Subcutaneous mastectomy in female-to-male transsexuals: Optimizing perioperative and operative management in 8 years clinical experience

Wolter, A; Scholz, T.; Pluto, Naja; Diedrichson, J.; Arens-Landwehr, Andreas; Liebau, J.

doi:10.1016/j.bjps.2017.09.003

Cited by 33 publications

(28 citation statements)

References 18 publications

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“…Thus, in the authors' two intervention studies with a total of 258 breasts, nine of ten haematomas occurred in the placebo group ( P = 0·019, Fisher's exact test). In the few existing studies of intravenous TXA in breast surgery, a reduction in both bleeding and haematoma has been suggested.…”

Section: Discussionmentioning

confidence: 99%

Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial

et al. 2019

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Background Topical administration of tranexamic acid (TXA) may be an alternative to intravenous administration to reduce bleeding with a lower risk of systemic adverse events. The aim of this study was to investigate whether moistening a surgical wound with TXA before closure, leaving a thin film of drug only, would reduce postoperative bleeding. Methods This was a two‐centre, stratified, parallel‐group, placebo‐controlled, double‐blind RCT. Patients undergoing mastectomy with or without axillary lymph node clearance were randomized 1 : 1 to moistening of wound surface before closure with either 25 mg/ml TXA or 0·9 per cent sodium chloride (placebo). The primary endpoint was postoperative bleeding as measured by drain production in the first 24 h. Secondary endpoints were early haematoma, total drain production, postoperative complications and late aspirations of seroma within 3 months. Results Between 1 January 2016 and 31 August 2018, 208 patients were randomized. Two patients were converted to a different surgical procedure at surgery, and four did not receive the intervention owing to technical error. Thus, 202 patients were included in the study (101 in the TXA and 101 in the placebo group). TXA reduced mean drain production at 24 h (110 versus 144 ml; mean difference 34 (95 per cent c.i. 8 to 60) ml, P = 0·011). One patient in the TXA group had early haematoma compared with seven in the placebo group (odds ratio (OR) 0·13 (95 per cent c.i. 0·02 to 1·07); P = 0·057). There was no significant difference in postoperative complications between TXA and placebo (13 versus 10; OR 1·11 (0·45 to 2·73), P = 0·824) or need for late seroma aspirations (79 versus 67 per cent; OR 1·83 (0·91 to 3·68), P = 0·089). Conclusion Moistening the wound with TXA 25 mg/ml before closure reduces postoperative bleeding within the first 24 h in patients undergoing mastectomy. Registration number: NCT02627560 (https://clinicaltrials.gov).

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Section: Discussionmentioning

confidence: 99%

Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial

et al. 2019

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“…1,6,[22][23][24][25][26][27][28] From all the surgical techniques, semicircular periareolar mastectomy was the most satisfactory compared with other techniques (Table 2). 8,13,22,[24][25][26]29 Liposuction alone had the lowest overall satisfaction (2.2); however, only 1 study used this technique. 25…”

Section: Satisfaction Assessment Toolsmentioning

confidence: 98%

“…2). 6,8,14,[22][23][24][26][27][28][29][30][31][32][33] The majority of TGNB patients underwent mastectomy with FNG.…”

Section: Pooled Overall Patient Satisfactionmentioning

confidence: 99%

Transgender and Gender-nonbinary Patient Satisfaction after Transmasculine Chest Surgery

Bustos

Mascaró

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…Our cohort was added to the qualitative synthesis and tables. A total of 19 articles were included (Tables 1,2) (7,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Search Resultsmentioning

confidence: 99%

Nipple-areola complex reconstruction in transgender patients undergoing mastectomy with free nipple grafts: a systematic review of techniques and outcomes

et al. 2021

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Nipple-areola complex (NAC) reconstruction in transgender and gender non-binary (TGNB) individuals undergoing chest wall masculinization surgery is critical for adequate satisfaction and aesthetic results. Here, we conducted a systematic review to find the various techniques and outcomes of NAC reconstruction in double-incision mastectomy and free nipple grafts (DIM-FNG). A comprehensive search of several databases was conducted based on PRISMA guidelines. We included studies that described the NAC reconstruction technique after DIM-FNG, and evaluated the surgical outcomes, or satisfaction, or aesthetic results after a minimum duration of follow-up of 6 months. Studies were assessed for risk of bias.A qualitative synthesis was performed. A total of 19 studies, comprising 1,587 patients (3,174 breasts), were included. There was a total of 14 studies using the conventional FNG technique, 4 describing new approaches for NAC reconstruction in FNG and 1 study comparing the conventional FNG technique to another alternative technique. A total of 1,347 patients underwent DIM-FNG with conventional FNG and 240 underwent alternative techniques for NAC reconstruction after DIM-FNG. Postoperative complications were low, and satisfaction was high for conventional and alternative techniques. Newer techniques aim to reshape the new NACs in an oval shape, reduce nipple size and place the NACs using the pectoralis major lateral and inferior borders as reference. In addition, a horizontal oval incision at the recipient site may avoid an undesired vertical NAC.

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Subcutaneous mastectomy in female-to-male transsexuals: Optimizing perioperative and operative management in 8 years clinical experience

Cited by 33 publications

References 18 publications

Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial

Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial

Transgender and Gender-nonbinary Patient Satisfaction after Transmasculine Chest Surgery

Nipple-areola complex reconstruction in transgender patients undergoing mastectomy with free nipple grafts: a systematic review of techniques and outcomes

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