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Transgender Top Surgery in Adolescents and Young Adults
Sarah P. Erpenbeck; Francesco M. Egro MBChB MSc MRCS; Elizabeth A. Moroni MD MHA; Brandon T. Smith MS; Lorelei J. Grunwaldt MD FACS FAAP
University of Pittsburgh Medical Center
2021-01-31
Presenter: Sarah Erpenbeck
Affidavit:
A shortened (800 word) communication is in the process of publication by the Journal of Plastic and Reconstructive Surgery
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Female to male transgender top surgery is shown to have beneficial psychological effects for treatment of gender dysphoria. However, surgical outcomes have not been well studied in young adults. The aim of this study is to compare the outcomes between a periarerolar mastectomy (PM) and double incision mastectomy (DIM) in young adults undergoing female to male top surgery.
Methods: A retrospective study of young adults undergoing transgender top surgery by a single surgeon between 2010-2019 was conducted. PM and DIM techniques were compared based on demographics, clinical characteristics, surgical outcomes, and aesthetic outcomes.
Results: A total of 89 patients underwent a subcutaneous mastectomy (PM=28.1%, DIM=71.9%). Patients with greater grade 2 (PM=8.0%, DIM=40.6%, p=0.003) and grade 3 ptosis (PM=0.0%, DIM=31.3%, p=0.002) were more likely to undergo a DIM. Complications were comparable among the two groups. The most frequent complication was hypertrophic or keloid scarring in 11.2% of patients and was more frequent in DIM (PM=0%, DIM=15.6%, p=0.056). Secondary revision was more frequent in PM (PM=16%, DIM=6.3%, p=0.15). Aesthetic outcomes were significantly better in the PM group than the DIM group in all categories examined. The overall average aesthetic outcome score was also significantly higher in patients who underwent PM (PM=9.1, DIM=6.3, p<0.001).
Conclusion: Female to Male transgender top surgery is a safe treatment option in young adults with gender dysphoria. The low rates of complication and secondary revisions among PM and DIM patients suggest that both techniques can be safely used in young adults and provide beneficial aesthetic outcomes.
