Transsexual breast evacuation

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غلامحسین غرابی دکتر زیبایی

Specialist in plastic and cosmetic surgery
Member of the American Society of Plastic Surgeons
Member of the Iranian Plastic Surgeons Association


تخلیه سینه ترنس سکشوال

Transsexual breast evacuation

To better understand the subject of “transsexual”, we need to review the meanings of the two words SEX and GENDER.

It is the biological structure of the body and includes the sexual organs and reproduction of a person. Biological differences, hormones, chromosomes, and internal and external sexual organs play a major role in gender differences.

You may be surprised, but sex is very different from gender. Gender includes social patterns and behaviors that culture and society provide to the sexes. In fact, it is these patterns that determine the range of behavioral expectations of different sexes (male and female).

In culture and society, one’s sex is fixed, but one’s gender determines one’s gender role.

Gender role is a set of sexual behaviors and stereotypes that society and culture expect from any gender. In different cultures, these roles can be different. For example, femininity and masculinity are among these gender patterns. According to these stereotypes, people with male sexual organs are male and “need” to display masculine behaviors such as “power, violence, resistance, and so on.” And people with female genitals are female, and “should” express feminine behaviors such as “kindness, gentleness, taste, and so on.”

The problem arises when one’s form contradicts one’s perception of one’s own gender. These roles have become an obstacle to his acceptance into society as the desired gender and the discussion of gender identity.

The definition that one has of oneself is called gender identity. This identity may not be the same as his or her sexual organs or physical characteristics. A person who does not match gender identity and sexual organ is referred to as “transsexual” or “transgender.” In other words, transgenderism refers to a person who is not related to his or her biological gender and gender identity. For example, a person who has a male sexual organ but has a female sexual identity. In some cases, the severity of the body’s conflict with identity may be so great that hormone therapy and surgery can alter the body and identity. Such people are called “transgender.”

Not to mention, people with biological characteristics or genitals of both sexes are born. In these individuals, some organs and characteristics of one sex predominate, but other organs and physical characteristics may also belong to the other sex. Such people are called Intersex.

The prelude to understanding and empathy is awareness. People who try to understand and prove their sexual identity do not need pity or compassion, and their only expectation from society and those around them is that they recognize their sexual identity and understand their situation.

Transgender people fall into three categories:

  • Transgender without surgery
  • Medium intensity transgender
  • High intensity transgender

The main difference between these three categories is their desire to have surgery and the stages of change, as well as their sexual desire.

The process of diagnosing and treating a transsexual lasts at least 2 years and consists of three stages:

  • Referral to a psychologist and psychiatrist and mental health tests
  • Hormone therapy and living in the role of the desired sex
  • Referral to a plastic surgeon and urologist.


 Operation technique

Female breasts are divided into three groups based on their size and the position of the nipple:

  • Mild ptosis
  • Moderate ptosis
  • Severe ptosis

Various open surgery techniques are recommended for mastectomy for transsexual clients and are used by surgeons. Recently, with the advancement of my technology, using a completely innovative method, using ultrasonic waves (Vaser Lipo) from the axilla area, by making a hole of 4 to 8 mm, the breast tissue is liquefied and without surgical incision, the breast tissue is emptied. Obviously, this technique is only used for groups one and two, and its success rate is over 95%. For group three, open-mastectomy mastectomy is still used.

Duration of action

It takes between 3 and 5 hours for ultrasound surgery and 4 to 5 hours for open surgery.


This procedure requires general anesthesia.

Inpatient / outpatient status

Mastectomy by advanced UAL technique and the use of ultrasonic waves do not require hospitalization.

In open surgery, a decision will be made about the patient’s hospitalization or discharge according to the patient’s general condition.

side effects

In VASER Lipo Method:

  • Temporary bruising of the surgical site
  • Temporary redness of the surgical site


  • Infection
  • Bleeding and hematoma
  • Skin burns at the surgical site
  • Improper skin shrinkage (in people with poor skin quality)
  • Hyper pigmentation


The patient is usually discharged after full alertness and diet tolerance.

Wear special garment for at least 2 or 3 weeks.

Two days after surgery, bathing is allowed. The drain is removed by a doctor after two to four days.

You will return to daily work within a week. Intense exercise before 4 to 6 weeks is not allowed.


If the surgery is performed by a skilled and experienced surgeon in the field of transsexual clients, the results will be brilliant and long lasting.


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Dr. Gholamhossein Ghorabi

Dr. Gholamhossein Ghorabi, a subspeciality in Aesthetic, plastic and reconstructive surgery, an active member of the International Society of Aesthetic Plastic Surgery (ISAPS) and Iranian Society of Plastic and Aesthetic Surgeons (ISPAS).