Long-Term Changes in Free Nipple Graft Morphology and Patient-Reported Outcomes in Gender-Affirming Mastectomies

• Published in: Aesthetic plastic surgery 2022-10, Vol.46 (5), p.2174-2180
• Main Authors: Timmermans, F. W., Elfering, L., Smit, J. M., van de Grift, T. C., Bouman, M. B., Mullender, M. G.
• Format: Article
• Language: English
• Subjects: Body measurements; Gender reassignment surgery; Mastectomy; Medicine; Medicine & Public Health; Morphology; Original Article; Otorhinolaryngology; Patient satisfaction; Plastic Surgery; Three dimensional imaging; Transgender persons
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-021-02666-w

Background After gender-affirming mastectomies with free nipple grafts, satisfaction with nipples tends to fall short behind chest outcomes. This might be related to changes in nipple areolar complex (NAC) dimensions over time. Therefore, the aim of this study is to establish the long-term changes in NAC morphology and compare these to cisgender male NAC outcomes. Materials An observational, cross-sectional study was performed. Data from two prospective cohorts were collected: (1) transgender men after a mastectomy with free nipple grafts and (2) cisgender men (reference sample). Demographics and 3-D images were collected for both groups. NAC measurements were performed on the 3-D images at 4 time points (7-, 30-, 90- and 365-days postoperative) in transgender men and once in cisgender men. Furthermore, the BODY-Q (nipple module) was administered postoperatively at 30-, 90- and 365-days in transgender men. Results In total, 67 transgender and 150 cisgender men were included. NAC width and height in trans men changed from 21.5 mm (±2.7) to 23.8 mm (±3.9, p