Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar

• Published in: Archives of plastic surgery 2019, 46(3), , pp.262-266
• Main Authors: Cely, Adriana Marcela Gonzalez, Triana, Carlos Enrique, Triana, Lina Maria
• Format: Article
• Language: English
• Subjects: Case Report; gender dysphoria; gynecomastia; mastectomy; transsexualism; 성형외과학
• ISSN: 2234-6163; 2234-6171
• DOI: 10.5999/aps.2018.00108

Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.