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. 2023 Oct 20;56(5):431-438.
doi: 10.1055/s-0043-1775552. eCollection 2023 Oct.

Breast Augmentation in Transwomen: Can We have a Formula?

Sasanka Sekhar Chatterjee  1   2 , Manoj Khanna  3 , Neelam Yadav  1
Affiliations

Breast Augmentation in Transwomen: Can We have a Formula?

Sasanka Sekhar Chatterjee et al. Indian J Plast Surg. .

Abstract

Background Breast augmentation in transwomen is a surgical challenge as there is no available guideline for preoperative assessment of breast implant size, which caters to them specifically. The aim of our study is to derive a formula for preoperative breast implant size estimation, which would remove the personal bias, help in one-to-one discussion, and better understanding, reducing operative time, cost, and revision surgery rate. Methods This is a retrospective study conducted from October 2018 to December 2020. We maintained a routine protocol for measurements in our patients, which has been previously published. Linear multivariate regression equation was applied to derive a formula using minimum of parameters, namely, CC (chest circumference at the inframammary fold [IMF]), POMP (circumference at the point of maximum projection of breast mound), and LOWERDIFF (lower value of difference in each breast between the stretched nipple [IMF] and the nonstretched nipple [IMF distance]). Results A total of 51 transwomen underwent surgery in this period. The mean volume of implant used was 354.51 mL. Complications consisted of pain and discomfort in six patients, delayed healing in two patients, and wound dehiscence in one. A formula for preoperative calculation of breast implant was obtained with these data. A mathematical correlation was found between complications encountered and the percentage by which the inserted implants exceeded the calculated size. Conclusion We could estimate the breast implant size preoperatively through a simple formula that require only four anthropometric measurements. This equation is a significant advantage for the surgeon and a useful tool for patient education. Its usefulness will be established if applied in prospective studies. From our study, it appears 9% above the calculated size is better avoided.

Keywords: breast augmentation; implant size estimation; silicone implant; transwomen.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
(A) Preoperative Antero posterior view of patient no. 41. (B) 18 months after implantation with motiva high profile 350cc implants antero posterior view of the same patient. (C) Preoperative Lateral view of patient no. 41. (D) 18 months after implantation with motiva high profile 350cc implants lateral view of same patient.
Fig. 2
Fig. 2
( A ) Preoperative views. ( B ) Eleven months after implantation with high-profile 410-mL implants showing ptosis. The estimated implant size was 357.67 mL (case 14). Female breast pattern can be noted.
Fig. 3
Fig. 3
( A ) Preoperative views of a case with tight skin envelope. ( B ) Eight months after implantation with 325-mL implants. While our calculation in this case estimated an implant size of 378.27 mL (case19), 380 mL would have been ideal.
See this image and copyright information in PMC

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