22 Jan SUBCUTANEOUS MASTECTOMY FOR GENDER DYSPHORIA
WHAT IS GENDER DYSPHORIA
Gender dysphoria is the profound sense of discomfort a person feels when their biological sex does not match their gender identity. In the past, this was called gender identity disorder. Subcutaneous mastectomy is one of the most demanded interventions by transgender patients. In addition, it is usually one of the first procedures that these patients undergo.
Recognizing and treating gender dysphoria in a timely manner can reduce the likelihood of depression and emotional distress. Being in a supportive environment, freely expressing your identity can help alleviate anxiety and depression.
The comprehensive management of these transgender patients includes medical treatment, surgical interventions and psychological support. It has to be guided and directed by a multidisciplinary team, integrated by endocrinologists, plastic surgeons, psychologists, psychiatrists, etc.
WHAT IS SUBCUTANEOUS MASTECTOMY?
It is the removal of breast tissue while preserving its skin coverage. It is performed in breast oncologic surgery and in sex reassignment surgery (from female to male). Subcutaneous mastectomy in these patients is a relevant intervention, since it allows achieving a flat and masculine thorax. The procedure consists of removing all the breast tissue, and also the skin in case it is excessive. Sometimes it is necessary to reposition the nipple-areola complex, since in certain large, ptosic breasts with excess skin, the nipple is too low.
For someone who has the physical attributes of a woman but identifies with the male gender, breasts pose a serious problem.
This intervention facilitates the integration and well-being of these patients.
The procedure lasts about 2-3 hours and requires hospitalization of the patient.
TYPES OF SEX REASSIGNMENT MASTECTOMY
There are two ways of performing the procedure, depending on the size of the breasts:
- Small breasts: the perioareolar technique is used, which consists of making an incision around the areola, through which the mammary gland is removed. With this technique, the areola is preserved, in which a reduction in size is performed. This allows only a minimal scar to remain around the areola.
- Large breasts: in these cases the areola grafting technique is used, in which the mammary gland is removed. On the other hand the areola is transplanted
- as a graft, leaving a more visible scar around the areola and a more visible scar in the submammary fold.
The following are two examples
Example 1: mastectomy with areola grafting.
Example 2: mastectomy with periareolar approach.