Mastectomy in transgender patients: The experience of a Portuguese reference center

IF 1.8 Q3 SURGERY

JPRAS Open Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI:10.1016/j.jpra.2026.01.044

Inês Catalão, José M. Azevedo, Miguel Sítima, Gonçalo Tomé, Sara Ramos

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引用次数: 0

Abstract

Gender-affirming mastectomy represents a fundamental procedure in the transition process for transgender patients, substantially contributing to psychosocial well-being. This study presents the 13-year experience of the only reference center in Portugal and aims to analyze surgical techniques, outcomes, complications and patient-reported satisfaction following chest wall masculinization.

A retrospective review was conducted of all trans men who underwent gender-affirming mastectomy between October 2011 and December 2024. Surgical techniques were selected based on breast size, ptosis and skin elasticity. Demographics, operative details, complications, and revision procedures were recorded, and postoperative satisfaction was assessed.

A total of 87 patients underwent chest wall masculinization surgeries, including 174 mastectomies. Inframammary mastectomies with nipple-areolar complex grafts were performed in 55%, concentric periareolar in 34%, and hemiperiareolar in 9.2% of cases. Mean body mass index was higher in the inframammary group (25.8 vs. 22.8 kg/m²; p < 0.001). The overall complication rate was low. Hematoma occurred in 13%, hypertrophic scarring in 11% (significantly associated with inframammary technique; p < 0.05), and no infections were recorded. Secondary revision surgery was required in 8.0% of patients. Among survey respondents (47%), the mean satisfaction score was 8.5/10, with no reports of regret.

Gender-affirming mastectomy is a safe and effective procedure that provides significant aesthetic and psychosocial outcomes. Individualized surgical technique selection based on anatomical features yields high patient satisfaction and low complication rates.

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跨性别患者的乳房切除术：葡萄牙参考中心的经验。

性别确认乳房切除术是跨性别患者过渡过程中的一项基本程序，对社会心理健康有重大贡献。本研究介绍了葡萄牙唯一参考中心13年的经验，旨在分析胸壁男性化后的手术技术、结果、并发症和患者报告的满意度。对2011年10月至2024年12月期间接受性别确认乳房切除术的所有跨性别男性进行了回顾性审查。根据乳房大小、上睑下垂和皮肤弹性选择手术技术。统计资料，手术细节，并发症和翻修程序记录，并评估术后满意度。共有87例患者接受了胸壁男性化手术，其中包括174例乳房切除术。乳下乳房切除术合并乳头-乳晕复合移植物占55%，同心性乳晕周围占34%，半乳晕周围占9.2%。乳下组的平均体重指数更高（25.8 vs 22.8 kg/m²；p < 0.001）。总体并发症发生率低。血肿发生率为13%，增生性瘢痕发生率为11%（与乳腺下技术显著相关，p < 0.05），无感染记录。8.0%的患者需要进行二次翻修手术。在调查对象中（47%），平均满意度得分为8.5/10，没有遗憾的报告。性别确认乳房切除术是一种安全有效的手术，可提供显著的美学和社会心理效果。根据解剖特征选择个体化手术技术，患者满意度高，并发症发生率低。

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

JPRAS Open Medicine-Surgery

CiteScore

1.60

自引率

0.00%

发文量

审稿时长

22 weeks

期刊介绍： JPRAS Open is an international, open access journal dedicated to publishing case reports, short communications, and full-length articles. JPRAS Open will provide the most current source of information and references in plastic, reconstructive & aesthetic surgery. The Journal is based on the continued need to improve surgical care by providing highlights in general reconstructive surgery; cleft lip, palate and craniofacial surgery; head and neck surgery; skin cancer; breast surgery; hand surgery; lower limb trauma; burns; and aesthetic surgery. The Journal will provide authors with fast publication times.