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P111. A SINGLE SURGEON RETROSPECTIVE REVIEW OF CHEST MASCULINIZATION SURGERY IN TRANSGENDER AND NON-BINARY ADOLESCENTS AND YOUNG ADULTS

Garcia, Maxine S. BA1; Ghafoor, Essie S. MBS1; Ascha, Mona MD2; Corcoran, Julia MD1

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Plastic and Reconstructive Surgery - Global Open: April 2022 - Volume 10 - Issue 4S - p 102-103
doi: 10.1097/01.GOX.0000828792.30328.16
  • Open

PURPOSE: Gender-affirming surgery improves the quality of life of transgender and non-binary (TGNB) individuals. Individuals designated female at birth (DFAB) may pursue chest-masculinization surgery to alleviate chest dysphoria. Top surgery is safe in adults, but outcomes and safety of top surgery among TGNB adolescents and young adults (AYA) remain unknown.

METHODS: A single-surgeon identified 88 consecutive TGNB AYA patients undergoing top surgery over 4.5 years for review. Demographic variables were collected. Outcomes of interest included hematoma/seroma incidence, infection, nipple graft loss and pigmentation, and operating room return. Descriptive statistics were calculated. For patients with nipple-areola complex (NAC) grafts, repigmentation quality was rated on a scale from 1 to 5.

RESULTS: Median (interquartile range) age was 18.3 (17.0-20.0) years. Most patients underwent double-incision free nipple graft technique (n=59, 67.0%) with drain placement (n=63, 71.6%). Seventeen patients (19.3%) experienced hematoma, 24 (27.3%) seroma, and two (2.3%) infection. Six patients (6.8%) underwent unplanned reoperation, all for hematoma evacuation. Nine patients (10.2%) underwent planned reoperation, for scar revision or excess tissue excision. Most scars healed appropriately (n=76, 86.4%). Median (IQR) NAC pigmentation score was 6 (4-8.3).

CONCLUSION: Top surgery among TGNB AYA is a safe procedure with comparable complication incidence to those in TGNB adult patients, (Berry et al., 2011; Frederick et al., 2017). Our findings provide healthcare practitioners, insurers, public health officials and legislators evidence of safety and efficacy in chest-masculinizing surgery in TGNB AYA patients.

Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.