Plastic and Reconstructive Surgery, Global Open (Mar 2019)

Differences in Chest Measurements between the Cis-female and Trans-female Chest Exposed to Estrogen and Its Implications for Breast Augmentation

  • Allison C. Nauta, MD,
  • Kyle M. Baltrusch, MD,
  • Aaron L. Heston, BS,
  • Sasha K. Narayan, BS,
  • Sven Gunther, MD, MAS,
  • Nick O. Esmonde, MD, MPH,
  • Kylie S. Blume, MA,
  • Reid V. Mueller, MD,
  • Juliana E. Hansen, MD,
  • Jens Urs Berli, MD

DOI
https://doi.org/10.1097/GOX.0000000000002167
Journal volume & issue
Vol. 7, no. 3
p. e2167

Abstract

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Background:. Gender confirming primary breast augmentation is becoming more common. The purpose of this study was to compare the demographic and anatomical differences in cis-female and trans-female populations. Methods:. This was a retrospective analysis of trans-female patients and cis-female patients undergoing primary breast augmentation at a single institution. Analysis included patient demographics and preoperative chest measurements including sternal notch to nipple distance (SSN), breast width (BW), nipple to inframammary fold distance (N-IMF), and nipple to midline distance (N-M). Continuous variables were compared using independent t tests, and discrete variables were compared using Pearson’s χ2 tests. Results:. Eighty-two trans-female and 188 cis-female patients undergoing primary breast augmentation were included. Trans-female patients were older (40.37 versus 34.07), more likely to have psychological comorbidities (50% versus 12.23%), and had a higher body mass index, 27.46 kg/m2 versus 22.88 kg/m2 (P = 1.91E-07), than cis-female patients. Cis-female patients most commonly had an ectomorph body habitus (52% versus 26%), whereas trans-female patients most commonly had an endomorph body habitus (40% versus 7%). Pseudoptosis or ptosis was more commonly seen in cis-female patients (P = 0.0056). There were significant differences in preoperative breast measurements including sternal notch to nipple distance, BW, and N-M between groups, but not in N-IMF. The ratio of BW/N-IMF was statistically significant (P = 2.65E-07 on right), indicating that the similarity in N-IMF distance did not adjust for the difference in BW. Conclusions:. The trans-female and cis-female populations seeking primary breast augmentation have significant demographic and anatomical differences. This has implications for surgical decision-making and planning to optimize outcomes for trans-female patients.