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Negenborn VL, van Turnhout AAWM, Fuchs SP, Lisabeth-Broné K, Vermulst N, Vogten JM, Twisk JWR, Vriens-Nieuwenhuis EJC, Mullender MG, van der Sluis WB. A retrospective study on surgical outcomes and patient satisfaction of EGIS ® ADM in one-stage implant-based breast reconstruction. J Plast Reconstr Aesthet Surg 2018; 72:137-171. [PMID: 30446418 DOI: 10.1016/j.bjps.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 10/08/2018] [Accepted: 10/28/2018] [Indexed: 11/19/2022]
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Klassen AF, Kaur M, Johnson N, Kreukels BP, McEvenue G, Morrison SD, Mullender MG, Poulsen L, Ozer M, Rowe W, Satterwhite T, Savard K, Semple J, Sørensen JA, van de Grift TC, van der Meij-Ross M, Young-Afat D, Pusic AL. International phase I study protocol to develop a patient-reported outcome measure for adolescents and adults receiving gender-affirming treatments (the GENDER-Q). BMJ Open 2018; 8:e025435. [PMID: 30344182 PMCID: PMC6196938 DOI: 10.1136/bmjopen-2018-025435] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION A critical barrier to outcome assessment in gender-affirming healthcare is the lack of a specific patient-reported outcome measure (PROM). This phase I protocol describes an international collaboration between investigators in Canada, Denmark, the Netherlands and the USA who have coalesced to develop a new PROM (ie, the GENDER-Q) to evaluate outcomes of psychological, hormonal and surgical gender-affirming treatments. METHODS AND ANALYSIS This phase I study uses an interpretive description approach. Participants aged 16 years and older seeking any form of gender-affirming treatments in centres located in Canada, Denmark, the Netherlands and the USA will be invited to take part in qualitative interviews. Participants will review BREAST-Q and FACE-Q scales hypothesised to contain content relevant to specific gender-affirming treatments. Interviews will elicit new concepts for additional scale development. Each interview will be digitally recorded, transcribed and coded. The main outcome of this phase I study will be the development of a conceptual framework and set of scales to measure outcomes important to evaluating gender-affirming treatments. To this end, analysis will be used to add/drop/revise items of existing scales to achieve content validity. For new concepts, coding will assign top-level domains and themes/subthemes to participant quotes. Codes will be used to develop an item pool to inform scale development. Draft scales will be shown to transgender and gender diverse persons and experts to obtain feedback that will be used to refine and finalise the scales. The field-test version of the GENDER-Q will be translated by following rigorous methods to prepare for the international field-test study. ETHICS AND DISSEMINATION This study is coordinated at McMaster University (Canada). Ethics board approval was received from the Hamilton Integrated Ethics Board (Canada), the Medical Ethical Committee at VUmc (The Netherlands) and Advarra (USA). Findings will be published in peer-reviewed journals and presented at national and international conferences and meetings.
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Paul CPL, Emanuel KS, Kingma I, van der Veen AJ, Holewijn RM, Vergroesen PPA, van de Ven PM, Mullender MG, Helder MN, Smit TH. Changes in Intervertebral Disk Mechanical Behavior During Early Degeneration. J Biomech Eng 2018; 140:2678255. [PMID: 29801164 DOI: 10.1115/1.4039890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Indexed: 11/08/2022]
Abstract
Intervertebral disk (IVD) degeneration is commonly described by loss of height and hydration. However, in the first stage of IVD degeneration, this loss has not yet occurred. In the current study, we use an ex vivo degeneration model to analyze the changes in IVDs mechanical behavior in the first phase of degeneration. We characterize these changes by stretched-exponential fitting, and suggest the fitted parameters as markers for early degeneration. Enzymatic degeneration of healthy lumbar caprine IVDs was induced by injecting 100 μL of Chondroïtinase ABC (Cabc) into the nucleus. A no-intervention and phosphate buffered saline (PBS) injected group were used as controls. IVDs were cultured in a bioreactor for 20 days under diurnal, simulated-physiological loading (SPL) conditions. Disk deformation was continuously monitored. Changes in disk height recovery behavior were quantified using stretched-exponential fitting. Disk height, histological sections, and water- and glycosaminoglycan (GAG)-content measurements were used as gold standards for the degenerative state. Cabc injection caused significant GAG loss from the nucleus and had detrimental effects on poro-elastic mechanical properties of the IVDs. These were progressive over time, with a propensity toward more linear recovery behavior. On histological sections, both PBS and Cabc injected IVDs showed moderate degeneration. A small GAG loss yields changes in IVD recovery behavior, which can be quantified with stretched-exponential fitting. Parameters changed significantly compared to control. Studies on disk degeneration and biomaterial engineering for degenerative disk disease (DDD) could benefit from focusing on IVD biomechanical behavior rather than height and water-content, as a marker for early disk degeneration.
