Q&A WITH DR. DANIEL JACOBS: Which top surgery incision types can work for you? How do you find out? скачать в хорошем качестве

Q&A WITH DR. DANIEL JACOBS: Which top surgery incision types can work for you? How do you find out?

Q&A WITH DR. DANIEL JACOBS: Which top surgery incision types can work for you? How do you find out? THE MOSSER METHOD To determine which procedures/incision types coils work for you, our surgeons use the “Mosser Method,” which is based on the inframammary angle & is used to measure relevant aspects such as skin elasticity, chest tissue, & excess skin. For a detailed breakdown of the Mosser Method to determine which procedure(s) is right for you: genderconfirmation.com/choosing-ftm-top-surgery/ CHEST RECONSTRUCTION TOP SURGERY PROCEDURE OPTIONS The most common option is the double incision procedure. Minimal scar techniques such as the keyhole or periareolar incision are also available. Skin excision procedures which may preserve the nerve supply to the nipples are nerve preservation double incision, inverted T, buttonhole, lollipop, & fishmouth. Each procedure comes with both benefits & risks to consider, so a thorough discussion with a surgeon is often the best way to match your desires, priorities, & anatomy with the best procedure for you. INCISION OPTIONS INCLUDE THE FOLLOWING: The incisions used during your surgery will depend on the size of your chest & its level of elasticity or firmness. Liposuction incision Liposuction may rarely be performed alone (if you have a very small chest and no skin sagging), or more commonly be done in combination with other incision patterns to remove excess tissue. Liposuction requires a very small incision (about 4mm). Most patients require more extensive tissue removal. Keyhole Incision A keyhole incision is ideal for patients with small chests & high skin elasticity. A small incision is made under or across the lower border of the areola. It can’t address excess skin. Circumareolar/Periareolar Incision A periareolar incision is ideal for patients with moderate chest tissue & high skin elasticity. A circular incision is made all the way around the edge of the areola to remove chest tissue. A slightly larger ring incision is then made to remove excess skin. The skin is pulled taut toward the center & the nipple is reattached. This effect mimics the act of pulling a drawstring bag closed. Another vertical incision that extends below the areola may also be necessary to remove extra excess skin. Double Incision A double incision approach is usually needed for patients with large chests, or chests that sag quite a bit. A horizontal or U-shaped incision is made on the lower border of the pectoral (chest) muscle so that chest & fatty tissue can be removed. Another incision is then made to remove the nipple. Each nipple is resized, if wanted, & then replaced as a free nipple graft. Inverted T (anchor) & Buttonhole Incision An inverted T (anchor) incision pattern is also an option for patients with larger chests with extra skin. This procedure keeps the nipple & areola attached to the nerves & other tissue–there’s no need for a free nipple graft. It’s likely that nipple sensation will be significantly diminished or need to recover from being numb. Advantages include avoiding the free nipple graft & having a nipple & areola that is more full in appearance. Disadvantages include the presence of an additional vertical incision, & it can’t achieve the same level of flatness as double incision (because of the tissue left behind to supply blood to the nipple). Buttonhole is nearly identical to inverted T. The primary difference is that buttonhole does not require a vertical incision because it is performed on patients who have less chest tissue & skin to remove. Fishmouth Incision This produces incision contours that are higher on the chest & more consistent with the border of the chest muscle. BUT, it requires the final areola position to be in line with the scar, which is not a natural proportion between the areola & the shadow of the muscle, which this scar is trying to mimic. Fishmouth incision is uncommon. Other Incision Types There’s the lollipop incision, similar to the periareolar incision but with a vertical incision extending down from the areola, & 2-stage periareolar in which the 1st stage is a keyhole approach to remove all chest tissue & see how the skin responds. If possible, peri is done at the 2nd stage. ______________________________________________ For more educational resources about incision types/procedures: genderconfirmation.com/ftm-top-surgery-options/ To book a consultation with Dr. Jacobs or with another GCC surgeon: genderconfirmation.com/consultation-request/ Please visit our website: genderconfirmation.com ⠀ #DrMosser #DrFacque #DrLey #DrDanielJacobs #topsurgery #genderconfirmationcenter #trans #transgender #sanfrancisco #GenderAffirmingCare #TransCare #transgendersurgery #nonbinary #nonbinarysurgery #breastreduction #fishmouth #doubleincision #buttonhole #tanchor #hockeystick #lollipop #periareolar #keyhole #nervepreservationdoubleincision #reinnervation