%0 Journal Article
%T Prospective assessment of the quality of life and nipple sensation after gender-affirming chest surgery.
%A Kanlagna A
%A Oillic J
%A Verdier J
%A Perrot P
%A Lancien U
%J J Plast Reconstr Aesthet Surg
%V 94
%N 0
%D 2024 Jul 14
%M 38759510
%F 3.022
%R 10.1016/j.bjps.2024.05.022
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.