ArticleCureus2025
Techniques for Preserving the Nipple Areolar Complex in Chest Masculinization for All Chest Sizes.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Current literature on gender-affirming top surgery techniques predominantly focuses on achieving optimal binary male aesthetic outcomes. However, goals for surgery are unique, and preservation of the nipple-areolar complex (NAC) for aesthetics and sensation can be of primary importance to patients. This paper provides an algorithm for preserving the NAC based on chest size and native NAC position. Written consent was obtained for all before and after patient photos. Photos were taken as part of patient care and documentation from one surgeon at Women's College Hospital in Toronto, Canada, between January 2020 and March 2022. Four techniques are highlighted in detail in this report: (1) keyhole (subcutaneous) mastectomies, (2) periareolar mastectomies, (3) nipple-preserving double-incision mastectomies, and (4) inverted T mastectomies. Current literature for top surgery focuses primarily on double-incision mastectomies with free nipple grafts or a smaller subset of periareolar and keyhole mastectomies. We have outlined several techniques to preserve the NAC, and an algorithm has been recommended based on chest size and preoperative NAC position. NAC preservation is possible for most chest sizes when performing masculinizing chest surgeries. The algorithm we have described provides guidance for surgeons to choose which technique to use based on the patient's breast volume, ptosis, and NAC position to preserve the entire NAC.
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