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van de Grift TC, Mullender MG, Bouman MB. Shared Decision Making in Gender-Affirming Surgery. Implications for Research and Standards of Care. J Sex Med 2018; 15:813-815. [PMID: 29803349 DOI: 10.1016/j.jsxm.2018.03.088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 03/27/2018] [Accepted: 03/31/2018] [Indexed: 12/18/2022]
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Özer M, Pigot GLS, Bouman MB, van de Grift TC, Elfering L, van Mello NM, Al-Itejawi HHM, Buncamper ME, Mullender MG. Development of a Decision Aid for Genital Gender-Affirming Surgery in Transmen. J Sex Med 2018; 15:1041-1048. [PMID: 29861358 DOI: 10.1016/j.jsxm.2018.04.644] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/24/2018] [Accepted: 04/27/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND As genital gender-affirming surgery (GAS) is a demanding and life-changing intervention, transmen should be able to make choices about the surgical treatment based on outcomes that are most important to them, while taking into consideration the concomitant risks involved. AIM Develop a decision aid (DA) for genital surgery in transmen (DA-GST) that can assist both transmen and health care professionals (HCPs) in making a well-informed decision about the surgical treatment. METHODS A qualitative focus group study was performed. 5 Focus groups were organized with both HCPs and transmen. These were led by an independent professional moderator. Data collected during these focus groups were analyzed to provide content for the DA. OUTCOMES To develop content for a DA-GST. RESULTS Data collected during the focus groups related to the treatment options, information deemed relevant by transmen, and the arguments for or against each treatment option. Collected items were divided into the following themes: outcome, quality of life, environment, sexuality, and beliefs. CLINICAL IMPLICATIONS The tool will be useful in assisting both transmen and HCPs in the shared decision-making process regarding genital GAS by exploring which domains are most relevant for each specific individual. STRENGTHS & LIMITATIONS This DA was developed according to an iterative participatory design approach to fit the needs of both transmen and HCPs. Issues that transmen find important and relevant pertaining to genital GAS were translated into arguments that were incorporated in the DA-GST. The study is limited by the group that had participated. Not all arguments for or against specific surgical options may be covered by the DA-GST. CONCLUSION An online DA was developed to support transmen with their decision-making process concerning all surgical options for removal of reproductive organs and genital GAS. Özer M, Pigot GL, Bouman M-B, et al. Development of a Decision Aid for Genital Gender-Affirming Surgery in Transmen. J Sex Med 2018;15:1041-1048.
