Giulia Lo Russo, Leonardo Scortecci, Francesca Ruccia, Ankur Khajuria, Leonardo Gada
{"title":"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。","authors":"Giulia Lo Russo, Leonardo Scortecci, Francesca Ruccia, Ankur Khajuria, Leonardo Gada","doi":"10.1007/s00266-025-04942-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>-16</sup>).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence v: </strong>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 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Giulia Lo Russo, Leonardo Scortecci, Francesca Ruccia, Ankur Khajuria, Leonardo Gada\",\"doi\":\"10.1007/s00266-025-04942-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The most used technique was DI (82.4%) followed by HP (11.4%) and PA (6.2%). 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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.
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 .
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.
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