Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.
Body Image ; Breast ; Cicatrix ; Feminization ; Gender Dysphoria ; Gender Identity ; Gynecomastia ; Humans ; Hypopigmentation ; Male ; Mastectomy ; Prevalence ; Thorax ; Transplants ; Transsexualism

In this report, we present a rare case of solid silicone implant displacement to the contralateral side after aesthetic gluteal augmentation, a phenomenon that has never been reported before in the literature. A 29-year-old woman with a history of gluteal augmentation 9 months previously and soft tissue infection presented for a consultation due to 3 days of sudden progressive pain in the right gluteus with erythema and edema, without a history of trauma. Displacement of the left gluteal implant to the right gluteal pocket was shown by magnetic resonance imaging. Because the patient refused implant removal, the decision was made to perform capsulotomy, to reconstruct the gluteal pockets, and to preserve the implants. The patient showed a satisfactory early and late postoperative course. Possible causes of this complication include poor surgical technique, with insufficient tissue preservation to keep the pockets apart, and the presence of seroma or hematoma that favored an infectious process, thereby leading to deterioration of the dissected soft tissues with dehiscence of the wound favoring the displacement of the implant.