Body Contouring
Related to gender affirmation surgery, silicone or saline breast implants in trans-females often evidence as incidental notations on chest radiography, CT, and MRI, yet the most common body contouring gender affirmation surgery is subcutaneous mastectomy. Since the nipple-areola complex is preserved, retaining malignant transformation risk, Doo et al. recommend trans-males submit to regular postsurgical breast cancer screening. Likewise, trans-female patients who have undergone neoadjuvant hormone replacement therapy have an increased risk for breast cancer and should be routinely screened.
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Regarding soft-tissue placement for desired aesthetic results, according to Doo: “the sequelae of fat augmentation, including complications such as fat necrosis, are seen incidentally on radiologic imaging and are not routinely evaluated postoperatively. Because of many factors, patients may instead choose to obtain gluteal silicone injections or implants, which may also be incidentally encountered on routine imaging, either as stand-alone findings or as complications including granulomas and emboli to the brain or lungs.”
Maxillofacial Contouring
Preoperative medical imaging, especially for facial feminization, is utilized to assess the anatomical need for frontal eminence reduction, with surgeons downstream referencing a skull radiograph to evaluate sinus cavity size and anterior table thickness. Meanwhile, Illegal silicone injections, long targeted toward all transgender populations, typically register incidentally on imaging studies, as do facial augmentations achieved via neurotoxin injections or fillers, such as calcium hydroxylapatite or hyaluronic acid. As Doo explains, “postoperative imaging is not typically obtained because external aesthetic results can be adequately evaluated by the surgeon,” unless unique complications with radiologic correlates—bony erosions from impaction of alloplastic silicone prostheses or bone and cartilage autografts, embolization from injection or filler materials, etc.—present themselves.
“Otherwise,” Doo says, “radiologists may typically see incidental uncomplicated postsurgical findings on routine head and neck imaging.”
About ARRS
Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiology society in the North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, topical symposia and AJR Live Webinars, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.
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