Ngamcherd Sitpahul
Instructor and Consultant Plastic Surgeon
Division of Plastic and Reconstructive Surgery,
Ramathibodi Hospital, Mahidol University, Bangkok
Thailand
Educational Background
Bachelor's Degree, Doctor of Medicine, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
June 1999 – June 2005
Residency in Plastic and Reconstructive Surgery, Ramathibodi
Hospital, Mahidol University, Bangkok, Thailand
July 2008 – June 2013
Visiting Fellow of Gender confirmation Surgery, Supron Clinic, Chonburi, Thailand
November 2015 – December 2015
Visiting Fellow of Gender confirmation Surgery, Yanhee Hospital, Bangkok,Thailand
January 2016 – April 2016
Clinical Fellow of Microsurgery, China Medical University Hospital, Taichung, Taiwan
June 2018 – December 2018
Work Experience
Consultant Plastic Surgeon at Pratumthani Hospital,
Pratumthani,Thailand
July 2013 – June 2014
Consultant Plastic Surgeon at Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand
July 2014 – Present
Leadership of Gender Variation Clinic at Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand
December 2014 – Present
Topic: Aesthetic Breast Surgery in FtM Transgender
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 al
