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FTM Top Surgery Journal Articles

NEW! The Impact of Male Chest Reconstruction on Chest Dysphoria in Transmasculine Adolescents and Young Men; A Preliminary Study
Johanna Olson-Kennedy, Jonathon Warus. Journal of Adolescent Health , Volume 60 , Issue 2 , S88, February 2017.
Of the minors who had undergone male chest reconstruction, 93% reported being satisfied with the surgery "all of the time." No youth reported regret about the procedure. Results reflect the positive impact of male chest reconstruction witnessed in a clinical setting.

Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study.
Sarah Peitzmeier, Ivy Gardner, Jamie Weinand, Alexandra Corbet, Kimberlynn Acevedo. Culture, Health & Sexuality, May 2016.
Chest binding involves the compression of chest tissue for masculine gender expression among people assigned a female sex at birth, particularly transgender and gender non-conforming individuals. There are no peer-reviewed studies that directly assess the health impacts of chest binding, yet transgender community resources commonly discuss symptoms such as pain and scarring. A cross-sectional 32-item survey was administered online to an anonymous, non-random sample of adults who were assigned a female sex at birth and had had experience of binding (n = 1800). Multivariate regression models were used to identify practices associated with self-reported health outcomes. Of participants, 51.5% reported daily binding. Over 97% reported at least one of 28 negative outcomes attributed to binding. Frequency (days/week) was consistently associated with negative outcomes (22/28 outcomes). Compression methods associated with symptoms were commercial binders (20/28), elastic bandages (14/28) and duct tape or plastic wrap (13/28). Larger chest size was primarily associated with dermatological problems. Binding is a frequent activity for many transmasculine individuals, despite associated symptoms. Study findings offer evidence of how binding practices may enhance or reduce risk. Clinicians caring for transmasculine patients should assess binding practices and help patients manage risk.

Top Surgery in Transgender Men: How Far Can You Push the Envelope?
Bluebond-Langner, Rachel M.D.; Berli, Jens U. M.D.; Sabino, Jennifer M.D.; Chopra, Karan M.D.; Singh, Devinder M.D.; Fischer, Beverly M.D. Plastic & Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 873e–882e.
The authors present their grading scale and the outcomes of the largest cohort of top surgery published to date. Application of this grading system can help determine which patients will benefit from a subcutaneous mastectomy with free nipple graft versus a circumareolar technique, with the primary endpoint being need for aesthetic revisions.

Sexual reassignment surgery in female-to-male transsexuals: an algorithm for subcutaneous mastectomy.
Wolter A, Diedrichson J, Scholz T, Arens-Landwehr A, Liebau J. J Plast Reconstr Aesthet Surg. 2015 Feb;68(2):184-91. doi: 10.1016/j.bjps.2014.10.016. Epub 2014 Oct 18.
In this study, we introduce an algorithm to facilitate choosing the appropriate mastectomy technique depending on morphological aspects.

Improved results after implementation of the Ghent algorithm for subcutaneous mastectomy in female-to-male transsexuals.
Bjerrome Ahlin H, Kölby L, Elander A, Selvaggi G.
J Plast Surg Hand Surg. 2014 Dec;48(6):362-7. doi: 10.3109/2000656X.2014.893887. Epub 2014 Mar 11.
At the Sahlgrenska University Hospital, a two-step procedure was used for mastectomies through 2002-2011. With this procedure, all patients were operated on with a concentric circular incision in the first session of surgery, followed by a second session 7-12 months later. From July 2011, a new approach was adopted, which consists of treating patients according to the algorithm and methods described by Monstrey et al. The aim of this study is to evaluate these two different approaches and determine if similar results, possibly with fewer surgeries and overall lower complication rate, can be achieved by using multiple techniques and a decision-making algorithm as compared to the two-step approach where only a concentric circular technique was used.

Subcutaneous mastectomy in female-to-male transsexuals: a retrospective cohort-analysis of 202 patients.
Cregten-Escobar P, Bouman MB, Buncamper ME, Mullender MG. J Sex Med. 2012 Dec;9(12):3148-53.
This study shows a correlation between the surgical technique, complication rate, and length of hospital stay. The largest series of subcutaneous mastectomies in female-to-male transsexuals to date is presented. In general, the larger the breast, the larger the scars that remain after the operation. On the other hand, the smaller the scars resulting from the operation, the higher the risk of hematoma.

Operative management and techniques of mastectomy in female-to-male transsexuals.
Morath S, Papadopulos N, Schaff J. Handchir Mikrochir Plast Chir. 2011 Aug;43(4):232-9. doi: 10.1055/s-0031-1273735. Epub 2011 May 17.
All procedures were conducted in a very scar-saving manner, however, a higher rate of correction procedures was necessary to individually adjust skin shrinking and thereby optimising the prior aesthetic results.

Combined Hysterectomy/Salpingo-Oophorectomy and Mastectomy is a Safe and Valuable Procedure for Female-to-Male Transsexuals.
Ott, J., van Trotsenburg, M., Kaufmann, U., Schrögendorfer, K., Haslik, W., Huber, J. C. and Wenzl, R. (2010). Journal of Sexual Medicine, 7: 2130–2138. doi: 10.1111/j.1743-6109.2010.01719.x

Chest-wall contouring surgery in female-to-male transsexuals: a new algorithm.
Monstrey S, Selvaggi G, Ceulemans P, Van Landuyt K, Bowman C, Blondeel P, Hamdi M, De Cuypere G. Department of Plastic Surgery, Gent University Hospital, Belgium. Plast Reconstr Surg. 2008 Mar;121(3):849-59.
Skin excess and skin elasticity are the key factors in choosing the appropriate technique for subcutaneous mastectomy. Although the complication rate is low and patient satisfaction is high, secondary aesthetic corrections are often indicated.

Mastectomy for Female to Male Transsexuals.
NAMBA YUZABURO (Okayama Univ., JPN) TSUTSUI TETSUYA (Okayama Univ., JPN) KIMATA YOSHIHIRO (Okayama Univ., JPN) KOSHIMA ISAO (Univ. Tokyo, Graduate School of Medicine, JPN). Japanese Journal of Plastic & Reconstructive Surgery, VOL.49;NO.9;PAGE.985-991(2006).
Clinical experiences and information about mastectomy for FTM transsexuals.

Breast cancer after bilateral subcutaneous mastectomy in a female-to-male transsexual.
Burcombe RJ, Makris A, Pittam M, Finer N. Breast. 2003 Aug;12(4):290-3.
Female-to-male transsexual, aged 33, who developed breast cancer 10 years after cosmetic bilateral subcutaneous mastectomy and nipple reimplantation. The complex hormonal pathways involved and the implications of undergoing prophylactic mastectomy because of a high risk of familial breast cancer are discussed.

Circumareolar mastectomy in female-to-male transsexuals and large gynecomastias: a personal approach.
Colić MM. Aesthetic Plast Surg. 2000 Nov-Dec;24(6):450-4.
This technique provides naturally flat masculine breasts, leaving sufficient dermal vascularization for the nipple-areola complex which is of the utmost importance. All the patients were very satisfied with the result because of the periareolar scar only.

Chest wall contouring for female-to-male transsexuals: Amsterdam experience.
Hage JJ, Bloem JJ. Ann Plast Surg. 1995 Jan;34(1):59-66.
At the Academic Hospital of the Free University (Amsterdam, The Netherlands), usually one of three techniques is applied for a subcutaneous mastectomy. We describe and discuss our experience with 70 patients operated on before April 1993.

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Last updated: 11/13/17

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