Mastectomy Plan for Gender-Affirming Surgery

Understanding Mastectomy for Transgender Men

A mastectomy, or breast removal surgery, is a critical procedure for individuals transitioning from female to male. This surgery involves the complete removal of breast tissue to create a flat chest, alongside reducing the size of the nipples and areolas. This step is essential in the male-to-female gender affirmation process and is designed to preserve normal sensation and minimize scarring.

Surgical Techniques

There are various techniques for performing a mastectomy. Surgeons select the most appropriate method based on individual factors such as breast size, skin elasticity, and any sagging.

Surgical Procedure Steps

1. Anesthesia
   • General anesthesia is administered for patient comfort.
2. Incision
   • An incision is made in a predetermined area, allowing for the removal of breast tissue to achieve a flat contour.
3. Excess Skin Removal
   • Any excess skin is excised, and the chest is shaped to resemble a masculine form.
4. Nipple and Areola Adjustment
   • The surgeon repositions and reduces the size of the nipples and areolas to achieve a natural male appearance.

Important Considerations

• Qualified Surgeons
  • Mastectomies should only be performed by board-certified plastic surgeons to minimize surgical risks and achieve the best outcomes.
• Post-Surgery Compliance
  • Following surgery, patients must adhere strictly to post-operative care instructions to avoid potential complications.

Additional Details

• Service Duration
  • The procedure typically lasts between 3 to 4 hours, depending on individual complexity.
• Pre-Surgery Consultation
  • An appointment must be scheduled in advance for pre-operative evaluation.
• Candidate Criteria
  • Suitable for individuals with a BMI under 30. Higher BMI may incur additional costs, as assessed by the surgeon.
  • Recommended for those with a breast size of cup B+.
  • Ideal for first-time patients (those who have not undergone previous procedures).
  • Suitable for women identifying as masculine (trans men).
  • Conducted by specialized plastic surgeons and anesthetists.
• Personalized Approach
  • Each case is unique; surgeons conduct thorough evaluations to tailor the procedure to the individual’s needs.
  • Incision patterns are designed to align with the patient’s existing breast structure and address specific concerns.
• Recovery
  • Generally, there is minimal swelling and bruising, with recovery times varying based on individual health.

Pre-Procedure Preparation

• Health Assessments
  • Comprehensive health checks and COVID-19 RT-PCR tests are mandatory.
• Mental Health Evaluation
  • Two consultations with mental health professionals are required to assess readiness for surgery.
• Attire Recommendations
  • Patients are advised to wear button-up shirts for convenience on the day of discharge.
• Medication Restrictions
  • Avoid aspirin and ibuprofen for at least two weeks prior to surgery.
  • Discontinue all supplements, anti-inflammatory medications, and herbs at least two weeks before the procedure to prevent complications.
• Photography for Records
  • Some facilities may take before-and-after photos for comparison.
• Smoking Cessation
  • Smoking must be stopped at least two weeks prior to surgery to reduce the risk of complications related to healing.

Post-Operative Care

• Dressings
  • Bandages should remain intact for at least one week post-surgery, or until advised by the surgeon to switch to a bra without underwire.
• Fluid Drainage
  • Surgeons may place drains to minimize swelling.
• Medication Adherence
  • Pain relief and antibiotics prescribed by the surgeon must be taken as directed.
• Activity Restrictions
  • Patients should avoid vigorous activities for 2 to 4 weeks.

Eligibility for Mastectomy

• Health Screening
  • Candidates must be in good health and able to undergo surgery safely.
• Mental Health Diagnosis
  • A mental health assessment confirming gender identity disorder is necessary, along with a desire for physical transition.
• Duration of Gender Expression
  • Candidates should have lived and presented as male for at least one year.
• Age Requirement
  • Must be at least 20 years old. If under 20, parental or guardian consent is required.