Out-of , i performed 52 two-sided subcutaneous mastectomies at the Agency out-of Synthetic, Reconstructive and Visual Functions, Trakya University Health, Edirne, Poultry ( Desk step one ). The common patient decades is actually twenty eight.2 (age groups, 18-47). The brand new weights regarding customers have been anywhere between forty and you will 100 kilogram and you may average bmi (BMI) are 23.4 (Bmi range, fifteen.6-36.7). 30 clients got a track record of choosing testosterone hormonal medication just before process. Hormones medication is actually abandoned 4 weeks ahead of medical intervention. Along with, for every diligent undergone a whole psychological, endocrinological, urologic and gynecological comparison, hence allowed the newest medical diagnosis off “FtM transsexualism” to-be generated. An enthusiastic ultrasound test try performed to check the presence of glandular muscle and also to exclude people pathologic size in every instances. ‘Diligent Informed Concur Form’ are extracted from most of the someone.

Desk step 1

Preoperatively, the choice of techniques was predicated on nipple dimensions and you can training off surface extreme, epidermis suppleness, NAC proportions and updates. A several degrees breast group are performed considering nipple proportions and you can body extreme:

All customers was indeed advised in regards to the suitable techniques of incisions and you will you’ll postoperative marks. For these clients who would perhaps not deal with postoperative scars beyond the subpectoral shade, this disorder are detailed. Up coming, specific subcutaneous mastectomy try chosen in accordance with the algorithm demonstrated in the Profile step 1 . Compatible antibiotics was basically applied 1 hour up until the operation as well as for the five weeks immediately following. Someone satisfaction survey are did 12 months following the surgery to test the overall artistic outcome of subcutaneous mastectomy. Diligent pleasure try ranked once the “decent” (5), “good” (4), “satisfactory” (3), “shorter high enough” (2) and you will “unsatisfactory” (1).

Surgical procedure

All the subcutaneous mastectomies was indeed performed below general anesthesia. Towards the patient in vulnerable standing, certain facial skin cuts have been made centered on preoperative scars. Within the elevation away from flaps, extremely careful dissection is actually performed in preserving all the subcutaneous lbs over the fresh mammary gland. Thus, sufficient density epidermis provides an aesthetically pleasing chest wall surface physical appearance rather than strictly adhered and you may disheartened parts between the surface and boobs wall.

From the instances of bust with just minimal size and you may surface extreme, the fresh Webster technique was utilized ( Shape 2 ). This new incision initiate of ‘three’ status from inside the areola-skin combination and finishes in the ‘nine’ position. It could be offered laterally and you can medially from the no less than step 1 cm , to own better exposure of your subcutaneous dissection urban area. Through the height away from NAC complex, a small amount of mammary muscle should be provided around this flap to eliminate despair deformity. Then, subcutaneous mastectomy is carried out. At the end of this procedure, to create an aesthetically pleasing male breasts contour, the mandatory amount of subcutaneous pounds structure are excised out-of over the amount of this new submammary bend, if required. Although the technique is much harder, because of the brief publicity screen through which dissection and you will hemostasis are executed, so it small incision leads to a properly-undetectable infra-areolar scar. As well, nipple protection can be carried out, when needed. A suction drain is positioned on subcutaneous dissection urban area. Although not, in the event the patient has got the interest in an inferior areola, this method are going to be changed in order to an effective concentric periareolar strategy.

The new concentric periareolar techniques are used for chest that have moderate skin way too much and a beneficial skin flexibility (B glass) and tits with reduced epidermis excessively but having good higher NAC state-of-the-art ( Figure step 3 ). A few concentric slices are built. The very first is placed in brand new areola to the wished diameter which will make another NAC, in addition to larger you’re built with the ideal diameter, permitting the brand new excision out of an adequate amount of way too much mammary facial skin. Then your area anywhere between two sectors is actually deepithelialized to eliminate decreasing the blood circulation towards NAC. Subcutaneous mastectomy is carried out owing to an effective semicircular cut placed in new deepithelialized town. A sufficient amount of mammary tissue would be left beneath the NAC flap; which flap are carefully dissected which have an extensive-built dermal pedicle. If required, the fresh new submamount out-of subcutaneous weight cells out of over the level of so it flex. A sucking sink is positioned from inside the dissection hole. The fresh exterior circle will be sutured to quicker you to definitely by purse-string style. The process gives a great publicity screen to possess dissection and hemostasis. And it also allows the fresh reduction of large areola and you may an excessive amount of epidermis. Also, when the nipple reduction is necessary, you can accomplish it in the same class just like the vascular source of it flap method is generally reliable.