Masculine Chest-Wall Contouring in FtM Transgender: a Personal Approach.
BACKGROUND
Chest-wall contouring surgery is one of the first steps in sexual reassignment in female-to-male (FtM) transsexuals that contributes to strengthening of the self-image and facilitates living in the new gender role. The main goal is to masculinize the chest by removing the female contour. Chest contour, scar placement, scar shape, scar length, nipple-areola position, nipple size and the areola size are the key points.


METHODS
Between July 2013 and June 2016, 25 FtM transgender patients underwent surgical procedures to create a masculine chest-wall contour. In our study, we just considered 16 patients who have undergone chest surgery with the double incision method.


RESULTS
The patients' survey revealed a high satisfaction rate with the aesthetic result. In our group, no complications occurred, and two patients have undergone supplementary surgery for axillary dog-ear revision and nipple reconstruction.


CONCLUSIONS
The authors propose a new technical approach and indications for FtM transgender patients' surgery. A longer scar that emphasizes the pectoralis muscle, a smaller nipple and a resized and refaced areola are the key points of our technique to give a masculine appearance to the chest. The scars are permanent, but most of them will fade and the patients are enthusiastic with their new "male" chest appearance. The high level of satisfaction, the great aesthetic result and the low rate of complications suggest to us the use of this technique in medium- and large-size breasts.


METHODS
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Department Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy. giulialorusso70@gmail.com.
Giulia
G
Lo Russo
Department Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
Sara
S
Tanini
Department Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
Marco
M
Innocenti
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D016462:Mammaplasty / Q000379:methods*; D057228:Masculinity; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D009558:Nipples / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D035441:Thoracic Wall / Q000601:surgery*; D063106:Transgender Persons; D055815:Young Adult
Chest-wall contouring; Double incision method; Female-to-male transsexuals; Free nipple graft; Mastectomy; Mastoplasty; Sexual reassignment surgery