Away from , we did 52 bilateral subcutaneous mastectomies within Service from Vinyl, Reconstructive and you will Visual Surgery, Trakya College Health, Edirne, Chicken ( Table step one ). sonraki Sayfa The average diligent ages are 28.dos (age range, 18-47). The latest weights of clients was in fact anywhere between 40 and you may one hundred kilogram and mediocre body mass index (BMI) try 23.4 (Body mass index variety, 15.6-thirty six.7). 30 people got a reputation getting testosterone hormones treatment prior to operation. Hormone therapy is left behind a month in advance of medical intervention. Along with, for every single patient underwent a whole psychiatric, endocrinological, urologic and you can gynecological investigations, and therefore acceptance the newest medical diagnosis away from “FtM transsexualism” to-be made. An enthusiastic ultrasound test is actually performed to test the clear presence of glandular tissue and prohibit one pathologic size in most circumstances. ‘Patient Told Consent Form’ was obtained from all anybody.
Dining table 1
Preoperatively, the option of techniques was centered on breast dimensions and you may studies from facial skin an excessive amount of, skin suppleness, NAC size and you may status. A four amounts nipple category was did considering breast dimensions and you may epidermis extreme:
All of the people was in fact informed regarding the suitable approach from incisions and it is possible to postoperative scars. For these clients who would not take on postoperative markings outside the subpectoral trace, this disorder was listed. After that, particular subcutaneous mastectomy are chose in accordance with the formula showed inside the Profile 1 . Appropriate antibiotics was basically applied one hour up until the procedure and for the 5 months after. An individual fulfillment survey was did 1 year after the procedures to test the overall artistic outcome of subcutaneous mastectomy. Patient fulfillment was ranked just like the “very good” (5), “good” (4), “satisfactory” (3), “less satisfactory” (2) and you can “unsatisfactory” (1).
Operative process
All subcutaneous mastectomies was did lower than standard anesthesia. To your patient inside susceptible condition, certain epidermis incisions were made predicated on preoperative markings. In elevation out of flaps, extremely careful dissection is performed to preserve all subcutaneous fat significantly more than this new mammary gland. Thus, sufficient occurrence skin produces a great looking bust wall structure physical appearance without strictly adhered and you will disheartened components involving the epidermis and you may breasts wall.
On the cases of breasts with minimal proportions and facial skin excessively, the fresh new Webster techniques was applied ( Figure dos ). The latest cut begins off ‘three’ reputation in areola-facial skin combination and you will concludes within ‘nine’ standing. It could be prolonged sideways and you may medially because of the no less than 1 cm, for most readily useful coverage of your own subcutaneous dissection area. During the elevation out-of NAC advanced, some mammary structure will likely be included around this flap to eliminate anxiety deformity. Next, subcutaneous mastectomy is accomplished. At the conclusion of this procedure, to form an aesthetically pleasing male breasts profile, the desired amount of subcutaneous pounds cells is excised out of above the quantity of the fresh new submammary fold, if required. As the method is more difficult, from the quick coverage window by which dissection and you may hemostasis are executed, this quick incision causes a properly-concealed infra-areolar mark. At exactly the same time, nipple protection can be performed, when needed. A suction sink is placed from the subcutaneous dissection urban area. not, whether your diligent gets the desire for an inferior areola, this procedure is changed to a concentric periareolar method.
The fresh new concentric periareolar techniques are used for chest with moderate body a lot of and a great body suppleness (B glass) or chest with just minimal epidermis excess however, which have a highest NAC state-of-the-art ( Profile 3 ). Two concentric slices are designed. The foremost is placed in this new areola on the need diameter in order to make a unique NAC, in addition to big a person is constructed with a suitable diameter, providing brand new excision out-of enough excessively mammary facial skin. Then your city ranging from a couple circles is deepithelialized to get rid of compromising the blood circulation into the NAC. Subcutaneous mastectomy is carried out by way of an excellent semicircular cut listed in the deepithelialized city. An adequate amount of mammary cells would be left in NAC flap; this flap is meticulously dissected which have a wide-oriented dermal pedicle. If necessary, the new submamount regarding subcutaneous weight tissues off above the level of so it flex. A sucking sink is put from inside the dissection cavity. The fresh new outer circle is then sutured in order to reduced you to by purse-string fashion. The technique provides a great visibility windows to have dissection and you may hemostasis. Therefore allows the fresh decrease in large areola and you may excessive epidermis. As well as, if nipple reduction will become necessary, you can accomplish it in the same class due to the fact vascular supply of that it flap method is primarily reputable.