Abstract：
BACKGROUND: In the existing literature, assessing transgender patients\' quality of life after surgery, especially using standardized surveys, is rare. The nipple sensation regarding the operating technique has neither been studied in a prospective nor standardized way.
METHODS: For one year, we prospectively assessed transgender patients operated on for a gender-affirming chest surgery in our unit. Each patient answered the BREAST-Q© survey and the BODY-Q© chest module survey before and six months after the surgery. In addition, a measure of nipple sensation was performed using Semmes-Weinstein monofilaments pre-and post-operatively to compare surgical techniques.
RESULTS: Fifty-one patients (102 breasts) were included in our study. The average age was 23.1 years and the average BMI was 24.8 kg/m2. Twenty-one patients (45%) had double incision and free nipple graft mastectomy, 14 (27%) patients had double incision and inferior pedicle mastectomy, while the 14 (27%) other patients had a semi-circular technique. Our study shows an improvement in all the scores of the surveys after surgery (p < 0.0001). Patients with double incision and inferior pedicle mastectomies rated a significantly higher satisfaction with nipples (p = 0.013) and significantly better sexual well-being (p = 0.007) than other techniques. In addition, preservation of nipple sensation was shown in patients operated by semi-circular technique (p < 0.001) and inferior pedicle technique (p < 0.0001).
CONCLUSIONS: Our prospective study confirms the significant improvement in the quality of life of transgender patients after chest gender-affirming surgery. Double incision with inferior pedicle seems to provide better satisfaction with nipples, higher sexual well-being, and preservation of nipple sensation.
METHODS: For one year, we prospectively assessed transgender patients operated on for a gender-affirming chest surgery in our unit. Each patient answered the BREAST-Q© survey and the BODY-Q© chest module survey before and six months after the surgery. In addition, a measure of nipple sensation was performed using Semmes-Weinstein monofilaments pre-and post-operatively to compare surgical techniques.
RESULTS: Fifty-one patients (102 breasts) were included in our study. The average age was 23.1 years and the average BMI was 24.8 kg/m2. Twenty-one patients (45%) had double incision and free nipple graft mastectomy, 14 (27%) patients had double incision and inferior pedicle mastectomy, while the 14 (27%) other patients had a semi-circular technique. Our study shows an improvement in all the scores of the surveys after surgery (p < 0.0001). Patients with double incision and inferior pedicle mastectomies rated a significantly higher satisfaction with nipples (p = 0.013) and significantly better sexual well-being (p = 0.007) than other techniques. In addition, preservation of nipple sensation was shown in patients operated by semi-circular technique (p < 0.001) and inferior pedicle technique (p < 0.0001).
CONCLUSIONS: Our prospective study confirms the significant improvement in the quality of life of transgender patients after chest gender-affirming surgery. Double incision with inferior pedicle seems to provide better satisfaction with nipples, higher sexual well-being, and preservation of nipple sensation.
摘要：
背景：在现有文献中，评估变性患者手术后的生活质量，特别是使用标准化的调查，是罕见的。尚未以前瞻性或标准化的方式研究有关操作技术的乳头感觉。
方法：一年，我们前瞻性评估了在本单位接受性别确认胸部手术的变性患者.每位患者在手术前和手术后六个月回答了BREAST-Q®调查和BODY-Q®胸部模块调查。此外,术前和术后使用Semmes-Weinstein单丝测量乳头感觉,以比较手术技术.
结果：我们的研究包括51例患者（102例乳房）。平均年龄为23.1岁，平均BMI为24.8kg/m2。21例患者（45％）进行了双切口和免费乳头移植乳房切除术，14例（27％）患者进行了双切口和下椎弓根乳房切除术，而其他14例（27％）患者采用了半圆形技术。我们的研究表明，手术后的所有调查评分均有所改善（p<0.0001）。与其他技术相比，双切口和下蒂乳房切除术的患者对乳头的满意度显着提高（p=0.013），性健康水平显着提高（p=0.007）。此外,通过半圆形技术（p<0.001）和下椎弓根技术（p<0.0001）手术的患者显示乳头感觉的保留。
结论：我们的前瞻性研究证实了跨性别患者在胸部性别确认手术后的生活质量显著改善。下椎弓根的双切口似乎对乳头有更好的满意度，更高的性幸福感，和乳头感觉的保存。
方法：一年，我们前瞻性评估了在本单位接受性别确认胸部手术的变性患者.每位患者在手术前和手术后六个月回答了BREAST-Q®调查和BODY-Q®胸部模块调查。此外,术前和术后使用Semmes-Weinstein单丝测量乳头感觉,以比较手术技术.
结果：我们的研究包括51例患者（102例乳房）。平均年龄为23.1岁，平均BMI为24.8kg/m2。21例患者（45％）进行了双切口和免费乳头移植乳房切除术，14例（27％）患者进行了双切口和下椎弓根乳房切除术，而其他14例（27％）患者采用了半圆形技术。我们的研究表明，手术后的所有调查评分均有所改善（p<0.0001）。与其他技术相比，双切口和下蒂乳房切除术的患者对乳头的满意度显着提高（p=0.013），性健康水平显着提高（p=0.007）。此外,通过半圆形技术（p<0.001）和下椎弓根技术（p<0.0001）手术的患者显示乳头感觉的保留。
结论：我们的前瞻性研究证实了跨性别患者在胸部性别确认手术后的生活质量显著改善。下椎弓根的双切口似乎对乳头有更好的满意度，更高的性幸福感，和乳头感觉的保存。
