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Dermal nipple-areola complex flap method in female to male gender affirming surgery
  1. Mari Irgens Bøkset1,
  2. Lena Felicia Carstensen2 and
  3. Jesper Poul Næsted Jensen1
  1. 1Department of Plastic Surgery, Sydvestjysk Sygehus, Esbjerg, Denmark
  2. 2Department of Breast Surgery, Sydvestjysk Sygehus, Esbjerg, Denmark
  1. Correspondence to Dr Mari Irgens Bøkset; mboekset{at}


Subcutaneous mastectomy plays a major role in female to male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola complex (NAC) flap, with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularisation. This case report describes how the novel approach may potentially be applied as an alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The technique is simple, provides an aesthetically appealing outcome and presumably poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or resizing of the NAC where required.

  • plastic and reconstructive surgery
  • surgery

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  • Contributors All authors have contributed equally to this manuscript.

  • Funding This study was funded by Odense Universitetshospital (406788).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.