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Surgical Masculinization of the Breast: Clinical Classification and Surgical Procedures

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  • Breast Surgery
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Abstract

Introduction

Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization and a classification for these patients.

Methods and Materials

From July 2003 to May 2014, 68 patients seeking a more masculine thorax underwent surgery. They were divided into five groups depending on three factors: excess fatty tissue, breast tissue, and skin. A specific surgical treatment was assigned according to each group. The surgical treatments included thoracic liposuction, subcutaneous mastectomy, periareolar skin resection in one or two stages, and mastectomy with a nipple areola complex graft. The evaluation was performed 6 months after surgery to determine the degree of satisfaction and presence of complications.

Results

Surgery was performed on a total of 68 patients, 45 male and 22 female, with ages ranging from 18 to 49 years, and an average age of 33 years. Liposuction alone was performed on five patients; subcutaneous mastectomy was performed on eight patients; subcutaneous mastectomy combined with liposuction was performed on 27 patients; periareolar skin resection was performed on 11 patients; and mastectomy with NAC free grafts was performed on 16 patients. The surgical procedure satisfied 94% of the patients, with very few complications.

Conclusions

All patients who wish to obtain a masculine breast shape should be treated with only one objective regardless patient’s gender: to obtain a masculine thorax. We recommend a simple mammary gland classification for determining the best surgical treatment for these patients

Level of Evidence V

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References

  1. Fruhstorfer BH, Malata CM (2003) A systematic approach to the surgical treatment of gynaecomastia. Br J Plast Surg 56(3):237–246

    Article  CAS  PubMed  Google Scholar 

  2. Webster JP (1946) Mastectomy for gynecomastia through a semicircular intra-areolar incision. Ann Surg 124(3):557–5753

    Article  PubMed Central  Google Scholar 

  3. Morselli PG (1996) “Pull-through”: a new technique for breast reduction in gynecomastia. Plast Reconstr Surg 97(2):450–454

    Article  CAS  PubMed  Google Scholar 

  4. ASAPS statistics. Cosmetic Surgery National Data Bank. Statistics 2012

  5. Nydick M, Bustos J, Dale JH Jr, Rawson RW (1961) Gynecomastia in adolescent boys. JAMA 178(4):449–454

    Article  CAS  PubMed  Google Scholar 

  6. Hage JJ, Kesteren PJM (1995) Chest-wall contouring in female-to-male transsexuals: basic considerations and review of the literature. Plast Reconstr Surg 96:386

    Article  CAS  PubMed  Google Scholar 

  7. Carlson HE (1980) Gynecomastia. N Engl J Med 303(14):795–799

    Article  CAS  PubMed  Google Scholar 

  8. Pensler JM, Silverman BL, Sanghavi J et al (2000) Estrogen and progesterone receptors in gynecomastia. Plast Reconstr Surg 106(5):1011–1013

    Article  CAS  PubMed  Google Scholar 

  9. Bannayan GA, Hajdu SI (1972) Gynecomastia: clinicopathologic study of 351 cases. Am J Clin Pathol 57(4):431–437

    Article  CAS  PubMed  Google Scholar 

  10. Rohrich RJ, Ha RY, Kenkel JM, Adams WP Jr (2003) Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg 111(2):909–923 discussion 924–5

    Article  PubMed  Google Scholar 

  11. Lemaine V, Cayci C, Simmons PS, Petty P (2013) Gynecomastia in adolescent males. Semin Plast Surg. 27(1):56–61

    Article  PubMed  PubMed Central  Google Scholar 

  12. Adekunle A, Malata CM (2012) Gynecomastia: evolving paradigm of management and comparison of techniques. Plast Reconstr Surg 129(2):366e–367e

    Article  CAS  PubMed  Google Scholar 

  13. Monstrey S, Selvaggi G, Ceulemans P, Monstrey S, Van Landuyt K, Bowman C, Blondeel P, Hamdi M, De Cuypere G (2008) Chest-wall contouring surgery in female-to-male transsexuals: a new algorithm. Plast Reconstr Surg 121(3):849–859

    Article  CAS  PubMed  Google Scholar 

  14. Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51(1):48–52

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Plastic Surgery, INNOVARE Cirugia Plástica Especializada. Jalisco Institute of Reconstructive Surgery “Dr. José Guerrerosantos”, Zapopan, Jalisco, Mexico

    Lazaro Cardenas-Camarena

  2. Division of Plastic Surgery, Jalisco Institute of Reconstructive Surgery “Dr. José Guerrerosantos”, Guadalajara, Jalisco, Mexico

    Carlos Dorado & Rosa Nava

  3. Private Practice at INNOVARE, Cirugía Plástica Especializada, Zapopan, 45019, Jalisco, Mexico

    Maria Teresa Guerrero

Authors
  1. Lazaro Cardenas-Camarena
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  2. Carlos Dorado
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  3. Maria Teresa Guerrero
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  4. Rosa Nava
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Corresponding author

Correspondence to Lazaro Cardenas-Camarena.

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The authors have no conflict of interest to declare in relation to the content of this article.

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Cardenas-Camarena, L., Dorado, C., Guerrero, M.T. et al. Surgical Masculinization of the Breast: Clinical Classification and Surgical Procedures. Aesth Plast Surg 41, 507–516 (2017). https://doi.org/10.1007/s00266-016-0731-9

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  • DOI: https://doi.org/10.1007/s00266-016-0731-9

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