XVII Harry Benjamin International Gender Dysphoria Association Symposium
31 October - 4 November 2001, Galveston, Texas, U.S.A.

Subcutaneous Mastectomy in Female-to-Male Transsexuals

MONSTREY, STAN Belgium
Co-authors: Genarro Selvaggi, Koenraad Van Landuyt, Phillip Blondeel, Moustapha Hamdi & Piet Hoebeke (Belgium)
E-mail: stan.monstrey@rug.ac.be

Subcutaneous mastectomy is considered by many Female-to-Male (FTM) transsexuals as the most important (and first performed) operative procedure of their gender reassignment surgery. Male-chest-contouring surgery consist of a resection of the glandular breast tissue and, if necessary, also of the excess of skin envelope while keeping the nipple in the exact position. In this presentation we will report on 92 patients who underwent a subcutaneous mastectomy. An algorithm will be presented on the different procedures which have been performed, depending on the amount of breast tissue and on the excess and quality of the breast skin:

1. a semi-circular, peri-areolar approach
2. a trans-areolar approach with partial resection of a large nipple
3. a circular approach with purse-string
4. a circular approach with purse-string and medio-lateral skin resection
5. an infra-mammary approach with free nipple transfer.

Indications, advantages, disadvantages and complications of each operative procedure will be discussed.