Away from , we did 52 two-sided subcutaneous mastectomies at the Service away from Synthetic, Reconstructive and you will Artistic Surgery, Trakya School Medical, Edirne, Chicken ( Desk step one ). An average diligent age is actually 28.dos (a long time, 18-47). This new weights of people have been ranging from forty and you can one hundred kilogram and you can average body mass index (BMI) try 23.4 (Body mass index range, 15.6-thirty six.7). Thirty customers had a track record of acquiring testosterone hormones treatment prior to process. Hormones therapy is abandoned 4 weeks ahead of medical intervention. Plus, for each diligent underwent a complete psychological, endocrinological, urologic and you can gynecological assessment, hence anticipate this new medical diagnosis away from “FtM transsexualism” becoming made. A keen ultrasound examination is actually did to check on the existence of glandular tissue and also to prohibit people pathologic size in all circumstances. ‘Patient Told Concur Form’ was taken from all the some body.
Desk step one
Preoperatively, the option of method is actually predicated on breast dimensions and you can knowledge from surface continuously, skin suppleness, NAC dimensions and reputation. A four degrees breast classification try performed centered on nipple dimensions and you will facial skin excessive:
Most of the customers were informed Our site regarding the appropriate approach out of incisions and you will you’ll postoperative scars. Of these customers who perhaps not accept postoperative markings outside of the subpectoral shade, this disorder is actually noted. After that, particular subcutaneous mastectomy was chose based on the formula showed in Profile step one . Appropriate antibiotics was basically given one hour through to the procedure and for the 5 days immediately following. An individual satisfaction questionnaire is actually performed 1 year following the procedures to test the entire aesthetic result of subcutaneous mastectomy. Diligent pleasure is actually ranked as “decent” (5), “good” (4), “satisfactory” (3), “reduced sufficient” (2) and you may “unsatisfactory” (1).
Medical procedure
Every subcutaneous mastectomies have been did lower than general anesthesia. On the patient when you look at the vulnerable position, specific body slices have been made considering preoperative scars. Inside elevation from flaps, very mindful dissection was performed to preserve all subcutaneous lbs over the mammary gland. Therefore, adequate density skin produces an aesthetically pleasing breasts wall surface physical appearance without purely followed and you will depressed portion within skin and you will chest wall structure.
In the cases of breasts with reduced dimensions and body too much, the Webster technique was utilized ( Figure 2 ). The newest cut initiate out of ‘three’ status into the areola-body conjunction and you may ends during the ‘nine’ reputation. It could be longer laterally and you may medially by about step 1 cm, to have most useful visibility of subcutaneous dissection area. During level regarding NAC complex, a small amount of mammary tissue is going to be included lower than which flap to prevent anxiety deformity. Then, subcutaneous mastectomy is accomplished. At the end of this technique, to create an aesthetically pleasing masculine tits figure, the desired quantity of subcutaneous fat structure shall be excised out of above the number of the latest submammary bend, if required. Even though the method is more challenging, from the small visibility window by which dissection and hemostasis are carried out, it short incision contributes to a highly-undetectable infra-areolar mark. As well, breast reduction can be performed, when needed. A sucking sink is put regarding subcutaneous dissection urban area. Yet not, whether your patient provides the curiosity about an inferior areola, this technique will be revised in order to good concentric periareolar means.
The fresh new concentric periareolar techniques can be used for tits which have average epidermis excess and you can a good surface elasticity (B cup) and for tits with reduced body a lot of however, with an excellent high NAC complex ( Figure 3 ). A couple of concentric slices are built. The very first is placed in the newest areola for the desired diameter to help make an alternative NAC, while the bigger a person is constructed with the right diameter, enabling this new excision regarding an adequate amount of continuously mammary facial skin. Then your urban area anywhere between a few groups are deepithelialized to end compromising the fresh new blood flow on the NAC. Subcutaneous mastectomy is done compliment of a beneficial semicircular cut listed in the new deepithelialized town. Enough mammary tissue should be remaining beneath the NAC flap; this flap are cautiously dissected having a broad-established dermal pedicle. If required, the fresh submamount from subcutaneous weight structure out-of over the amount of so it bend. A sucking drain is placed in the dissection cavity. The fresh external network will be sutured in order to faster one from the purse-sequence trend. The process brings a publicity screen getting dissection and hemostasis. And it enables new reduced total of highest areola and you can extreme facial skin. Along with, if the breast prevention is necessary, it can be done in identical session because vascular supply of it flap strategy is mainly legitimate.
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