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Negenborn VL, Dikmans REG, Bouman MB, Winters HAH, Twisk JWR, Ruhé PQ, Mureau MAM, Smit JM, Tuinder S, Hommes J, Eltahir Y, Posch NAS, van Steveninck-Barends JM, Meesters-Caberg MA, van der Hulst RRWJ, Ritt MJPF, Mullender MG. Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial. Br J Surg 2018; 105:1305-1312. [PMID: 29663320 PMCID: PMC6099293 DOI: 10.1002/bjs.10865] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/12/2017] [Accepted: 02/19/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND In the multicentre randomized trial BRIOS (Breast Reconstruction In One Stage), direct-to-implant (DTI) breast reconstruction with an acellular dermal matrix (ADM) was associated with a markedly higher postoperative complication rate compared with two-stage tissue expander/implant breast reconstruction. This study aimed to identify factors that contribute to the occurrence of complications after DTI ADM-assisted breast reconstruction. METHODS Data were obtained from the BRIOS study, including all patients treated with DTI ADM-assisted breast reconstruction. Logistic regression analyses were performed to identify factors predictive of postoperative complications. RESULTS Fifty-nine patients (91 breasts) were included, of whom 27 (35 breasts) developed a surgical complication. Reoperations were performed in 29 breasts (32 per cent), with prosthesis removal in 22 (24 per cent). In multivariable analyses, mastectomy weight was associated with complications (odds ratio (OR) 1·94, 95 per cent c.i. 1·33 to 2·83), reoperations (OR 1·70, 1·12 to 2·59) and removal of the implant (OR 1·55, 1·11 to 2·17). Younger patients (OR 1·07, 1·01 to 1·13) and those who received adjuvant chemotherapy (OR 4·83, 1·15 to 20·24) more frequently required reoperation. In univariable analyses, adjuvant radiotherapy showed a trend towards more complications (OR 7·23, 0·75 to 69·95) and removal of the implant (OR 5·12, 0·76 to 34·44), without reaching statistical significance. CONCLUSION Breast size appeared to be the most significant predictor of complications in DTI ADM-assisted breast reconstruction. The technique should preferably be performed in patients with small to moderate sized breasts. Registration number: NTR5446 ( http://www.trialregister.nl).
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de Vet HC, Mullender MG, Eekhout I. Specific agreement on ordinal and multiple nominal outcomes can be calculated for more than two raters. J Clin Epidemiol 2018; 96:47-53. [DOI: 10.1016/j.jclinepi.2017.11.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/24/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022]
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Smit JM, Negenborn VL, Jansen SM, Jaspers MEH, de Vries R, Heymans MW, Winters HAH, van Leeuwen TG, Mullender MG, Krekel NMA. Intraoperative evaluation of perfusion in free flap surgery: A systematic review and meta-analysis. Microsurgery 2018; 38:804-818. [DOI: 10.1002/micr.30320] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/03/2018] [Accepted: 03/02/2018] [Indexed: 12/21/2022]
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van der Sluis WB, Pavan N, Liguori G, Bucci S, Bizic MR, Kojovic V, Hess J, Meijerink WJ, Mullender MG, Özer M, Smit JM, Buncamper ME, Krege S, Djordjevic ML, Trombetta C, Bouman MB. Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development: an international, multicentre, retrospective study on surgical characteristics and outcomes. BJU Int 2018; 121:952-958. [DOI: 10.1111/bju.14155] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Özer M, Mortimore I, Jansma EP, Mullender MG. Labiaplasty: motivation, techniques, and ethics. Nat Rev Urol 2018; 15:175-189. [DOI: 10.1038/nrurol.2018.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Paul CPL, Smit TH, de Graaf M, Holewijn RM, Bisschop A, van de Ven PM, Mullender MG, Helder MN, Strijkers GJ. Quantitative MRI in early intervertebral disc degeneration: T1rho correlates better than T2 and ADC with biomechanics, histology and matrix content. PLoS One 2018; 13:e0191442. [PMID: 29381716 PMCID: PMC5790235 DOI: 10.1371/journal.pone.0191442] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 01/04/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction Low-back pain (LBP) has been correlated to the presence of intervertebral disc (IVD) degeneration on T2-weighted (T2w) MRI. It remains challenging, however, to accurately