What is transgender mastectomy?
Transgender mastectomy is a surgical procedure, performed under general anesthesia, in which breast tissue is removed in transgender patients. This procedure is indicated for transgender patients who want to be treated to end the distress caused by gender dysphoria. It serves primarily to enable these patients to physically transition to their self-affirmed gender.
Why is it performed?
Transgender patients require breast surgery in order to feel good about their identity. However, they often choose not to undergo surgery. They may relate to their body in different ways and must make an individual decision that best suits their needs.
Some cases in which the doctor himself will recommend not to carry out such intervention are:
- Mental health conditions.
- Health conditions, such as heart disease, thrombosis, kidney disease, etc.
- Conditions that limit capacity.
What does it consist of?
The surgeon begins by making an incision in the back of the breast. A drainage tube will then be inserted to prevent fluid accumulation in the breast spacer during the first stage of the procedure. The incision will be closed with suture seams, healing in the chest and under the armpit.
If the patient has small breasts it is possible to preserve the nipple and areola, while if they are voluminous it is likely that they will have to be removed to resize and reposition them.
What are the risks involved?
Like any major surgery, transgender mastectomy involves some risk to the patient in the form of:
- Risk of bleeding.
- Adverse reaction to anesthesia.
- Improper wound healing.
What is the preparation for transgender mastectomy?
Before undergoing transgender mastectomy, the patient should meet with the surgeon to explain what their expectations are. He, in turn, will give you certain dietary indications, as well as some guidelines that you will need for anesthesia.
Also, before being a candidate for this surgery, the patient must undergo an evaluation of the following points:
- A review of family and personal medical histories.
- A physical examination, including evaluation of the internal genitalia.
- A laboratory analysis to measure lipids, blood sugar, liver enzymes, electrolytes and prolactin hormone, as well as a complete blood count.
- A review of vaccinations.
- An age and gender appropriate screening test.
- Identifying and addressing smoking, drug abuse, excessive alcohol use, HIV or other sexually transmitted infections.
- A discussion of sperm freezing (semen cryopreservation).
- A mental evaluation to ensure that the patient is fully aware of the procedure he is about to undergo.
What care is required after surgery?
After surgery, the breast will remain in a compression wrap for several weeks. Small plastic tubes will likely be placed at the site where the breasts were removed to drain any fluid that accumulates after surgery. It is important to sleep with your torso elevated for the first week and to avoid lifting for several weeks after surgery.
Regardless of the surgical technique used, some breast tissue may remain, so the patient should be screened periodically for breast cancer as a precaution.
What to expect from the results?
Transgender mastectomy can play an important role in alleviating gender dysphoria in transgender men and improving their quality of life.
Research indicates that most transgender men are satisfied with their surgical results. For this reason, it is extremely important to speak candidly with the surgeon to ensure that he knows what your expectations are and can choose the most appropriate treatment in each case.