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When Testosterone Needs to be Contrasted: A Preliminary Study of Scar Prevention in Transmen Top Surgery with an Innovative Galenic Preparation

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  • Genital Surgery
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Abstract

Background

Transmen are individuals who live a marked incongruence between the assigned gender and the experienced gender. Crucial and life-changing steps in their transition are testosterone treatment and mastectomy to remove the stigma of feminine identity. After surgery, patients’ attention turns to the scars, often not aesthetically pleasant. We thus created an innovative galenic preparation for scar treatment after surgery composed by spironolactone, alfa bisabolol and silicone gel. Functional outcomes, side effects and satisfaction were assessed.

Methods

For the present prospective randomized controlled study, 30 patients with similar demographic characteristics who underwent double incision mastectomy with NA grafts between February 2014 and June 2019 were selected. The treatment Group A (n = 15) was treated for 12 months with “Top Surgery Scar go,” the control Group B (n = 15) with silicon gel. Statistical analysis including Wilcoxon test and Kruskal–Wallis test per variable was performed. To assess satisfaction, a second Wilcoxon test was applied.

Results

The differences between Group A and Group B were statistically significant, especially at T12 with very low p values. Satisfaction was greater in Group A (p value = 3e−4). No major side effects were noticed in Group A.

Conclusions

TSSgo scar innovative treatment showed long-term efficacy in comparison with silicon gel in terms of improved scar tissue texture, pigmentation, pliability and height. It is easy to set up, cost-effective and safe. Further studies are necessary to better assess efficacy and validity of TSSgo, but it appears to be promising as the new treatment of reference for scar management after top surgery in transmen.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Acknowledgments

We thank Federica Calabrese (Ph.D. student at Helmholtz center for Environmental research—UFZ—Leipzig) for assistance with statistical analysis and graphics and for giving comments that greatly improved the manuscript.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy

    Sara Tanini, Sara Calabrese & Giulia Lo Russo

  2. Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, Florence, Italy

    Alessandra D. Fisher & Mario Maggi

Authors
  1. Sara Tanini
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  2. Sara Calabrese
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  3. Alessandra D. Fisher
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  4. Mario Maggi
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  5. Giulia Lo Russo
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Correspondence to Giulia Lo Russo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Tanini, S., Calabrese, S., Fisher, A.D. et al. When Testosterone Needs to be Contrasted: A Preliminary Study of Scar Prevention in Transmen Top Surgery with an Innovative Galenic Preparation. Aesth Plast Surg 44, 1006–1013 (2020). https://doi.org/10.1007/s00266-020-01678-2

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  • DOI: https://doi.org/10.1007/s00266-020-01678-2

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