From , i performed 52 two-sided subcutaneous mastectomies from the Agencies away from Plastic material, Reconstructive and you may Visual Surgery, Trakya University Healthcare, Edirne, Poultry ( Dining table step 1 ). The average patient ages are 28.2 (age groups, 18-47). The brand new loads from customers was ranging from 40 and you can one hundred kg and you will average body mass index (BMI) is actually 23.cuatro (Bmi assortment, fifteen.6-36.7). Thirty clients had a history of receiving testosterone hormones therapy before procedure. Hormone cures was deserted 30 days ahead of medical input. And, for each diligent undergone an entire psychological, endocrinological, urologic and you can gynecological review, which anticipate the new medical diagnosis out of “FtM transsexualism” to be generated. A keen ultrasound examination is did to check the existence of glandular muscle in order to ban any pathologic bulk in all times. ‘Patient Advised Agree Form’ is actually extracted from all anyone.
Dining table 1
Preoperatively, the choice of technique are based on breast dimensions and training away from body excessive, facial skin suppleness, NAC dimensions and you may standing. A several degrees breast category was did predicated on breast proportions and surface extreme:
Every patients have been advised concerning the compatible strategy regarding slices and you can you can easily postoperative marks. For those customers who would maybe not deal with postoperative scars outside the subpectoral shade, this problem try listed. Then, certain subcutaneous mastectomy try chose according to the algorithm presented inside the Contour step 1 . Compatible antibiotics was administered one hour before process and the 5 days immediately after. An individual satisfaction questionnaire is actually did one year adopting the operations to check on the general artistic consequence of subcutaneous mastectomy. Patient pleasure is rated given that “very good” (5), “good” (4), “satisfactory” (3), “reduced sufficient” (2) and you may “unsatisfactory” (1).
All the subcutaneous mastectomies was in fact did significantly less than standard anesthesia. To your diligent in vulnerable updates, specific epidermis incisions have been made based on preoperative markings. Within the height off flaps, most careful dissection is performed to preserve all singleparentmeet ekЕџi of the subcutaneous lbs a lot more than the new mammary gland. Hence, adequate density epidermis produces an aesthetically pleasing boobs wall structure looks in the place of purely followed and disheartened components involving the skin and you will boobs wall surface.
On cases of boobs with reduced size and you can facial skin too-much, the Webster strategy was applied ( Shape 2 ). The latest cut initiate off ‘three’ reputation when you look at the areola-body conjunction and you may finishes in the ‘nine’ condition. It could be offered sideways and you may medially from the about 1 cm, to own top publicity of your own subcutaneous dissection city. During level off NAC complex, a little bit of mammary tissues will likely be included significantly less than this flap to avoid despair deformity. Up coming, subcutaneous mastectomy is carried out. After this method, to make a great looking masculine boobs shape, the mandatory amount of subcutaneous weight muscle shall be excised away from over the quantity of the fresh new submammary bend, if necessary. Although the strategy is more complicated, of the brief visibility windows whereby dissection and you can hemostasis are carried out, so it small cut contributes to a proper-undetectable infra-areolar scar. On the other hand, breast cures can be performed, when needed. A suction sink is positioned regarding subcutaneous dissection city. not, should your diligent has got the desire for a smaller sized areola, this process are going to be changed so you can an effective concentric periareolar approach.
New concentric periareolar technique are used for breasts having moderate surface continuously and you may a body elasticity (B cup) and breasts with just minimal body excessively but which have an effective highest NAC cutting-edge ( Profile step three ). One or two concentric cuts are created. The foremost is listed in brand new areola toward wished diameter to help make another NAC, together with larger one is built with a suitable diameter, permitting brand new excision off an adequate amount of excess mammary surface. Then the urban area between two sectors try deepithelialized to quit reducing the fresh blood supply on the NAC. Subcutaneous mastectomy is accomplished owing to a great semicircular incision listed in the brand new deepithelialized city. An adequate amount of mammary tissues is kept underneath the NAC flap; that it flap was very carefully dissected that have a broad-based dermal pedicle. If required, the newest submamount away from subcutaneous pounds cells off above the number of that it fold. A suction sink is placed in the dissection cavity. New outer circle is then sutured so you’re able to smaller one from the purse-sequence fashion. The strategy provides good publicity screen having dissection and you will hemostasis. And it allows the latest reduced total of highest areola and you can excessive body. Also, when the nipple reduction is needed, you can accomplish it in identical tutorial because the vascular supply of which flap strategy is mainly legitimate.