Transgender (F-M) Mastectomy ("Top Surgery") - Case 1

This 35 year-old patient has been in transgender transition for many years and came to Minneapolis Plastic Surgery planning to start testosterone therapy, undergo top surgery, and begin full-time life (and name) as a male all at the same time. His breasts were not suitable for keyhole (periareolar) mastectomies, and skin-reducing total mastectomies with star-pattern nipple reduction, areola reductions, and reconstruction of the nipple/areola complex (NAC) as full-thickness skin grafts was performed in a 3 ½ to 4 hour operation in our nationally-accredited (QUAD A) on-site office surgical facility under a light general total intravenous (TIVA) anesthetic. This anesthetic technique allows minimal PONV (Post-Op Nausea and Vomiting) and a comfortable, quick recovery room stay before outpatient discharge. TIVA allows us to avoid overnight admission that more commonly occurs at a hospital or many outpatient surgical facilities where gas inhalation anesthesia is routinely used.