000			03759nam a22004817a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a1748-6815
024			_aS1748-6815(24)00311-5 [pii]
040			_aOvid MEDLINE(R)
099			_a38865842
245			_aFactors influencing intraoperative conversion from double- to single-incision mastectomy with free nipple grafts in 352 transgender and non-binary patients.
251			_aJournal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 95:28-32, 2024 Jun 06.
252			_aJ Plast Reconstr Aesthet Surg. 95:28-32, 2024 Jun 06.
253			_aJournal of plastic, reconstructive & aesthetic surgery : JPRAS
260			_c2024
260			_fFY2024
260			_p2024 Jun 06
265			_saheadofprint
265			_tPublisher
266			_d2024-08-07
266			_z2024/06/12 18:05
501			_aAvailable online from MWHC library: 1995 - present
520			_aBACKGROUND: Double-incision mastectomy (DIM) with free nipple grafts (FNG) is a common technique employed in gender-affirming mastectomy (GAM), but is associated with a high scar burden. Intraoperatively, the surgeon may opt for a single-incision mastectomy (SIM) along the inframammary folds (IMF) to optimize aesthetic outcomes. This study sought to identify factors predictive of intraoperative conversion.
520			_aCONCLUSION: Patients with larger breast cup size and greater degree of ptosis should be counseled preoperatively that they may be at a higher risk of conversion to a singular incision. Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
520			_aMETHODS: From February 2018 to November 2022, TGNB patients who underwent GAM at a single institution were retrospectively reviewed. Data regarding patient characteristics, perioperative details, postoperative complications, and aesthetic satisfaction were collected.
520			_aRESULTS: A total of 352 patients were identified. Median age and body mass index (BMI) were 25.0 years (IQR: 9.0) and 28.5 kg/m2 (IQR: 8.5), respectively. Most patients received IMF incisions (n = 331, 94.0%); of whom, 66 (19.9%) underwent intraoperative conversion from DIM to SIM with FNG. Larger breast cup-size (p < 0.001) and a greater degree of ptosis (p = 0.002) preoperatively were significantly associated with intraoperative conversion to SIM. There was no significant association between intraoperative conversion and the ratio of intermammary distance to the width of the chest wall (p = 0.086). Overall complication rates were significantly higher among patients with diabetes mellitus (p = 0.015) and a greater degree of ptosis (p = 0.018). 77.8% (n = 274) of patients were satisfied with their aesthetic outcome. NPWT usage was associated with higher rates of aesthetic satisfaction (83.6% vs. 77.8%; p = 0.005).
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aMedStar Franklin Square Medical Center
651			_aMedStar Washington Hospital Center
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aPlastic and Reconstructive Surgery
656			_aPlastic Surgery Residency
656			_aSurgery/Plastic Surgery
657			_aJournal Article
700			_aDel Corral, Gabriel A _bMSFMC
700			_aFan, Kenneth L _bMWHC
700			_aSlamin, Robert _bMGUH _cPlastic Surgery Residency _dMD
790			_aLava CX, Berger LE, Li KR, Marable JK, Shan HD, Hum JR, Slamin RP, Fan KL, Del Corral GA
856			_uhttps://dx.doi.org/10.1016/j.bjps.2024.05.038 _zhttps://dx.doi.org/10.1016/j.bjps.2024.05.038
942			_cART _dArticle
999			_c14389 _d14389