A New Algorithm for Masculine Chest-Wall Contouring in 560 Trans-AFAB (Assigned Female at Birth) Patients: Clinical Outcomes and Patient-Reported Satisfaction Using the TRANS-Q Questionnaire.

IF 2 3区医学 Q2 SURGERY

Aesthetic Plastic Surgery Pub Date : 2025-05-28 DOI:10.1007/s00266-025-04942-5

Giulia Lo Russo, Leonardo Scortecci, Francesca Ruccia, Ankur Khajuria, Leonardo Gada

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引用次数: 0

Abstract

Introduction: The preoperative plan is crucial in chest-wall contouring surgery. Choosing the right surgical technique may be challenging, especially when there are many variables to consider. Therefore, the senior author (GLR) described a novel and simpler preoperative algorithm which we used in our group of 560 trans-AFAB patients.

Methods: From 2016 to 2024, 560 consecutive trans-AFAB patients underwent top surgery with the new algorithm that uses the inferior border of pectoralis major muscle as a landmark to decide between three techniques: (1) Periareolar incision (PA), when the NAC is on the landmark, (2) hemi-periareolar incision (HP), when the NAC is above the landmark, and (3) double-incision technique with free nipple graft (DI) when the NAC is below the landmark. Complications, need for a touch-up, scar quality (through the Vancouver Scar Scale) and patient-reported outcomes (through TRANS-Q questionnaire) were analyzed.

Results: The most used technique was DI (82.4%) followed by HP (11.4%) and PA (6.2%). Hematoma occurred in 10.8% of the patients but only 1.7% needed a reintervention in the operating room. We performed a touch-up procedure in 9% of the patients. The most prevalent VSS score was 1 registered in 38.4% of patients. The TRANS-Q questionnaire revealed that the large majority of patients showed an improvement after surgery (p value: 1.41 × 10^-16).

Conclusion: This simple but effective new algorithm can support surgical choices and maximize the aesthetic outcomes in trans-AFAB patients' chest-wall contouring. High patient satisfaction and good surgical outcomes evidence the efficacy of this algorithm.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

查看原文本刊更多论文

560例Trans-AFAB（出生时指定为女性）患者的男性胸壁轮廓新算法：使用TRANS-Q问卷的临床结果和患者报告的满意度。

前言：术前计划是胸壁整形手术的关键。选择正确的手术技术可能具有挑战性，特别是当有许多变量需要考虑时。因此，资深作者（GLR）描述了一种新颖且更简单的术前算法，我们在560例跨afab患者中使用了该算法。方法：2016 - 2024年，连续560例经afab患者行顶手术，采用以胸大肌下缘为标志的新算法，选择三种技术：(1)NAC位于标志时的乳晕周围切口（PA）； (2) NAC位于标志上方时的半乳晕周围切口（HP）； (3) NAC位于标志下方时的双切口游离乳头移植技术（DI）。分析并发症、补片需求、疤痕质量（通过温哥华疤痕量表）和患者报告的结果（通过TRANS-Q问卷）。结果：使用最多的是DI(82.4%)，其次是HP（11.4%）和PA（6.2%）。10.8%的患者发生血肿，但只有1.7%的患者需要在手术室进行再干预。我们对9%的患者进行了修补手术。最常见的VSS评分为1分，占38.4%。TRANS-Q问卷显示，绝大多数患者术后均有改善（p值：1.41 × 10-16）。结论：这种简单有效的新算法可以支持手术选择，并最大限度地提高跨afab患者胸壁轮廓的美观效果。患者满意度高，手术效果好，证明了该算法的有效性。证据等级v：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.