When Testosterone Needs to be Contrasted: A Preliminary Study of Scar Prevention in Transmen Top Surgery with an Innovative Galenic Preparation

Aesthetic Plast Surg. 2020 Jun;44(3):1006-1013. doi: 10.1007/s00266-020-01678-2. Epub 2020 Mar 20.

Abstract

Background: Transmen are individuals who live a marked incongruence between the assigned gender and the experienced gender. Crucial and life-changing steps in their transition are testosterone treatment and mastectomy to remove the stigma of feminine identity. After surgery, patients' attention turns to the scars, often not aesthetically pleasant. We thus created an innovative galenic preparation for scar treatment after surgery composed by spironolactone, alfa bisabolol and silicone gel. Functional outcomes, side effects and satisfaction were assessed.

Methods: For the present prospective randomized controlled study, 30 patients with similar demographic characteristics who underwent double incision mastectomy with NA grafts between February 2014 and June 2019 were selected. The treatment Group A (n = 15) was treated for 12 months with "Top Surgery Scar go," the control Group B (n = 15) with silicon gel. Statistical analysis including Wilcoxon test and Kruskal-Wallis test per variable was performed. To assess satisfaction, a second Wilcoxon test was applied.

Results: The differences between Group A and Group B were statistically significant, especially at T12 with very low p values. Satisfaction was greater in Group A (p value = 3e-4). No major side effects were noticed in Group A.

Conclusions: TSSgo scar innovative treatment showed long-term efficacy in comparison with silicon gel in terms of improved scar tissue texture, pigmentation, pliability and height. It is easy to set up, cost-effective and safe. Further studies are necessary to better assess efficacy and validity of TSSgo, but it appears to be promising as the new treatment of reference for scar management after top surgery in transmen.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords: Scar; Scar prevention; Scar treatment; Silicon gel; Testosterone; Top surgery; Transmen.

MeSH terms

  • Breast Neoplasms*
  • Cicatrix* / prevention & control
  • Cicatrix* / surgery
  • Esthetics
  • Follow-Up Studies
  • Humans
  • Mastectomy
  • Prospective Studies
  • Retrospective Studies
  • Testosterone
  • Treatment Outcome

Substances

  • Testosterone