Summary
Background
Chest reconstruction in many female-to-male (FTM) transgender individuals is an essential
element of treatment for their gender dysphoria. In existing literature, there are
very few longitudinal studies utilizing validated survey tools to evaluate patient
reported outcomes surrounding this surgery. The purpose of our study is to prospectively
evaluate patient reported satisfaction, improvement in body image, and quality of
life following FTM chest wall reconstruction.
Methods
Our study was a prospective analysis of FTM patients who underwent chest reconstruction
by a single surgeon (C.A.) between April 2015 and June 2016. The patients were surveyed
preoperatively and 6 months after surgery utilizing the BREAST-Q breast reduction/mastectomy
questionnaire and the Body Uneasiness Test (BUT-A). Analysis was performed on their
self-reported demographic information, survey results, and chart review data.
Results
Of 87 eligible patients, 42 completed all surveys and could be linked to their chart
data. From the BREAST-Q surveys, significant improvements were observed in the domains
of breast satisfaction, psychosocial well-being, sexual satisfaction, and physical
well-being. From the BUT-A surveys, we observed significant improvement in body image,
avoidance, compulsive self-monitoring, and depersonalization. Groups with mental health
conditions had poorer initial BUT-A scores and greater degree of improvement after
surgery.
Conclusions
As the prevalence of gender affirming surgery increases and as health policies are
being developed in this area, the need for evidence-based studies surrounding specific
interventions is essential. This study demonstrates significant improvement in a number
of quality of life measurements in FTM patients after undergoing chest masculinization
surgery.
Keywords
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Article info
Publication history
Published online: February 04, 2018
Accepted:
January 21,
2018
Received:
July 1,
2017
Footnotes
☆Parts of this article have been presented at the following meetings: 1. Mountain West Society of Plastic Surgeons (MWSPS) Meeting, March 18, 2017, Park City, Utah; 2. World Professional Association of Transgender Health (WPATH) Meeting, June 17, 2016, Amsterdam; 3. US Professional Association of Transgender Health (USPATH) Inaugural Meeting, February 2, 2017, Los Angeles. ASPS 2017 Residents Day, October 7, 2017.
Identification
Copyright
© 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Sexual well-being in transgender patients: Could gender confirming-chest surgery be enough?Journal of Plastic, Reconstructive & Aesthetic SurgeryVol. 74Issue 12
- PreviewWe read with interest the article by Agarwal et al. entitled "Quality of life improvement after chest wall masculinization in female-to-male transgender patients: A prospective study using the BREAST-Q and Body Uneasiness Test", published in January 2018 in the Journal.1 We commend the authors for contributing with this relevant work to an aspect of plastic surgery that is often neglected: transgender patient care. Their prospective study assessed the impact of mastectomy on body image, physical well-being, sexual satisfaction and chest satisfaction using the BREAST-Q and BUT-A questionnaires.
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