Gender dysphoria is today, much more known and accepted than it was until a few decades ago. Society is increasingly aware that not everyone identifies with the sex assigned to them at birth and, therefore, they have the right to change it.

Sex change is a very delicate process that cannot be carried out overnight. Patients have to be diagnosed with persistent gender dysphoria to start taking hormones and subsequently access surgery that changes the physical attributes that characterize them as a woman for those of a man, or vice versa.

One of the operations consists of the removal of the breasts in the case of women whose sex does not correspond to their gender identity. This procedure is called bilateral mastectomy. We will talk about her in this article.

What is a bilateral mastectomy?

This intervention is also carried out in certain cases of breast cancer, and even preventively if there is a high risk of suffering from this disease. Although on these occasions, after the removal of the breast tissue affected by the tumor, breast reconstruction is done.

This time we are going to focus on the intervention carried out in a sex change process. For someone who has the physical attributes of a woman but who feels identified with the male gender, the breasts pose a serious problem, so it is usual to go under the knife.

Bilateral mastectomy is the surgical intervention that is responsible for reducing the size of the breasts and making the pectorals more masculine in appearance.

The intervention can be divided into two parts. In the first one, the extraction of the breast tissue is made. The fat that shapes the breast is removed to make the area flat. In most cases, removing breast tissue is not enough to make the breast resemble a man’s.

For this reason, the second part of the intervention usually involves the introduction of prostheses that help to shape the breast in the most similar way possible to that of the male breast, making the pectoral area larger and wider.

A subcutaneous mastectomy is usually carried out to preserve the nipples and mammary areolas, which will also be operated on to adapt their size to the new dimensions of the breast.

The technique used to carry out the operation depends on the size of the breasts. If it is a small breast, a periareolar intervention is usually performed: the breast tissue is removed through a small incision, so that the scars that remain are minimal.

In contrast, bulky-sized breasts are practiced with an expanded periareolar technique, opening from the periareolar area to the armpit. The scars are more visible, but with time, they become disguised if the patient chooses not to remove the hair from the chest.

How is the operation carried out and what results are obtained?

The intervention is carried out under general anesthesia and normally takes two to four hours. The patient must spend the first night in the hospital; If all goes well, you can go home the next day to continue your recovery.

Once the area is healed, the patient has a masculine-looking torso. The scars will be, in principle, quite visible, but they will be nuanced with time.

On some occasions, once the incisions made are completely healed, you can see folds near the areola or some small imperfection in the nipple. These problems can be corrected through secondary surgeries, which will already be outpatient and will be carried out under local anesthesia.

How is the postoperative?

In any operation that affects the chest area, the patient must rest completely for about three days. After the fourth or fifth day, you can gradually regain your normal rhythm of life. Of course, you should refrain from gaining weight for a few weeks.

In the specific case of bilateral mastectomy, a drain is placed in each breast to facilitate the discharge of fluid. The drains will be removed within 48 hours. From that moment, the patient will have to wear a compression girdle or band, or a compression shirt, for a period of three or four weeks.

Wearing this type of garment is essential during recovery since the pressure they exert on the intervened area prevents bruises from appearing and, at the same time, allows the skin that is in the process of recovery to adhere exactly where it should.

In a few weeks, the recovery process is complete, and the patient can already perform all kinds of activities. But you still have to be wary of scars. Keep in mind that the healing process is always longer than it seems.

At first, it is normal for the area where the incision was made to be red and even somewhat swollen, even if it is completely healed. It is a natural process. In this way, if there are no problems, the appearance will improve over time.

For the healing process to develop properly and that, with time, the traces of the bilateral mastectomy are minimal, the specialists recommend always keeping the scars well hydrated and exercising caution when sunbathing.

During the first weeks, and even during the first months after the operation, it is strongly discouraged to expose the skin of the chest directly to the sun, even if a good sunscreen is used.

In some cases, that recommendation is extended until a year has passed since the operation. Even in those cases in which the healing has already finished.

It should be borne in mind that the sun can make them acquire a more pronounced tone compared to the rest of the skin. That is why the use of a quality sunscreen with a high protection factor is always recommended.

If the scars are well cared for, after a few years, they will barely be visible and the patient will be able to show off male pectorals normally.