Female-to-Male Gender-Affirming Chest Reconstruction Surgery
Female-to-Male Gender-Affirming Chest Reconstruction Surgery
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DOI：
10.1093/asj/sjy098
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发表时间：
2019-01-17
影响因子：
2.9
通讯作者：
Kuzon Jr, William M.
中科院分区：
文献类型：
--
作者：
Ammari, Tareq;Sluiter, Emily C.;Kuzon Jr, William M.
对性别确认手术的需求不断增加。胸部轮廓手术或“顶部”手术对于女变男 (FtM) 变性人群尤其重要。这篇继续医学教育 (CME) 文章批判性地评价了有关顶级手术的现有文献，以便整形外科医生了解当前的实践，并使用决策算法和患者的术前解剖结构和特征来确定最佳的手术技术。由于术前患者解剖结构存在显着差异，因此不存在单一的最佳手术方法，并且为了提供有用的决策框架，所描述的手术方法被分类为： 方法 1-不切除皮肤的远程切口手术；方法 2-乳晕周围皮肤切除手术；并采用除乳晕周围皮肤切除之外的皮肤切除方法进行三乳房切除手术。审查有助于确定最适合个体患者的手术技术的决策算法。有关并发症发生率和患者满意度的数据将改善知情同意讨论并创造切合实际的患者期望。
There is an increased demand for gender affirmation surgery. Chest contouring, or "top" surgery, is especially important in the female-to-male (FtM) transgender population. This Continuing Medical Education (CME) article critically appraises the available literature on top surgery to allow plastic surgeons to understand current practices and determine the best surgical technique using a decision algorithm and the patient's preoperative anatomy and characteristics. Because a single best surgical approach does not exist due to significant variance in preoperative patient anatomy, and in order to provide a useful framework for decision making, surgical approaches described are categorized as: approach 1-remote incision procedures without skin excision; approach 2-procedures with periareolar skin excision; and approach 3-mastectomy procedures with skin excision other than periareolar skin excision. Decision algorithms that help determine the most suitable surgical technique for individual patients are reviewed. Data on complication rates and patient satisfaction will improve informed consent discussions and create realistic patient expectations.