{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:55:12Z","timestamp":1788411312784,"version":"build-2803163510"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T00:00:00Z","timestamp":1648944000000},"content-version":"vor","delay-in-days":945,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,9,15]],"date-time":"2019-09-15T00:00:00Z","timestamp":1568505600000},"content-version":"tdm","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>\n          Background  Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades.<\/jats:p><jats:p>\n          Methods  Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department.<\/jats:p><jats:p>\n          Results  In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients\u2019 habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%).<\/jats:p><jats:p>\n          Conclusions  Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions.<\/jats:p>","DOI":"10.5999\/aps.2018.01214","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:41:38Z","timestamp":1568940098000},"page":"433-440","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis"],"prefix":"10.1055","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1062-9385","authenticated-orcid":false,"given":"Shafreena","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9227-6415","authenticated-orcid":false,"given":"Seirah","family":"Keval","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-0301","authenticated-orcid":false,"given":"Robert","family":"Sader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2371-0243","authenticated-orcid":false,"given":"Lara","family":"K\u00fcenzlen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9179-6646","authenticated-orcid":false,"given":"Marcus","family":"Kiehlmann","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3902-1242","authenticated-orcid":false,"given":"Gabriel","family":"Djedovic","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital Frankfurt, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2449-4776","authenticated-orcid":false,"given":"Ahmet","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Helios Clinic Wuppertal, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-2117","authenticated-orcid":false,"given":"Ulrich Michael","family":"Rieger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,4,3]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1054\/bjps.1999.3235","article-title":"Comparison of nipple and areolar sensation after breast reduction by free nipple graft and inferior pedicle techniques","volume":"53","author":"OA Ahmed","year":"2000","journal-title":"Br J Plast Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"3148","DOI":"10.1111\/j.1743-6109.2012.02939.x","article-title":"Subcutaneous mastectomy in female-to-male transsexuals: a retrospective cohort-analysis of 202 patients","volume":"9","author":"P Cregten-Escobar","year":"2012","journal-title":"J Sex Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.bjps.2014.10.016","article-title":"Sexual reassignment surgery in female-to-male transsexuals: an algorithm for subcutaneous mastectomy","volume":"68","author":"A Wolter","year":"2015","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1097\/01.prs.0000299921.15447.b2","article-title":"Chest-wall contouring surgery in female-to-male transsexuals: a new algorithm","volume":"121","author":"S Monstrey","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1177\/1457496916645964","article-title":"Chest-wall contouring surgery in female-to-male transgender patients: a one-center retrospective analysis of applied surgical techniques and results","volume":"106","author":"M Kaariainen","year":"2017","journal-title":"Scand J Surg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1055\/s-0031-1281493","article-title":"Sex reassignment surgery in the female-to-male transsexual","volume":"25","author":"SJ Monstrey","year":"2011","journal-title":"Semin Plast Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/BF01570696","article-title":"Inferior pedicle reduction technique for larger forms of gynecomastia","volume":"16","author":"AN Kornstein","year":"1992","journal-title":"Aesthetic Plast Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.bjps.2007.12.009","article-title":"Evaluation of surgical procedures for sex reassignment: a systematic review","volume":"62","author":"PA Sutcliffe","year":"2009","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/00006534-199508000-00019","article-title":"Chest-wall contouring in female-to-male transsexuals: basic considerations and review of the literature","volume":"96","author":"JJ Hage","year":"1995","journal-title":"Plast Reconstr Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00000637-199501000-00012","article-title":"Chest wall contouring for female-to-male transsexuals: Amsterdam experience","volume":"34","author":"JJ Hage","year":"1995","journal-title":"Ann Plast Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/00000658-194609000-00011","article-title":"Mastectomy for gynecomastia through a semicircular intra-areolar incision","volume":"124","author":"JP Webster","year":"1946","journal-title":"Ann Surg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1097\/00006534-197903000-00009","article-title":"Concentric circle operation for massive gynecomastia to excise the redundant skin","volume":"63","author":"BA Davidson","year":"1979","journal-title":"Plast Reconstr Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/BF01578332","article-title":"A new periareolar mammaplasty: the \u201cround block\u201d technique","volume":"14","author":"L Benelli","year":"1990","journal-title":"Aesthetic Plast Surg"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/00000637-197907000-00007","article-title":"Creation of a male chest in female transsexuals","volume":"3","author":"WR Lindsay","year":"1979","journal-title":"Ann Plast Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.bjps.2005.12.001","article-title":"Some personal suggestions on surgery in large or ptotic breasts for female to male transsexuals","volume":"59","author":"JC McGregor","year":"2006","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.bjps.2007.10.049","article-title":"Transgender patient satisfaction following reduction mammaplasty","volume":"62","author":"L Nelson","year":"2009","journal-title":"J Plast Reconstr Aesthet 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Surg"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"e1798","DOI":"10.1097\/GOX.0000000000001798","article-title":"The safety, cosmetic outcome, and patient satisfaction after inferior pedicle reduction mammaplasty for significant macromastia","volume":"6","author":"MM Baslaim","year":"2018","journal-title":"Plast Reconstr Surg Glob Open"}],"container-title":["Archives of Plastic 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