Masculinization of the Chest in Transmen with Large Breasts

• Published in: Indian journal of plastic surgery 2024-04, Vol.57 (2), p.91-98
• Main Authors: Balakrishnan, Thalaivirithan Margabandu, Kumar, Shramya Shodhan, Aruchamy, M, Begum, U Rasheedha, Sridharan, M
• Format: Article
• Language: English
• Subjects: adjunctive liposuction; free nipple–areola grafting; masculinization; mastectomy; Original; top surgery; transmen
• ISSN: 0970-0358; 1998-376X
• DOI: 10.1055/s-0044-1779481

Surgery to masculinize the chest is a frequently sought-after procedure by transmen who wish to conform their physical appearance to their gender identity. In our study, the outcomes of surgical masculinization comprising subcutaneous mastectomy through a modified elliptical incision, liposuction, reduced inert nipple-areola grafting, and quilting stitches were analyzed.  Thirty-two transmen with large breasts and hypertrophied nipples and areolae underwent the above-mentioned masculinizing procedure in this prospective cohort study. Our statistically validated institutional aesthetic outcome assessment score (IAOAS) was used to analyze the outcomes at the end of the follow-up period.  The average period of follow-up was 24.5 months. The average final IAOAS was 23.1. The rate of complications was found to be associated with using breast binders. In all, 22 of 32 patients (68.75%) had an excellent outcome score, while 10 patients (31.25%) had a good outcome score (  = 0.025).  Top surgery is crucial for transmasculine patients to achieve their desired gender identity as males. It is imperative that this procedure is performed to their complete satisfaction. Our single-staged comprehensive approach of subcutaneous mastectomy and liposuction with reduced inert nipple and areola grafts, which aids in a swift transition to a male role, is a prerequisite for bottom surgery at our institute.