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Nipple-Areolar Complex Position in Female-to-Male Transsexuals After Non-skin-excisional Mastectomy: A Case–Control Study in Japan

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  • Breast Surgery
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Abstract

Background

Mastectomy is performed in female-to-male transsexual (FTM TS) patients as a surgical treatment to make a female thorax resemble a male thorax; however, no studies have examined the nipple-areolar complex (NAC) position in FTM TS patients after mastectomy.

Patients and Methods

The NAC position in 41 FTM TS patients before and after non-skin-excisional mastectomy was examined and compared with that in 50 age- and BMI-matched biologically male subjects as controls. The factors affecting the NAC position after the operation were also examined and verified by multiple regression analysis.

Results and Conclusions

After non-skin-excisional mastectomy, the NAC in the FTM TS patients was positioned significantly more medially (horizontal NAC position ratio {(‘internipple distance’/‘width of thorax’) × 100} [HNPR]: preoperatively, 70.07% ± 4.19%; postoperatively, 63.28% ± 3.79%) and cranially (vertical NAC position ratio {(‘distance from sternal notch to nipple height’/‘distance from sternal notch to umbilicus’) × 100} [VNPR]: preoperatively, 43.87% ± 3.68%; postoperatively, 41.37% ± 3.15%). Postoperatively, the NAC in the FTM TS patients was located significantly more medially than that in the control subjects (HNPR: 63.28% ± 3.79% to 66.79% ± 4.82%), although the height of the NAC was the same. Multiple regression analysis revealed that the NAC position on breasts characterized by ptosis, a high projection, and lateral leaning (low skin elasticity and a substantial amount of skin between the nipples) tended to be positioned more medially after non-skin-excisional mastectomy. Laterally deviated eccentric circular type mastectomy may be a good option for FTM TS patients who have moderately sized breasts with such features.

Level of Evidence IV

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan

    Yu Kagaya

  2. Department of Plastic and Reconstructive Surgery, Yamanashi University Hospital, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3863, Japan

    Ichiro Shiokawa & Akira Momosawa

  3. Keiseikai Clinic, 1-7-30 Higashi-shinsaibashi, Chuo-ku, Osaka-shi, Osaka, Japan

    Hiroki Karasawa

  4. Skin Clinic Fujieda, 1-3-1 Maejima, Fujieda-shi, Shizuoka, Japan

    Kentaro Ono

Authors
  1. Yu Kagaya
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  2. Ichiro Shiokawa
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  3. Hiroki Karasawa
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  4. Kentaro Ono
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  5. Akira Momosawa
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Corresponding author

Correspondence to Akira Momosawa.

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The authors declare that they have no conflicts of interest to disclose:

Ethical Approval

This case–control study was approved by the institutional review board of the participating institutions and conducted in accordance with the Declaration of Helsinki on investigations involving humans.

Informed Consent

Although informed consent was obtained in the form of an opt-out option on the Web site, for the two patients whose photographs were used in the present article, informed consent was obtained from each patient on an individual basis.

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Kagaya, Y., Shiokawa, I., Karasawa, H. et al. Nipple-Areolar Complex Position in Female-to-Male Transsexuals After Non-skin-excisional Mastectomy: A Case–Control Study in Japan. Aesth Plast Surg 43, 1195–1203 (2019). https://doi.org/10.1007/s00266-019-01409-2

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  • DOI: https://doi.org/10.1007/s00266-019-01409-2

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