Out-of , we did 52 two-sided subcutaneous mastectomies at Institution regarding Plastic material, Reconstructive and you will Artistic Operations, Trakya College or university Healthcare, Edirne, Chicken ( Desk 1 ). The common patient ages try twenty eight.2 (a long time, 18-47). The latest weights of people have been ranging from 40 and one hundred kg and you can average bmi (BMI) is 23.4 (Bmi variety, fifteen.6-thirty six.7). 30 customers had a history of finding testosterone hormonal treatment in advance of operation. Hormones procedures is actually left behind 4 weeks prior to medical intervention. Along with, for every patient undergone a whole psychological, endocrinological, urologic and you can gynecological evaluation, and therefore acceptance the latest prognosis regarding “FtM transsexualism” becoming made. An enthusiastic ultrasound test was did to test the clear presence of glandular muscle in order to prohibit people pathologic mass in all times. ‘Diligent Informed Consent Form’ was taken from the someone.
Table 1
Preoperatively, the choice of techniques was predicated on nipple dimensions and you will knowledge from surface continuously, body suppleness, NAC dimensions and you can status. A four values breast class are performed according to breast dimensions and you may surface way too much:
Most of the clients was told about the suitable strategy out of cuts and you may you’ll postoperative marks. Of these customers who maybe not undertake postoperative markings beyond the subpectoral trace, this problem was noted. Up coming, specific subcutaneous mastectomy was picked in line with the formula displayed inside Profile step 1 . Appropriate antibiotics was in fact given one hour before procedure and for the five weeks immediately following. The patient fulfillment survey are performed 1 year following functions to test all round graphic result of subcutaneous mastectomy. Diligent satisfaction are rated while the “very good” (5), “good” (4), “satisfactory” (3), “less sufficient” (2) and you can “unsatisfactory” (1).
Surgical process
Every subcutaneous mastectomies was indeed did significantly less than standard anesthesia. To the diligent in prone position, certain skin slices have been made according to preoperative marks. Inside elevation off flaps, extremely cautious dissection are performed in preserving all the subcutaneous fat over the brand new mammary gland. Thus, enough occurrence epidermis supplies a great looking bust wall surface looks as opposed to purely adhered and depressed components amongst the facial skin and you may breasts wall structure.
About instances of chest with minimal dimensions and you will body excessive, the fresh Webster technique was applied ( Profile 2 ). The latest incision initiate off ‘three’ position for the areola-epidermis combination and you may concludes at the ‘nine’ position. It can be stretched laterally and you can medially of the at least step one cm, for top exposure of your subcutaneous dissection town. Throughout the elevation out of NAC state-of-the-art, a small amount of mammary cells shall be incorporated under which flap to quit anxiety deformity. After that, subcutaneous mastectomy is performed. After this procedure, to create an aesthetically pleasing masculine bust figure, the required amount of subcutaneous pounds structure will be excised of above the level of the brand new submammary flex, if necessary. While the strategy is more challenging, of the brief publicity windows through which dissection and you can hemostasis are performed, this brief incision results in a highly-concealed infra-areolar mark. In addition, breast reduction can be executed, when needed. A sucking sink is placed regarding the subcutaneous dissection town. However, whether your patient comes with the interest in a smaller sized areola, this process would be modified so you’re able to good concentric periareolar strategy.
The brand new concentric periareolar method are used for chest having average epidermis way too much and you will an effective epidermis flexibility (B glass) and boobs with minimal epidermis way too much however, having a good highest NAC advanced ( Profile 3 ). Several concentric slices were created. The first is placed in new areola into need diameter to manufacture a unique NAC, as well as the large you’re designed with the ideal diameter, permitting the excision out of enough excessive mammary facial skin. Then urban area between one or two circles was deepithelialized to eliminate decreasing the latest blood flow on the NAC. Subcutaneous mastectomy is accomplished by way of a good semicircular cut listed in the fresh new deepithelialized area. A sufficient amount of mammary tissue are kept according to the NAC flap; that it flap was very carefully dissected with a wide-built dermal pedicle. If necessary, brand new submamount from subcutaneous weight tissues regarding over the level of it flex. A sucking drain is put during the dissection cavity. The new exterior community will then be sutured so you can smaller you to definitely from the purse-sequence fashion. The technique gives a beneficial publicity windows getting dissection and you can hemostasis. 
Also it allows the fresh decrease in highest areola and an excessive amount of skin. And additionally, if nipple cures is required, it can be done in identical training since vascular way to obtain that it flap strategy is generally credible.