Subcutaneous Mastectomy Improves Satisfaction with Body and Psychosocial Function in Trans Men: Findings of a Cross-Sectional Study Using the BODY-Q Chest Module

Grift, Tim C. van de; Elfering, Lian; Greijdanus, Marijke; Smit, Jan Maerten; Bouman, Mark‐Bram; Klassen, Anne F.; Mullender, Margriet G.

doi:10.1097/prs.0000000000004827

Cited by 65 publications

(38 citation statements)

References 16 publications

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“…Clinically significant reductions in psychopathology and substance abuse following GAS have been documented in the literature, 28,29 including studies specific to masculinizing mastectomy. 6,8 As such, continued investigation into the safety, efficacy, and epidemiology of this procedure is essential to facilitate the development of optimal and ethical management strategies. However, there are numerous challenges associated with research into this population and procedure.…”

Section: Discussionmentioning

confidence: 99%

“…5 Importantly, masculinizing chest reconstruction has been shown to significantly improve psychosocial functioning and quality of life. 6–8 Expanded access to care and improvements in social stigma have led to a substantial rise in the number of gender-affirming surgeries (GAS) performed in the United States over the past 5 years, opening up new avenues for quality improvement. 9 Ongoing evaluation and review of epidemiologic and postoperative complications data are imperative to maintaining high standards of care and identifying demographic disparities.…”

Section: Introductionmentioning

confidence: 99%

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Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes

Cuccolo

Kang

Boskey

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: Mastectomy is a commonly requested procedure in the transmasculine population and has been shown to improve quality of life, although there is limited research on safety. The aim of this study was to provide a nationwide assessment of epidemiology and postoperative outcomes following masculinizing mastectomy and compare them with outcomes following mastectomy for cancer prophylaxis and gynecomastia correction in cisgender patients. Methods: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2017 was queried using International Classification of Diseases and Current Procedural Terminology codes to create cohorts of mastectomies for 3 indications: transmasculine chest reconstruction, cancer risk-reduction (CRRM), and gynecomastia treatment (GM). Demographic characteristics, comorbidities, and postoperative complications were compared between the 3 cohorts. Multivariable regression analysis was used to control for confounders. Results: A total of 4,170 mastectomies were identified, of which 14.8% (n = 591) were transmasculine, 17.6% (n = 701) were CRRM, and 67.6% (n = 2,692) were GM. Plastic surgeons performed the majority of transmasculine cases (85.3%), compared with the general surgeons in the CRRM (97.9%) and GM (73.7%) cohorts. All-cause complication rates in the transmasculine, CRRM, and GM cohorts were 4.7%, 10.4%, and 3.7%, respectively. After controlling for confounding variables, transgender males were not at an increased risk for all-cause or wound complications. Multivariable regression identified BMI as a predictor of all-cause and wound complications. Conclusion: Mastectomy is a safe and efficacious procedure for treating gender dysphoria in the transgender male, with an acceptable and reassuring complication profile similar to that seen in cisgender patients who approximate either the natal sex characteristics or the new hormonal environment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes

Cuccolo

Kang

Boskey

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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“…Similarly to previous PRO−based cross−sectional studies [10,11,53], the relationships identified using correlation coefficients should be interpreted as associations and not causal relations [33]. The present study may act as a data reference to generate hypotheses that justify further investigations.…”

Section: Discussionmentioning

confidence: 84%

Facial Appearance and Psychosocial Features in Orthognathic Surgery: A FACE-Q- and 3D Facial Image-Based Comparative Study of Patient-, Clinician-, and Lay-Observer-Reported Outcomes

Denadai

Chou

et al. 2019

JCM

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Outcome measures reported by patients, clinicians, and lay-observers can help to tailor treatment plans to meet patients’ needs. This study evaluated orthognathic surgery (OGS) outcomes using pre- and post-OGS patients’ (n = 84) FACE-Q reports, and a three-dimensional facial photograph-based panel assessment of facial appearance and psychosocial parameters, with 96 blinded layperson and orthodontic and surgical professional raters, and verified whether there were correlations between these outcome measurement tools. Post-OGS FACE-Q and panel assessment measurements showed significant (p < 0.001) differences from pre-OGS measurements. Pre-OGS patients’ FACE-Q scores were significantly (p < 0.01) lower than normal, age-, gender-, and ethnicity-matched individuals’ (n = 54) FACE-Q scores, with no differences in post-OGS comparisons. The FACE-Q overall facial appearance scale had a low, statistically significant (p < 0.001) correlation to the facial-aesthetic-based panel assessment, but no correlation to the FACE-Q lower face and lips scales. No significant correlation was observed between the FACE-Q and panel assessment psychosocial-related scales. This study demonstrates that OGS treatment positively influences the facial appearance and psychosocial-related perceptions of patients, clinicians and lay observers, but that there is only a low, or no, correlation between the FACE-Q and panel assessment tools. Future investigations may consider the inclusion of both tools as OGS treatment endpoints for the improvement of patient-centered care, and guiding the health-system-related decision-making processes of multidisciplinary teams, policymakers, and other stakeholders.