stage degenerative disc disease (DDD) based on T2w MRI and measurements of IVD height, particularly for early DDD. Several quantitative MRI techniques have been introduced to detect changes in matrix composition signifying early DDD. In this study, we correlated quantitative T2, T1rho and Apparent Diffusion Coefficient (ADC) values to disc mechanical behavior and gold standard early DDD markers in a graded degenerated lumbar IVD caprine model, to assess their potential for early DDD detection. Methods Lumbar caprine IVDs were injected with either 0.25 U/ml or 0.5 U/ml Chondroïtinase ABC (Cabc) to trigger early DDD-like degeneration. Injection with phosphate-buffered saline (PBS) served as control. IVDs were cultured in a bioreactor for 20 days under axial physiological loading. High-resolution 9.4 T MR images were obtained prior to intervention and after culture. Quantitative MR results were correlated to recovery behavior, histological degeneration grading, and the content of glycosaminoglycans (GAGs) and water. Results Cabc-injected IVDs showed aberrancies in biomechanics and loss of GAGs without changes in water-content. All MR sequences detected changes in matrix composition, with T1rho showing largest changes pre-to-post in the nucleus, and significantly more than T2 and ADC. Histologically, degeneration due to Cabc injection was mild. T1rho nucleus values correlated strongest with altered biomechanics, histological degeneration score, and loss of GAGs. Conclusions T2- and T1rho quantitative MR-mapping detected early DDD changes. T1rho nucleus values correlated better than T2 and ADC with biomechanical, histological, and GAG changes. Clinical implementation of quantitative MRI, T1rho particularly, could aid in distinguishing DDD more reliably at an earlier stage in the degenerative process.
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van de Grift TC, Pigot GL, Boudhan S, Elfering L, Kreukels BP, Gijs LA, Buncamper ME, Özer M, van der Sluis W, Meuleman EJ, Bouman MB, Mullender MG. A Longitudinal Study of Motivations Before and Psychosexual Outcomes After Genital Gender-Confirming Surgery in Transmen. J Sex Med 2017; 14:1621-1628. [DOI: 10.1016/j.jsxm.2017.10.064] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 11/17/2022]
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van der Sluis WB, Smit JM, Pigot GLS, Buncamper ME, Winters HAH, Mullender MG, Bouman MB. Double flap phalloplasty in transgender men: Surgical technique and outcome of pedicled anterolateral thigh flap phalloplasty combined with radial forearm free flap urethral reconstruction. Microsurgery 2017; 37:917-923. [PMID: 28556461 PMCID: PMC5697604 DOI: 10.1002/micr.30190] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 04/19/2017] [Accepted: 05/12/2017] [Indexed: 01/10/2023]
Abstract
Introduction Radial forearm free flap (RFFF) tube‐in‐tube phalloplasty is the most performed phalloplasty technique worldwide. The conspicuous donor‐site scar is a drawback for some transgender men. In search for techniques with less conspicuous donor‐sites, we performed a series of one‐stage pedicled anterolateral thigh flap (ALT) phalloplasties combined with RFFF urethral reconstruction. In this study, we aim to describe this technique and assess its surgical outcome in a series of transgender men. Patients and Methods Between January 2008 and December 2015, nineteen transgender men (median age 37, range 21–57) underwent pedicled ALT phalloplasty combined with RFFF urethral reconstruction in one stage. The surgical procedure was described. Patient demographics, surgical characteristics, intra‐ and postoperative complications, hospitalization length, and reoperations were recorded. Results The size of the ALT flaps ranged from 12 × 12 to 15 × 13 cm, the size of the RFFFs from 14 × 3 to 17 × 3 cm. Median clinical follow‐up was 35 months (range 3–95). Total RFFF failure occurred in two patients, total ALT flap failure in one patient, and partial necrosis of the ALT flap in one patient. Long‐term urinary complications occurred in 10 (53%) patients, of which 9 concerned urethral strictures. Conclusions In experienced hands, one‐stage pedicled ALT phalloplasty combined with RFFF urethral reconstruction is a feasible alternative surgical option in eligible transgender men, who desire a less conspicuous forearm scar. Possible drawbacks comprise flap‐related complications, difficult inner flap monitoring and urethral complications.
