Female-to-Male Chest Surgery in Transgender Patients: A Comparison Between Two Different Techniques and a Satisfaction Study in a Single-Center

Abstract
Background
Gender dysphoria is a distress due to a mismatch between the gender identity and the sex assigned at birth. 0,5% of the population suffer from gender dysphoria which represents 25 million people worldwide. Gender-affirming mastectomy is the most common procedure for FtM (female-to-male) patients.

Objectives
The aim of this single-center retrospective study is to present the outcomes after mastectomy and to evaluate patient satisfaction using the BODY-Q questionnaire.

Methods
Several data regarding patients’ characteristics and surgery have been collected. A satisfaction survey has been sent to patients. Two groups, “NAC grafts” and “semicircular”, have been compared for complications and satisfaction.

Results
104 patients have had a transgender mastectomy performed by three surgeons representing 208 mastectomies. There were five wound infections (4,8%), eight seromas (6,8%), ten hematomas (6,8%) and 23 partial/total NAC necrosis (20,4%). The complications rate in this study is similar to others in the literature. Few studies express interest in patient’s satisfaction after this type of surgery and even fewer use a suitable questionnaire.

Conclusions
Transgender mastectomy is a safe and often necessary procedure to improve quality of life of patients suffering from gender dysphoria. Nevertheless, there is currently no validated tool to assess post-operative satisfaction within this specific population group.