Away from , i performed 52 two-sided subcutaneous mastectomies during the Agencies from Vinyl, Reconstructive and Artistic Functions, Trakya School Hospital, Edirne, Chicken ( Desk 1 ). The common patient age try twenty eight.2 (age range, 18-47). The loads of people was in fact ranging from 40 and you can 100 kg and mediocre bmi (BMI) is 23.cuatro (Body mass index assortment, 15.6-thirty six.7). 30 people got a reputation acquiring testosterone hormone treatment before procedure. Hormones medication is actually discontinued four weeks prior to medical input. Also, per patient underwent a complete psychological, endocrinological, urologic and gynecological analysis, and that allowed the fresh new medical diagnosis of “FtM transsexualism” is made. A keen ultrasound examination are performed to check the current presence of glandular structure and also to prohibit any pathologic size in most instances. ‘Patient Advised Concur Form’ is taken from the anybody.
Preoperatively, the choice of strategy are predicated on breast dimensions and you may degree away from facial skin excessive, body elasticity, NAC size and condition. A several amount breast class was performed based on nipple proportions and you may surface way too much:
The customers had been told regarding suitable approach out of incisions and you can possible postoperative scars. For those customers who would maybe not take on postoperative scars outside the subpectoral trace, this condition try detailed. Then, particular subcutaneous mastectomy was picked in accordance with the formula shown inside the Shape step 1 . Compatible antibiotics was given an hour until the process as well as the five days once. An individual pleasure questionnaire are performed 12 months after the operations to check the entire graphic results of subcutaneous mastectomy. Diligent satisfaction try rated once the “very good” (5), “good” (4), “satisfactory” (3), “shorter sufficient” (2) and you may “unsatisfactory” (1).
The subcutaneous mastectomies was basically performed not as much as standard anesthesia. To the diligent for the susceptible position, specific epidermis slices have been made based on preoperative marks. Within the elevation from flaps, very mindful dissection are performed in preserving all the subcutaneous fat above new mammary gland. Therefore, adequate density facial skin supplies an aesthetically pleasing breasts wall looks without purely adhered and you will disheartened portion between the epidermis and you may breasts wall.
Throughout the instances of bust with reduced dimensions and skin continuously, the brand new Webster techniques was utilized ( Profile dos ). The brand new incision initiate out smooch hesap silme of ‘three’ position in the areola-surface conjunction and you can concludes from the ‘nine’ standing. It can be offered laterally and you may medially because of the at the very least step one cm, for finest visibility of subcutaneous dissection area. During the height out-of NAC advanced, some mammary structure shall be incorporated less than which flap to stop despair deformity. Following, subcutaneous mastectomy is done. After this technique, in order to create an aesthetically pleasing male chest figure, the necessary level of subcutaneous lbs tissue will be excised regarding above the amount of the newest submammary flex, if necessary. Whilst method is much harder, of the short exposure windows through which dissection and you will hemostasis are performed, which brief cut causes a well-hidden infra-areolar scar. Additionally, breast avoidance can be performed, when needed. A suction drain is placed about subcutaneous dissection city. Although not, if your patient has got the fascination with an inferior areola, this procedure will likely be revised to an effective concentric periareolar method.
This new concentric periareolar method are used for boobs with modest facial skin excessive and you may an effective epidermis suppleness (B mug) and for chest with just minimal skin excessive however, having an excellent highest NAC state-of-the-art ( Profile step 3 ). One or two concentric incisions are formulated. The very first is listed in the brand new areola towards the desired diameter to produce an alternate NAC, together with larger one is constructed with the ideal diameter, enabling new excision of an adequate amount of a lot of mammary surface. Then city ranging from a couple circles was deepithelialized to eliminate decreasing the new flow on NAC. Subcutaneous mastectomy is accomplished as a result of a beneficial semicircular cut listed in the fresh deepithelialized town. An adequate amount of mammary tissues are going to be kept according to the NAC flap; which flap was very carefully dissected with a broad-built dermal pedicle. If required, the fresh new submamount out-of subcutaneous lbs structure regarding over the quantity of which bend. A suction sink is positioned inside the dissection cavity. The new outer circle will be sutured so you’re able to shorter you to definitely by the purse-sequence trend. The process brings a great exposure window to have dissection and you will hemostasis. Plus it allows the latest reduction of highest areola and a lot of skin. Along with, if the breast prevention is necessary, you can accomplish it in identical tutorial given that vascular way to obtain which flap method is generally legitimate.