UNASSIGNED: This report aims to add to the growing body of knowledge addressing breast augmentation complications in transgender women and to highlight disparities in healthcare.
UNASSIGNED: A case of breast implant-associated seroma at our institution was analyzed through chart review. A literature review was conducted using PubMed to gather all articles discussing breast implant-associated fluid collections in transgender patients. Prior to publication of this report, a Waiver of Consent was granted by the E.R.\'s Institutional Review Board for the study under which this article was prepared.
UNASSIGNED: Our patient was an African American transgender woman presenting initially at age 60 with significant asymmetry due to dramatic swelling of her left breast. The patient underwent bilateral breast augmentation outside of the United States 2 decades prior. The patient noted a gradual painless increase in her left breast size starting 3 years prior. She admitted that she was hesitant to seek a second opinion after being treated dismissively by another surgeon. Subsequent management included mammography and mirrored recommendations for late breast implant-associated seromas in cisgender patients: ultrasound, aspiration for cytology and culture, and removal of the implant and capsule.
UNASSIGNED: The fluid collection in our patient was determined to be a chronic hematoma and was managed surgically. Though this patient eventually achieved a good outcome, treatment was delayed due to barriers she faced as a transgender woman.
UNASSIGNED: Literature demonstrates that recommended management of late-onset breast-implant-associated seroma does not differ based on gender identity; however, transgender and GNC adults are more likely to receive less thorough care than cisgender women. Any patients undergoing breast augmentation with implants should be routinely evaluated for late complications, including seromas, which require prompt attention and methodical evaluation due to their potentially malignant nature.
UNASSIGNED: This article is limited in that it is a single report of breast seroma. It is strengthened by a PubMed review gathering all articles discussing breast-implant-associated fluid collections in transgender patients.
UNASSIGNED: We propose better education of physicians on how to care for transgender and gender-diverse patients should help mitigate the neglect and late presentation of such medical conditions in this vulnerable and marginalized population.
本报告旨在增加对变性女性隆胸并发症的认识,并强调医疗保健方面的差异。
■通过图表回顾分析了我们机构的一例乳房植入物相关血清肿。使用PubMed进行了文献综述,收集了所有讨论变性患者乳房植入物相关液体收集的文章。在本报告发表之前,E.R.的机构审查委员会对编写本文的研究授予了豁免同意。
我们的患者是一名非洲裔美国变性人女性,最初在60岁时表现出明显的不对称,原因是她的左乳房剧烈肿胀。患者在20年前在美国境外接受了双侧隆胸手术。患者注意到她的左乳房尺寸从3年前开始逐渐无痛增加。她承认,在被另一位外科医生不屑一顾后,她不愿寻求第二意见。随后的管理包括乳房X线照相术和对顺式患者晚期乳房植入物相关血清瘤的镜像建议:超声,细胞学和培养的愿望,以及移除植入物和胶囊。
■我们患者的液体收集被确定为慢性血肿,并通过手术治疗。虽然这个病人最终取得了良好的结果,由于她作为变性女性面临的障碍,治疗被推迟。
■文献表明,对迟发性乳房植入物相关性血清肿的推荐治疗没有基于性别认同的差异;然而,变性人和GNC成年人比顺性人女性更有可能接受不那么彻底的护理.任何使用植入物进行隆胸的患者都应进行常规评估,以确定是否有晚期并发症。包括血清,由于其潜在的恶性性质,需要迅速关注和有条理的评估。
■本文的局限性在于它是乳腺血清肿的单一报告。PubMed评论收集了所有讨论跨性别患者乳房植入物相关液体收集的文章,这一点得到了加强。
■我们建议对医生进行更好的教育,以了解如何照顾变性者和性别多样化的患者,应有助于减轻这一脆弱和边缘化人群对此类医疗状况的忽视和后期表现。