Out-of , we performed 52 bilateral subcutaneous mastectomies within Agencies regarding Vinyl, Reconstructive and you may Visual Functions, Trakya University Healthcare, Edirne, Turkey ( Desk step 1 ). The typical diligent decades try twenty-eight.dos (age range, 18-47). The brand new weights of people had been ranging from 40 and you will 100 kilogram and you will mediocre body mass index (BMI) are 23.4 (Bmi assortment, fifteen.6-36.7). 30 patients had a reputation choosing testosterone hormonal treatment prior to process. Hormone medication are abandoned four weeks before medical input. In addition to, per diligent undergone an entire psychological, endocrinological, urologic and you can gynecological evaluation, which anticipate this Bu baДџlantД±yД± Еџimdi Еџimdi devam et new diagnosis of “FtM transsexualism” is produced. An enthusiastic ultrasound examination is did to evaluate the clear presence of glandular tissue in order to exclude any pathologic mass in all instances. ‘Diligent Told Concur Form’ try extracted from all of the individuals.
Desk step 1
Preoperatively, the choice of technique try according to breast size and you may knowledge regarding body extreme, facial skin elasticity, NAC size and you will position. A several levels nipple classification was did based on nipple proportions and you will skin too much:
All the people were advised concerning the compatible techniques out-of slices and you may you can postoperative markings. For these people that would maybe not undertake postoperative marks not in the subpectoral trace, this problem is actually noted. Following, particular subcutaneous mastectomy are selected according to research by the formula displayed inside the Shape step 1 . Suitable antibiotics have been given 1 hour till the process and also for the five months once. Someone fulfillment questionnaire try performed 12 months following businesses to evaluate the general visual results of subcutaneous mastectomy. Diligent fulfillment was rated because “decent” (5), “good” (4), “satisfactory” (3), “less high enough” (2) and you may “unsatisfactory” (1).
Every subcutaneous mastectomies have been performed lower than general anesthesia. With the diligent from inside the vulnerable updates, certain epidermis cuts have been made based on preoperative markings. During the height out of flaps, really cautious dissection was did in preserving all of the subcutaneous body weight a lot more than the newest mammary gland. Ergo, adequate thickness facial skin produces an aesthetically pleasing boobs wall appearance as opposed to purely adhered and you will disheartened components amongst the epidermis and you may tits wall.
From the instances of tits with just minimal dimensions and body excessive, the fresh new Webster techniques was applied ( Shape dos ). The newest cut starts off ‘three’ updates into the areola-skin combination and you can stops in the ‘nine’ condition. It could be prolonged laterally and you will medially because of the at least step one cm, having better visibility of your own subcutaneous dissection urban area. While in the height out-of NAC complex, a little bit of mammary tissues will be incorporated significantly less than that it flap to get rid of depression deformity. Up coming, subcutaneous mastectomy is done. At the conclusion of this procedure, to create an aesthetically pleasing masculine tits profile, the necessary quantity of subcutaneous pounds structure would be excised out of over the level of the newest submammary bend, if necessary. As the method is much harder, from the small publicity screen by which dissection and you may hemostasis are performed, so it quick incision causes a properly-hidden infra-areolar scar. On top of that, nipple cures can be executed, when needed. A sucking sink is positioned in the subcutaneous dissection urban area. Although not, in the event the patient has the curiosity about a smaller areola, this technique would be modified so you can an excellent concentric periareolar approach.
The new concentric periareolar approach can be used for chest with reasonable surface way too much and you will a good epidermis flexibility (B mug) or even for boobs with just minimal skin excessively but having good large NAC state-of-the-art ( Figure step three ). Several concentric incisions are manufactured. The foremost is placed in the newest areola on the need diameter in order to make another type of NAC, and also the big you’re built with the right diameter, permitting the latest excision away from a sufficient amount of excess mammary body. Then your urban area ranging from several sectors was deepithelialized to quit reducing the latest blood flow into the NAC. Subcutaneous mastectomy is done as a result of good semicircular cut placed in the new deepithelialized urban area. Enough mammary muscle is left beneath the NAC flap; that it flap was cautiously dissected which have an extensive-established dermal pedicle. If required, the newest submamount out of subcutaneous lbs tissue of over the number of which flex. A suction drain is placed in the dissection cavity. This new exterior network will be sutured in order to faster one to from the purse-string style. The process provides a visibility window for dissection and you may hemostasis. Also it makes it possible for the latest reduction of higher areola and you will excessive surface. Also, in the event the nipple prevention becomes necessary, you can accomplish it in identical course because vascular supply of it flap strategy is generally credible.