Plastic Surgery Research Council

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Analysis of Top Surgery Results in the Female to Male Transgender Patients: Demonstrating High Satisfaction Beyond Aesthetic Outcome Using Advanced Linguistic Analyzer Technology and Social Media
Cara K. Black, BA, Kenneth L. Fan, MD, James Economides, MD, Rachel Camden, MS, Gabriel Del Corral, MD.
MedStar Georgetown University Hospital, Department of Plastic and Reconstructive Surgery, Washington, DC, USA.

Background: Subcutaneous mastectomy is a surgical option for patients wishing to undergo the female to male transition after appropriate medical therapy. Satisfaction rates are reported as high after the procedure. We examined patient satisfaction based on linguistic analysis of social media posts showing post-operative results and compared them to aesthetic quality ratings from plastic surgeons.
Methods: Fifty images of subcutaneous mastectomy post-operative results of female to male gender transition patients were selected from Instagram. The photo's corresponding post and comments were then analyzed for sentiment through the IBM Watson tone analyzer, which rated the presence of joy on a continuous scale from 0 to 1. Three plastic surgeons rated aesthetic quality on a nominal scale of 1 to 10. Results of both analyses were then compared.
Results: Joy was rated as a mean value of 0.74(0.13) in posts and 0.81(0.13) in comment clusters. The mean ratings of the post-operative results were found to be: chest contour 6.1/10(1.7), scar position 5.3/10(1.8), scar quality was 4.8(1.9), nipple position 5.2/10(1.9), and nipple quality 5.1/10(2.0). There was no association between the level of joy detected and the ratings of the results by plastic surgeons(p>0.05).
Conclusions: Despite wide variety in surgical appearance, there is a high level of satisfaction and social support. This is in contrast to the quality ratings by plastic surgeons. This demonstrates the strong psychological and functional underpinnings top surgery has for patients. Further quality of life outcome measures are required to elucidate subtilties in outcome.


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