Our Summary

This research paper studied the outcomes of transgender teenagers who underwent top surgery (gender-affirming mastectomy) between 2013 and 2020. The study found that the number of these surgeries increased significantly during this period. It also found that the patients were typically 16 years old when referred for the procedure and most of them had a specific type of surgery called a double-incision.

The study also looked at complications after the surgery. Out of the patients who had been followed up with for more than a year after their surgery, about 7% had experienced some kind of complication, such as bleeding, infection, or scarring. Around 11% of patients had revision surgery, which is a follow-up surgery to correct or improve the results of the initial surgery.

Interestingly, the study found that there was no significant difference in the rate of complications based on the patients’ demographics or clinical characteristics. This suggests that factors such as age, race, or pre-existing health conditions did not significantly affect the risk of complications.

Finally, the study found that very few patients (less than 1%) expressed regret after their surgery, and none of these patients chose to have a reversal surgery.

Overall, this study suggests that top surgery is generally safe and effective for transgender teenagers, with a low rate of complications and regret.

FAQs

  1. What were the typical age of transgender teenagers who underwent top surgery according to the study?
  2. What were the common complications experienced by patients after the surgery?
  3. Did any of the patients express regret after their surgery or chose to have a reversal surgery according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about mastectomy is to carefully follow post-operative instructions provided by the medical team. This may include proper wound care, wearing compression garments as directed, avoiding heavy lifting or strenuous activity for a certain period of time, and attending follow-up appointments to monitor healing and address any concerns. It is important to communicate openly with your healthcare provider about any symptoms or issues that arise during the recovery process.

Suitable For

Patients who are typically recommended mastectomy include those with:

  1. Breast cancer: Mastectomy is often recommended for patients with breast cancer, especially those with large tumors or tumors that are difficult to remove with a lumpectomy.

  2. Genetic mutations: Patients with a strong family history of breast cancer or genetic mutations such as BRCA1 or BRCA2 may be recommended mastectomy as a preventive measure.

  3. High risk of breast cancer: Patients with a high risk of developing breast cancer, such as those with a history of chest radiation therapy or certain benign breast conditions, may be recommended mastectomy.

  4. Gender dysphoria: Transgender individuals who experience gender dysphoria and desire a more masculine chest may be recommended mastectomy as part of gender-affirming surgery.

  5. Severe breast pain: Patients with severe breast pain (mastalgia) that does not respond to other treatments may be recommended mastectomy as a last resort.

  6. Breast reconstruction: Patients who have undergone mastectomy for breast cancer may choose to undergo breast reconstruction surgery to restore the shape and appearance of their breasts.

It is important for patients to discuss their individual circumstances with their healthcare provider to determine if mastectomy is the most appropriate treatment option for them.

Timeline

Here is a brief timeline of what a patient experiences before and after mastectomy:

Before Mastectomy:

  1. Consultation with a healthcare provider to discuss the reasons for mastectomy, potential risks and benefits, and the different types of mastectomy procedures available.
  2. Pre-operative tests and evaluations to ensure the patient is healthy enough for surgery.
  3. Preparing for surgery by following any pre-operative instructions given by the healthcare provider, such as fasting before the procedure.
  4. The day of the surgery, the patient will undergo the mastectomy procedure, which typically involves the removal of breast tissue and possibly lymph nodes.

After Mastectomy:

  1. Recovery in the hospital or outpatient setting, where the patient will be monitored for any post-operative complications.
  2. Follow-up appointments with the healthcare provider to monitor healing, address any concerns, and discuss post-operative care.
  3. Physical therapy and exercises to help regain strength and range of motion in the affected area.
  4. Emotional support and counseling to cope with changes in body image and self-esteem.
  5. Reconstruction options, such as breast implants or tissue flap reconstruction, may be discussed with the healthcare provider if desired.
  6. Long-term follow-up care to monitor for any signs of recurrence or complications, such as lymphedema or surgical site issues.

Overall, the timeline for a patient before and after mastectomy can vary depending on individual circumstances and the type of mastectomy procedure performed. It is important for patients to work closely with their healthcare provider to ensure a smooth and successful recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mastectomy include:

  1. What are the different types of mastectomy procedures available, and which one is most suitable for my specific situation?
  2. What are the potential risks and complications associated with mastectomy surgery?
  3. What is the recovery process like after mastectomy surgery, and how long is the expected recovery time?
  4. Will I need any additional procedures, such as reconstruction surgery, after mastectomy?
  5. How will mastectomy surgery affect my physical appearance and body image?
  6. What are the long-term effects of mastectomy surgery, both physically and emotionally?
  7. Are there any alternative treatments or therapies that I should consider before deciding on mastectomy?
  8. What support resources are available for patients undergoing mastectomy surgery, such as counseling or support groups?
  9. How often will I need follow-up appointments after mastectomy surgery, and what signs of complications should I watch out for?
  10. Can you provide me with information about the success rates and outcomes of mastectomy surgeries you have performed in the past?

Reference

Authors: Tang A, Hojilla JC, Jackson JE, Rothenberg KA, Gologorsky RC, Stram DA, Mooney CM, Hernandez SL, Yokoo KM. Journal: Ann Plast Surg. 2022 May;88(4 Suppl):S325-S331. doi: 10.1097/SAP.0000000000003135. PMID: 36248210