body too much however, with good large NAC state-of-the-art ( Profile step three ). Two concentric cuts manufactured. The very first is placed in brand new areola towards wanted diameter to help make an alternative NAC, as well as the big a person is designed with an appropriate diameter, enabling the latest excision of an adequate amount of continuously mammary skin. Then the city between a couple of circles try deepithelialized to cease diminishing the brand new blood flow with the NAC. Subcutaneous mastectomy is completed through good semicircular cut placed in the newest deepithelialized town. Enough mammary tissue are going to be leftover in NAC flap; this flap are meticulously dissected which have an extensive-built dermal pedicle. If necessary, the newest submamount out of subcutaneous body weight muscle out of over the amount of it fold. A suction drain is put inside dissection cavity. This new outer network is then sutured to help you smaller you to definitely of the purse-sequence trend. The strategy gets a visibility windows for dissection and you can hemostasis. And it also allows for brand new reduction of large areola and you can excessive body. Also, if nipple cures is necessary, it can be done in identical lesson due to the fact vascular source of so it flap technique is mainly reputable.