Breast Augmentation in the Transfemale Patient: Comprehensive Principles for Planning and Obtaining Ideal Results
| Autor: | Devin Coon, Halley Darrach, Beverly Fischer, Wilmina N. Landford, Erica Lee |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Esthetics medicine.medical_treatment Breast Implants Population 030230 surgery Transgender Persons Patient Care Planning 03 medical and health sciences Young Adult 0302 clinical medicine Patient satisfaction Postoperative Complications Sex Reassignment Surgery Medicine Inframammary fold Humans education Gender Dysphoria Breast augmentation Breast Implantation Retrospective Studies education.field_of_study business.industry Retrospective cohort study Evidence-based medicine Capsular contracture Surgery Treatment Outcome Patient Satisfaction 030220 oncology & carcinogenesis Mammaplasty Critical Pathways Female business Algorithms Follow-Up Studies |
| Zdroj: | Plastic and reconstructive surgery. 145(6) |
| ISSN: | 1529-4242 |
| Popis: | Background A growing number of transgender women present to plastic surgeons seeking breast augmentation. Despite some advocating their technical similarity, the authors have found substantially different planning and techniques are needed to obtain aesthetic results in transgender patients versus cosmetic breast augmentation. The authors sought to develop an approach for operative planning and technique to elucidate these differences and obtain consistent results. Methods All patients who underwent breast augmentation at the Johns Hopkins Center for Transgender Health were included in this study. Anthropometric assessments were obtained and comparative statistics between operative and nonoperative cohorts were calculated. Outcomes were analyzed and a patient-reported survey was performed to evaluate patient satisfaction. Results Fifty-nine consecutive transfemale patients presented for evaluation. Anthropometric measurements included base width (median, 15.0 ± 2.1 cm), notch-to-nipple distance (median, 22.0 cm), nipple-to-midline distance (median, 12.0 cm), areolar diameter (median, 3.5 ± 1.5 cm), and upper pole pinch (mean, 1.8 ± 1.1 cm). Thirty-six patients underwent augmentation mammaplasty. Postoperative complications (8.3 percent) included a minor hematoma and grade III capsular contracture in two patients. Patients were asked to complete a brief outcomes survey and reported an improvement in psychosocial well-being and high satisfaction rate (100 percent) with the overall cosmetic result. Conclusions Transgender female patients represent a unique patient population requiring special consideration of anatomical differences in key planning decisions. The authors delineate the first systematic algorithm that addresses these differences, emphasizing maneuvers such as routine inframammary fold lowering. This can allow experienced augmentation surgeons to obtain excellent aesthetic and patient-reported outcomes in this population. As with cosmetic breast augmentation, patient satisfaction rates are high. Clinical question/level of evidence Therapeutic, IV. |
| Databáze: | OpenAIRE |
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