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Incidence of Complications in Chest Wall Masculinization for the Obese Female-to-Male Transgender Population: A Case Series.

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Citation: World Journal of Plastic Surgery. 10(2):14-24, 2021 May.PMID: 34307093Institution: MedStar Washington Hospital CenterDepartment: MedStar Georgetown University Hospital | Plastic Surgery Residency | Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021 ISSN:

2228-7914

Name of journal: World journal of plastic surgeryAbstract: BACKGROUND: Chest masculinization is aimed at aligning physical appearance of female-to-male (FtM) transgender patients to their identifying gender. Despite limited evidence, obese FtM patients have historically been denied this procedure due to concerns of complications. We reviewed chest masculinization in the high body mass index (BMI) population to analyze the outcomes.CONCLUSION: Mastectomy can be safely performed for chest masculinization in obese FtM patients. The rate of acute complications is comparable to that of non-obese patients despite a mean BMI near 40 kg/m2 in this case series. A safe procedure with high satisfaction, obese FtM patients should not be excluded from the increased quality of life and dysphoria reduction chest wall masculinization offers.METHODS: A Medstar system single surgeon retrospective case review was performed of all FtM patients who underwent chest masculinization from Jan 2018 to Dec 2019 with a BMI greater than 30 kg/m2. Primary outcomes were mastectomy-site complications.RESULTS: Twenty-seven obese FtM patients who underwent bilateral chest masculinization were identified. Mean BMI was 39.2 kg/m2 (SD 5.2). Preoperatively, the majority of patients had a cup size of D or larger (77.3%) and grade 3 ptosis (80.0%). Overall rate of complications was 31.5% at median follow-up of 2.1 months. Individual complications included: partial nipple graft loss 18.5%, total nipple graft loss 5.6%, seroma 3.7%, hematoma 3.7%, infection 2.9%. No complications necessitated return to the operating room. However, the majority of patients (77.8%) were completely satisfied with their aesthetic outcome.All authors: Del Corral GA, Fan KL, Perez-Alvarez IM, Schwitzer J, Zolper EGFiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.29252/wjps.10.2.14

Date added to catalog: 2021-11-01

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Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	34307093	Available		34307093

BACKGROUND: Chest masculinization is aimed at aligning physical appearance of female-to-male (FtM) transgender patients to their identifying gender. Despite limited evidence, obese FtM patients have historically been denied this procedure due to concerns of complications. We reviewed chest masculinization in the high body mass index (BMI) population to analyze the outcomes.

CONCLUSION: Mastectomy can be safely performed for chest masculinization in obese FtM patients. The rate of acute complications is comparable to that of non-obese patients despite a mean BMI near 40 kg/m2 in this case series. A safe procedure with high satisfaction, obese FtM patients should not be excluded from the increased quality of life and dysphoria reduction chest wall masculinization offers.

METHODS: A Medstar system single surgeon retrospective case review was performed of all FtM patients who underwent chest masculinization from Jan 2018 to Dec 2019 with a BMI greater than 30 kg/m2. Primary outcomes were mastectomy-site complications.

RESULTS: Twenty-seven obese FtM patients who underwent bilateral chest masculinization were identified. Mean BMI was 39.2 kg/m2 (SD 5.2). Preoperatively, the majority of patients had a cup size of D or larger (77.3%) and grade 3 ptosis (80.0%). Overall rate of complications was 31.5% at median follow-up of 2.1 months. Individual complications included: partial nipple graft loss 18.5%, total nipple graft loss 5.6%, seroma 3.7%, hematoma 3.7%, infection 2.9%. No complications necessitated return to the operating room. However, the majority of patients (77.8%) were completely satisfied with their aesthetic outcome.

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