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“…Since no prior investigation employed the FACE-Q questionnaire and 3D morphometry for analysis of a cohort of patients, we could not perform a direct comparative appraisal of the current versus former findings. The generalizability of our findings cannot be assumed, as all included patients were treated by particular procedural strategies, including the digital occlusion set up, virtual surgery, surgeryfirst model, and two-jaw orthognathic surgery with single-splint technique 3,[45][46][47][48][49] . We enrolled a restricted final sample as only matched patients and controls were included for analysis.…”

Section: Discussionmentioning

confidence: 99%

Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction

Denadai

Chou

Seo

et al. 2020

Sci Rep

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Patient satisfaction with the shape and appearance of their nose after orthognathic surgery-based skeletofacial reconstruction is an important, but often overlooked, outcome. We assessed the nose-related outcomes through a recently developed patient-reported outcome instrument and a widely adopted 3D computer-based objective outcome instrument, to verify any correlation in the results produced by these tools. We collected FACE-Q nose appearance reports (2 scales) and 3D nasal morphometry (10 parameters) from patients with class III skeletal pattern and congenital cleft lip palate deformity (n = 23) or developmental dentofacial deformity (n = 23) after (>12 months) skeletofacial reconstruction. The cleft and dentofacial cohorts demonstrated significantly (p < 0.001) poorer satisfaction scores with regard to the FACE-Q nostrils scale than the normal age-, gender-, and ethnicity-matched subjects (n = 107), without any significant difference in FACE-Q nose scale. The cleft cohort had significantly (p < 0.001) smaller nasal length, nasal tip projection, and columellar angle and greater nasal protrusion, alar width, and columellar-labial angle values than the dentofacial and normal cohorts; however, there were no significant differences between the dentofacial versus normal cohorts. The FACE-Q nose and nostrils scales were significantly (p < 0.001; r = −0.26-0.27) correlated to the results of the 3D morphometric analysis, with regard to nasal length, alar width, columella angle, and columellar-labial angle parameters. This study revealed differences in satisfaction with the appearance of the nose according to the type of underlying deformity, and demonstrated a significant correlation (low correlation coefficients) between the patient-reports and 3D image-based outcome measure tools, which has implications for multidisciplinary-centered research, auditing, and clinical care. Facial deformities associated with abnormal maxillo-mandibular relationships, such as congenital cleft lip and palate and developmental dentofacial deformities, significantly affect oral function and facial aesthetics 1,2. Skeletofacial reconstruction using orthognathic surgery principle is a successful treatment modality for these abnormalities 3-5. However, a number of post-surgical facial modifications are the primary causes of concern among the patients, particularly changes in the nasal morphology 6. A growing number of studies have addressed this issue by adopting three-dimensional (3D) nasal measurements 6-15 , but the effects of skeletofacial reconstruction are beyond these imaging-guided outcome metrics 1,4,5. The patient satisfaction with the appearance of their nose is an important, albeit often overlooked, outcome parameter after orthognathic surgery. Therefore, including a patient's self-perception by employing patient-reported outcome (PRO) techniques may help clinicians to understand the health-related concerns of the patient 16,17. Literature reviews 4,5 have revealed that a plethora of PRO instruments have been utilized to primaril...

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Subcutaneous Mastectomy Improves Satisfaction with Body and Psychosocial Function in Trans Men: Findings of a Cross-Sectional Study Using the BODY-Q Chest Module

Abstract: Evidence-Based Outcomes Article.

Cited by 65 publications

References 16 publications

Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes

Mastectomy in Transgender and Cisgender Patients: A Comparative Analysis of Epidemiology and Postoperative Outcomes

Facial Appearance and Psychosocial Features in Orthognathic Surgery: A FACE-Q- and 3D Facial Image-Based Comparative Study of Patient-, Clinician-, and Lay-Observer-Reported Outcomes

Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction

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