title: Female-to-male transgender chest reconstruction: a large consecutive, single-surgeon experience.
abstract: BACKGROUND
  Chest reconstruction in the female-to-male transgender individual is not a common procedure due to the low prevalence of intractable gender dysphoria. It means that few surgeons acquire sufficient expertise and many UK patients find themselves travelling abroad to centres such as Singapore, Amsterdam and the United States.
  
  
  METHODS
  This study retrospectively evaluated 100 consecutive patients of a single surgeon over a 3-year period with prime outcome measures including surgical technique, complications, surgical revision and patient-reported satisfaction, using a simple, 1-5 linear analogue scoring system.
  
  
  RESULTS
  The median age was 28 years with a median excision of 345 g per breast. Complications occurred in 11 patients, five of which required surgical haematoma evacuation. Chi(2) analysis failed to show a correlation between testosterone supplementation and haemorrhagic sequelae (p>0.1). To date, 16 patients have undergone supplementary surgery, predominantly axillary dog-ear revision. Overall patient-reported satisfaction was 4.25.
  
  
  CONCLUSIONS
  Whilst only a part of the process in gender transitioning, chest reconstruction is important as it is frequently the initial surgical procedure and enables the large-breasted to live in their chosen role much more easily. Historically associated with high rates of both complication and revision surgery, this study demonstrates that both may be appreciably lower and associated with high levels of patient satisfaction so that there is a realistic, high-quality option for British patients who might otherwise feel the need to travel abroad for their surgery.
authors.affiliation: The Institute of Cosmetic & Reconstructive Surgery, London W1 8GR, UK. mail@aestheticus.co.uk
authors.forename: M G
authors.initials: MG
authors.lastname: Berry
authors.forename: Richard
authors.initials: R
authors.lastname: Curtis
authors.forename: Dai
authors.initials: D
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D000328:Adult; D001940:Breast / Q000601:surgery; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015187:Lipectomy / Q000379:methods; D008297:Male; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009558:Nipples / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D057830:Gender-Affirming Surgery / Q000379:methods*; D014189:Transsexualism / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult