ABSTRACT
The adult female breast is often the most outstanding secondary sexual characteristic. In transsexual females the presence of developed breasts may impair appearance and be at odds with feelings of masculinity. The absence of developed breasts acts similarly in transsexual males. Management of the complications of injected breasts, by subcutaneous mastectomy with excision of involved parts of the underlying pectoralis muscle, has been reported in multiple patients. Subsequent formal breast augmentation in these patients has had poor results. The most common reason for dissatisfaction with augmentation is inadequate breast size. In R. C. Kanhai's series from Amsterdam, 68 of 107 patients were satisfied with their initial augmentation. Twelve were satisfied with subsequent augmentation, of which the average size was 265 ml. Eighteen remained dissatisfied, feeling their breasts were too small. Nine remained dissatisfied for other reasons, of which only one was because the breasts were too large.
