Abstract
Background
Subcutaneous mastectomy is an accepted procedure for surgical reassignment in female-to-male (FtM) transsexuals. However, fatty degeneration of the mammary gland (FDMG) is sometimes observed in FtM transsexuals, with implications for mastectomy outcomes. In this study, we describe the characteristics and risk factors of FDMG.
Methods
A total of 48 FtM transsexual patients underwent bilateral subcutaneous mastectomies (96 subcutaneous mastectomies) at our clinics from January 2015 to February 2016. The patients were divided into FDMG and non-FDMG groups after evaluation of the cut surface of the resected mammary gland. The groups were compared in terms of age, smoking, hormonal therapy (testosterone), body mass index (BMI), breast size (top–under perimeter), distance between sternal notch and nipple–areolar complex (NAC), breast ptosis grade, weight of resected breast tissue, and complication rate. FDMG tissue specimens were examined histologically.
Results
Comparing the FDMG and non-FDMG groups, hormonal therapy was more common (91.3 vs. 72.0%, p = 0.049), BMI was higher (24.3 vs. 21.1%, p < 0.001), and distance between the sternal notch and NAC was longer (20.5 vs. 18.8%, p = 0.03).
Conclusions
Hormonal therapy, high BMI, and long distance from the sternal notch to the NAC are risk factors for FDMG and should be considered prior to mastectomy in FtM transsexuals.
Level of Evidence: Level III, risk/prognostic study
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Acknowledgments
The authors thank Shiro Jimi, Department of Pathology Morphology, Fukuoka University, for helpful comments.
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Taro Makino, Tadayoshi Fujita, and Tomoka Nakano declare that they have no conflict of interest.
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For this kind of retrospective study formal consent from a local ethics committee is not.
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Patients provided written consent before their inclusion on this study.Additional consent was obtained for the use of their images.
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Makino, T., Fujita, T. & Nakano, T. Fatty degeneration of mammary glands in female-to-male transsexuals. Eur J Plast Surg 40, 309–314 (2017). https://doi.org/10.1007/s00238-016-1269-4
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DOI: https://doi.org/10.1007/s00238-016-1269-4