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Paul CPL, de Graaf M, Bisschop A, Holewijn RM, van de Ven PM, van Royen BJ, Mullender MG, Smit TH, Helder MN. Static axial overloading primes lumbar caprine intervertebral discs for posterior herniation. PLoS One 2017; 12:e0174278. [PMID: 28384266 PMCID: PMC5383039 DOI: 10.1371/journal.pone.0174278] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 03/05/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction Lumbar hernias occur mostly in the posterolateral region of IVDs and mechanical loading is an important risk factor. Studies show that dynamic and static overloading affect the nucleus and annulus of the IVD differently. We hypothesize there is also variance in the effect of overloading on the IVD’s anterior, lateral and posterior annulus, which could explain the predilection of herniations in the posterolateral region. We assessed the regional mechanical and cellular responses of lumbar caprine discs to dynamic and static overloading. Material and methods IVDs (n = 125) were cultured in a bioreactor and subjected to simulated-physiological loading (SPL), high dynamic (HD), or high static (HS) overloading. The effect of loading was determined in five disc regions: nucleus, inner-annulus and anterior, lateral and posterior outer-annulus. IVD height loss and external pressure transfer during loading were measured, cell viability was mapped and quantified, and matrix integrity was assessed. Results During culture, overloaded IVDs lost a significant amount of height, yet the distribution of axial pressure remained unchanged. HD loading caused cell death and disruption of matrix in all IVD regions, whereas HS loading particularly affected cell viability and matrix integrity in the posterior region of the outer annulus. Conclusion Axial overloading is detrimental to the lumbar IVD. Static overloading affects the posterior annulus more strongly, while the nucleus is relatively spared. Hence, static overloading predisposes the disc for posterior herniation. These findings could have implications for working conditions, in particular of sedentary occupations, and the design of interventions aimed at prevention and treatment of early intervertebral disc degeneration.
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Dikmans REG, Negenborn VL, Bouman MB, Winters HAH, Twisk JWR, Ruhé PQ, Mureau MAM, Smit JM, Tuinder S, Eltahir Y, Posch NA, van Steveninck-Barends JM, Meesters-Caberg MA, van der Hulst RRWJ, Ritt MJPF, Mullender MG. Two-stage implant-based breast reconstruction compared with immediate one-stage implant-based breast reconstruction augmented with an acellular dermal matrix: an open-label, phase 4, multicentre, randomised, controlled trial. Lancet Oncol 2016; 18:251-258. [PMID: 28012977 DOI: 10.1016/s1470-2045(16)30668-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/15/2016] [Accepted: 10/18/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND The evidence justifying the use of acellular dermal matrices (ADMs) in implant-based breast reconstruction (IBBR) is limited. We did a prospective randomised trial to compare the safety of IBBR with an ADM immediately after mastectomy with that of two-stage IBBR. METHODS We did an open-label, randomised, controlled trial in eight hospitals in the Netherlands. Eligible women were older than 18 years with breast carcinoma or a gene mutation linked with breast cancer who intended to undergo skin-sparing mastectomy and immediate IBBR. Randomisation was done electronically, stratified per centre and in blocks of ten to achieve roughly balanced groups. Women were assigned to undergo one-stage IBBR with ADM (Strattice, LifeCell, Branchburg, NJ, USA) or two-stage IBBR. The primary endpoint was quality of life and safety was assessed by the occurrence of adverse outcomes. Analyses were done per protocol with logistic regression and generalised estimating equations. This study is registered at Nederlands Trial Register, number NTR5446. FINDINGS 142 women were enrolled between April 14, 2013, and May 29, 2015, of whom 59 (91 breasts) in the one-stage IBBR with ADM group and 62 (92 breasts) in the two-stage IBBR group were included in analyses. One-stage IBBR with ADM was associated with significantly higher risk per breast of surgical complications (crude odds ratio 3·81, 95% CI 2·67-5·43, p<0·001), reoperation (3·38, 2·10-5·45, p<0·001), and removal of implant, ADM, or both (8·80, 8·24-9·40, p<0·001) than two-stage IBBR. Severe (grade 3) adverse events occurred in 26 (29%) of 91 breasts in the one-stage IBBR with ADM group and in five (5%) of 92 in the two-stage IBBR group. The frequency of mild to moderate adverse events was similar in the two groups. INTERPRETATION Immediate one-stage IBBR with ADM was associated with adverse events and should be considered very carefully. Understanding of selection of patients, risk factors, and surgical and postsurgical procedures needs to be improved. FUNDING Pink Ribbon, Nuts-Ohra, and LifeCell.
