XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

Augmentation Mammaplasty in Male-to-Female Transsexuals: The Amsterdam Experience

Hage JJ, Kanhai RCJ, Karim RB, and Mulder JW

Department of Plastic and Reconstructive Surgery, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.

Driven by a persistent and unchangeable need to undo the discrepancy between physical reality of the body and gender of the mind, most male-to-female transsexuals seek physical feminization through hormonal and surgical treatment. In cases where the hormonal treatment has not resulted in sufficient growth of the breast, augmentation mammaplasty may be considered.

A survey is presented of 201 such cases operated on in the Academisch Ziekenhuis Vrije Universiteit in Amsterdam, The Netherlands, with an average age of 34 years and an average follow-up of 4 years.

In keeping with our protocol and the Standards of Care of the Harry Benjamin International Gender Dysphoria Association, most patients had estrogen therapy and a successful real-life experience for a minimum of 1.5 years. Mammaplasty was performed in two-third of our vaginoplasty patients and, in these, both procedures was usually performed simultaneously by two surgical teams. The average size of implants has nearly doubled over the years, from 165 to 287 cc. Male-to-female transsexuals often request a ‘distinctly’ feminine figure and repeated augmentation mammaplasties were required mostly in cases where the result of initial augmentation was not outspoken.