The Brazilian Association of Plastic Surgeons (BAPS) details how the mastectomy procedure works
June is LGBTQIA+ Pride Month, an important time to think about transgender people’s access to gender-affirming and plastic surgery. These procedures are usually requested by these individuals due to distress caused by the mismatch between their gender identity and the sex assigned at birth, which is called gender dysphoria. And among gender-affirming surgeries, the masculinizing mastectomy is one of the most sought after.
According to the plastic surgeon doctor Alexandre Charãoassociate member of BAPS (Brazilian Association of Plastic Surgeons) with a large number of cases of reconstructive surgery in transgender patients.
“The breast is the greatest symbol of femininity and not the genital organ, as many believe. Because of this, many of my patients seek not genital surgery, but mastectomy. When a transgender man decides to transition, c “It is a great discomfort with the presence of breasts, which attacks their self-image and damages their self-esteem. Therefore, these patients seek the plastic surgeon to perform the mastectomy”says the doctor.
Mastectomy: Your doctor provides details of the procedure
BAPS explains that, being motivated by gender dysphoria, mastectomy, when appropriately indicated by a specialist doctor, falls under Brazilian legislation as reconstructive surgery. Also, it can be performed in the Unified Health System (SUS).
“The goal of the mastectomy is the removal of the mammary gland and fatty tissue, the removal of excess skin and the repositioning of the areola and nipple”, says the plastic surgeon. The technique used in the mastectomy will be chosen by the plastic surgeon based on a number of factors, such as the volume and degree of breast ptosis and the amount of excess skin.
“The operation can be performed through periareolar incisions, i.e. around the areola, or through horizontal incisions, above the nipple and below the breast, for the complete removal of the breast with subsequent free grafting of the nipple and areola”, says Dr. Alexandre, who explains that mastectomy can still be combined with liposuction to reduce the amount of fatty tissue and improve results.
The scars will vary depending on the technique used, being larger in the case of horizontal incisions. “It is also important to note that, due to hormone therapy with the use of testosterone commonly performed by these patients, there is an increased risk of hypertrophic scarring,” warns the doctor, who says that, in general, patients undergoing masculinizing mastectomy are not as concerned about the appearance of the scar.
“The primary desire of transgender patients is to achieve a well-defined chest contour, without excess skin or bulges.”
But BAPS emphasizes that, before carrying out the procedure, the patient must be evaluated by an experienced and duly certified professional.
“When in doubt, check if the practitioner has RQE, which is the specialty qualification record, and follow other cases on the practitioner’s social networks”advises the expert, who claims that the mastectomy requires specific requirements to be performed.
“The minimum age for the procedure is 18 years. In addition, the patient must previously undergo a year of interdisciplinary follow-up, including a mental health professional and an endocrinologist. It is also recommended that the patient has an index of body mass (BMI) less than or equal to 27, as obese patients have a higher risk of complications. In addition, it is recommended to stop using hormones three weeks before surgery to reduce the risk of thrombosis”, the doctor specifies.
It is worth mentioning that, although hormone therapy is not a requirement for the operation, it is interesting, if the patient wishes, to start it before the procedure, since androgen hormones generate atrophy of the mammary epithelium, which facilitates the operation.
In the postoperative period, the patient needs to use a drain and dressings for seven days and a surgical vest for about a month. Physical therapy sessions may also be indicated to restore movement in the arm and shoulder. Finally, regarding breast cancer, a common concern among transgender men undergoing mastectomies, BAPS says information is still scarce, but evidence indicates that patients who have had the procedure and use testosterone are at a lower risk. to develop breast cancer. the illness.
“However, annual chest wall exams for early detection of breast cancer are essential, especially for patients with a family history of the disease”concludes Dr. Alessandro Caronte.
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