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Groen JW, Negenborn VL, Twisk JWR, Ket JCF, Mullender MG, Smit JM. Autologous Fat Grafting in Cosmetic Breast Augmentation: A Systematic Review on Radiological Safety, Complications, Volume Retention, and Patient/Surgeon Satisfaction. Aesthet Surg J 2016; 36:993-1007. [PMID: 27329661 DOI: 10.1093/asj/sjw105] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Autologous fat grafting (AFG) is increasingly used in cosmetic surgery. However, its efficacy and safety are still ambiguous. Both a comprehensive overview and recapitulation of the relevant literature provide current evidence on the efficacy and outcomes of AFG in cosmetic breast surgery. OBJECTIVES This review provides an up-to-date overview of the literature on AFG in cosmetic breast augmentation. METHODS A systematic review of the literature on AFG used for cosmetic breast augmentation was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study included selected studies that were published between January 1996 and February 2016 and reported on 10 patients or more who had a minimal mean follow-up period of 1 year. RESULTS In this study, 22 articles that reported on 3565 patients with follow-up periods ranging from 12 to 136 months were included. A complication rate of 17.2% (95% CI 15.9-18.5) was seen. Indurations were the most frequent complication (33.3%, 95% CI 20.4-46.3), followed by persistent pain (25%, 95% CI 0.5-49.5), and hematoma (16.4%, 95% CI 14.5-18.4). Mammograms revealed micro-calcifications (9.0%, 95% CI 6.4-11.5) and macro-calcifications (7.0%, 95% CI 3.8-10.2). The mean volume retention was 62.4% (range, 44.7-82.6%), with a satisfaction rate of 92% in patients and 89% in surgeons. CONCLUSIONS AFG is a promising method in achieving autologous cosmetic breast augmentation with satisfactory volume retention and satisfaction rates in eight and six studies, respectively. Complications and radiological findings are comparable to those after implant augmentation. Future studies should focus on cancer occurrence and detection to further substantiate AFG safety. In addition, grafting methods and the use of auxiliary procedures to identify factors leading to better outcomes in terms of volume retention should be investigated. Finally, objective questionnaires are needed to represent patient satisfaction. LEVEL OF EVIDENCE 3 Therapeutic.
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van de Grift TC, Kreukels BPC, Elfering L, Özer M, Bouman MB, Buncamper ME, Smit JM, Mullender MG. Body Image in Transmen: Multidimensional Measurement and the Effects of Mastectomy. J Sex Med 2016; 13:1778-1786. [PMID: 27667355 DOI: 10.1016/j.jsxm.2016.09.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/30/2016] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Transmen are generally dissatisfied with their breasts and often opt for mastectomy. However, little is known about the specific effects of this procedure on this group's body image. AIM To prospectively assess the effect of mastectomy on the body image of transmen, including cognitive, emotional, and behavioral aspects. METHODS During a 10-month period, all transmen applying for mastectomy were invited to participate in this study. The 33 participants completed assessments preoperatively and at least 6 months postoperatively. MAIN OUTCOME MEASURES Participants were surveyed on body satisfaction (Body Image Scale for Transsexuals), body attitudes (Multidimensional Body-Self Relations Questionnaire), appearance schemas (Appearance Schemas Inventory), situational bodily feelings (Situational Inventory of Body Image Dysphoria), body image-related quality of life (Body Image Quality of Life Inventory), and self-esteem (Rosenberg Self-Esteem Scale). Control values were retrieved from the literature and a college sample. RESULTS Before surgery, transmen reported less positive body attitudes and satisfaction, a lower self-esteem and body image-related quality of life compared with cisgender men and women. Mastectomy improved body satisfaction most strongly, although respondents reported improvements in all domains (eg, decreased dysphoria when looking in the mirror and improved feelings of self-worth). Most outcome measurements were strongly correlated. CONCLUSION Mastectomy improves body image beyond satisfaction with chest appearance alone. Body satisfaction and feelings of "passing" in social situations are associated with a higher quality of life and self-esteem.
