FTM Chest Contouring – Lessons Learned

I wrote a post, Chest Wall Contouring in Female-to-Male Transsexuals, in December as I prepared to do my first such surgery.  I was up front with him about him being my first FTM though not my first mastectomy.

Well, I had to perform a second procedure to correct the first.   Here is what I learned from this experience:

1.  A minimal scar is not worth having extra skin remain.  

I opted for the first surgery to use a peri-areolar incision/scar feeling it would allow enough skin excision and leave less of a scar.  The scar was smaller, but even after months to allow full contraction of the remaining skin turns out not enough skin excision.

The extended concentric circular scar looks good with a nice chest contour.

2.  The inframammary crease must be fully obliterated.

I knew this from my reading.  I thought I had done so.  I recommend freeing up the skin from the chest wall a good 2 inches below the marked crease to ensure it’s destruction.

3.   Use drains.

No matter how well you think you have controlled the hemostasis.

 

I am happy with the results after the revision.  The patient is too if his smile and statement are any indication -- “I can now look at my chest without revulsion.”