Patient Satisfaction, Sexual Health and Health-Related Quality of Life after Breast Augmentation with Anatomical Implants in Male-to-Female Transsexuals

ABSTRACT

Introduction.

Aim. The aim of this study was to measure patient satisfaction, sexual health and health-related quality of life after breast augmentation with anatomical implants in male-to-female transsexuals.

Main Outcome Measures.

Methods.

Results.

Conclusions.

Key Words. Breast Implantation; Breast Implants; Transsexualism; Quality of Life

Introduction

Breast augmentation in Male-to-Female (MtF) transsexuals is part of gender reassignment surgery. Many patients seek surgery so that their chests resemble to female gender. Techniques and results have been widely described in the literature. The World Professional Association for Transgender Health, in the 7th version of standards of care for the Health of Transsexual, Transgender and Gender Nonconforming People emphasize that although breast augmentation can be labelled as an aesthetic procedure, this operation can be medically necessary, depending on the unique clinical situation of a given patient’s condition and life situation. No studies report psychosocial and health-related quality of life (Hr-QOL) changes after breast augmentation in MtF transsexuals. The objective of this study was to evaluate the impact of breast augmentation using anatomical implants on patient-reported satisfaction, sexual health and Hr-QOL.

Materials and Methods

Research Ethics Board approval was granted for this study from the University Bordeaux Segalen, Bordeaux, France. Patients were recruited from the Transgender Health Network (Bordeaux University Hospital, Bordeaux, France) from November 2008 through February 2012. Inclusion criteria were: persistent, well-documented gender dysphoria, age ≥ 18 years, capacity to make a fully informed decision and to consent for treatment, sex reassignment surgery already performed, at least 12 months of feminizing hormone therapy prior to surgery and no previous breast surgery. The selection of implant size was based both on the patient’s chest anatomical characteristics and preference.

After signed informed consent was obtained, patients completed 2 questionnaires. Data were collected preoperatively and at postoperative month 3. All questionnaires were completed at home and were returned to the study coordinator by mail. Patient and treatment data were collected at baseline. Patient information included age, height, weight, employment, marital status, tobacco status, date of beginning of hormone therapy, date of sex reassignment surgery, sternal notch to nipple distance, breast width, thorax shape and amount of breast tissue. Treatment information included date of surgery, position of incision, pocket plane, size and shape of the implants. After surgery, surgical information was obtained from the electronic patient record on operative procedure, major postoperative complications and hospitalization stay.

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