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Bouman MB, van der Sluis WB, van Woudenberg Hamstra LE, Buncamper ME, Kreukels BP, Meijerink WJ, Mullender MG. Patient-Reported Esthetic and Functional Outcomes of Primary Total Laparoscopic Intestinal Vaginoplasty in Transgender Women With Penoscrotal Hypoplasia. J Sex Med 2016; 13:1438-1444. [DOI: 10.1016/j.jsxm.2016.06.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/22/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
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Negenborn VL, Groen JW, Smit JM, Niessen FB, Mullender MG. Autologous Fat Grafting: A Promising Technique with Various Indications. Reply: The Use of Autologous Fat Grafting for Treatment of Scar Tissue and Scar Related Conditions: A Systematic Review. Plast Reconstr Surg 2016; 138:1077e-1078e. [PMID: 27541617 DOI: 10.1097/prs.0000000000002810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Negenborn VL, Groen JW, Smit JM, Niessen FB, Mullender MG. The Use of Autologous Fat Grafting for Treatment of Scar Tissue and Scar-Related Conditions: A Systematic Review. Plast Surg Nurs 2016; 36:131-143. [PMID: 27606589 DOI: 10.1097/psn.0000000000000155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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46
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van der Sluis WB, Bouman MB, de Boer NK, Buncamper ME, van Bodegraven AA, Neefjes-Borst EA, Kreukels BP, Meijerink WJ, Mullender MG. Long-Term Follow-Up of Transgender Women After Secondary Intestinal Vaginoplasty. J Sex Med 2016; 13:702-10. [DOI: 10.1016/j.jsxm.2016.01.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/16/2015] [Accepted: 01/16/2016] [Indexed: 12/14/2022]
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47
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van der Sluis WB, Buncamper ME, Bouman MB, Neefjes-Borst EA, Heideman DAM, Steenbergen RDM, Mullender MG. Symptomatic HPV-related neovaginal lesions in transgender women: case series and review of literature. Sex Transm Infect 2016; 92:499-501. [DOI: 10.1136/sextrans-2015-052456] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/24/2016] [Accepted: 03/05/2016] [Indexed: 11/04/2022] Open
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48
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van der Sluis WB, Bouman MB, Meijerink WJ, Elfering L, Mullender MG, de Boer NK, van Bodegraven AA. Diversion neovaginitis after sigmoid vaginoplasty: endoscopic and clinical characteristics. Fertil Steril 2016; 105:834-839.e1. [DOI: 10.1016/j.fertnstert.2015.11.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 12/15/2022]
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49
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van der Sluis WB, Neefjes-Borst EA, Bouman MB, Meijerink WJHJ, De Boer NKH, Mullender MG, van Bodegraven AA. Morphological spectrum of neovaginitis in autologous sigmoid transplant patients. Histopathology 2015; 68:1004-12. [DOI: 10.1111/his.12894] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/14/2015] [Indexed: 02/03/2023]
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50
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Buncamper ME, Honselaar JS, Bouman MB, Özer M, Kreukels BPC, Mullender MG. Response to Editorial Comment on: Aesthetic and Functional Outcomes of Neovaginoplasty Using Penile Skin in Male-to-Female Transsexuals. J Sex Med 2015; 12:1637. [PMID: 26193765 DOI: 10.1111/jsm.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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