Che-Hao Hsu
Director
Hao-Skin Dermatologic and Cosmetic Clinic
Taiwan
Background
Medical Education & Fellowships
EMBA, National Taiwan University
M.D. School of Medicine, Taipei Medical University, Taipei
Internship, National Taiwan University Hospital, Taipei, Taiwan
Residency, Department of Surgery, Chang-Gung Memorial Hospital, Linkou Medical
Center,Taipei, Taiwan
Residency, Department of Dermatology, Cathay General Hospital, Medical
Center, Taipei, Taiwan
Attending Physician, Department of Dermatology, Cathay General Hospital,
Clinical Observer, Memorial Sloan Kettering Cancer Center, New York ,USA
Clinical Fellow, Toranomo Hospital , Tokyo, Japan
Clinical Instructor, College of Medicine, Taipei Medical University
Clinical Instructor, School of Medicine, Fu Jen Catholic University
Topic: Complications and Prevention of Laser and Light-based Devices Therapy
in Asian Patients
Abstract:
Background: Mastectomy or Top Surgery is a popularized surgical step for female-to-male (FTM)
transgender patients. The goal is to excise breast tissue and create a masculine chest contour. Despite
the rising demand for Top Surgery, debate still exists regarding how to select the most appropriate
surgical technique to optimize aesthetic outcomes safely.
Objectives: To determine the safety profile and aesthetic outcome of one surgeon's 7-years FTM Top
Surgery experience. To provide an algorithm for FTM surgery technique selection based on this
experience.
Methods: A retrospective chart review was performed on 1916 FTM patients (3832 mastectomies)
undergoing Top Surgery from 2016 to 2022. The author's Top Surgery algorithm utilizes 3 techniques,
Semicircular, Concentric Circular, and Free Nipple Graft (FNG), based on breast ptosis, breast size, and
skin elasticity. Demographic data, operative details, complications, and reoperations along with their
reasons were collected and analyzed.
Results: Of the 1716 patients, 24% underwent Semicircular 18% underwent Concentric Circular and the
remaining 58% underwent FNG procedures. The total complication rate was 15% and the total
reoperation rate was 11.2%, breast weight excised (175, 255 and 675 g). The aesthetic rating of results
was 9.5/10 for semicircular, 8/10 for Concentric Circular and 7/10 for FNG.
Conclusions: Safe and aesthetically pleasing results were achieved using this simplified algorithm.
Experience with FTM techniques can decrease complication and reoperation rates over time
