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Writer's pictureGender Equity

GEIGS Interview Dr. Gisele Botega: A Talk About Gender-affirming Mastectomy.

We’re starting a new series: GEIGS interviews. We’re going to talk with inspirational surgeons around the world. The first one is Dr. Gisele Botega, a plastic surgeon who’s doing amazing work with the transgender population in Brazil. Dr. Botega is currently a Titular Member of the Brazilian Society of Plastic Surgery.


During our talk, we approached her work and the development of her career. It goes without saying that Dr. Botega is an outstanding surgeon, but more importantly, a person. We're really happy with the opportunity to learn further about this new field, in which concepts and guidelines are still being formed.


We wish Dr. Botega all the best and once again, we appreciate the opportunity. ✨💜



In your opinion, what factors have contributed the most to building your career so far?

"The factor that most contributed was the experience of a job that makes me happy and gives me pleasure. It’s not easy, but when you achieve the balance between work and personal fulfillment, things like waking up early/ sleeping late, giving up some leisure activities and free days, and studying becomes easier and more natural."


How did your work with the trans population begin and why did you decide to go into this area of plastic surgery?

"My work with the trans population started in a very natural way, with the dissemination occurring spontaneously among previously operated patients satisfied with the results of their surgery. As the patients emerged, my interest also grew and I started to dig into the studies and learn even more. Then, I realized that I was professionally fulfilled by experiencing the paramount improvement in quality of life after the surgery. In a way, the victory of these patients turned into mine as well."


What is Gender-affirming Mastectomy surgery like?

"Gender-affirming Mastectomy is an important surgery for transmasculine and non-binary patients. Simplifying the process, it’s done through the total/partial removal of the mammary gland and the excess skin. Then repositioning and resizing the areolas, to make the breasts and chest more masculine in appearance."


Does the patient need to follow any prerequisites regarding age, follow-up with a multi-professional team, etc. before performing the surgery?

"In Brazil, patients must be at least 18 years old and be followed up by a multidisciplinary team psychologist, psychiatrist, and endocrinologist) for at least 1 year before surgery indication."


How do patients report feeling after the surgery?

"The description almost always refers to the conquest of freedoms. Freedom to dress without compression bands like the binder and to go to the beach and pool environments without wearing t-shirts. Also, the relief of having a chest in harmony with your gender identity. The achievement of passing (means the possibility of a person being socially read as a member of an identity group) is a milestone in increasing the quality of life for these men."

Do you see the need for something different in the care of these patients?

"Definitely the most important thing to improve care for the trans population is information. Education breaks down the main barrier to quality care, which is prejudice. Ignorance generates discrimination that makes ethical and quality care unfeasible."

What advice would you give to a medical student/surgery resident who would like to go down this path?

"The tip for the medical student who wants to follow the path of surgery and, in particular, surgery in the transgender population is to study beyond the book. Listen to your patient, pay attention to the demands of each one and respect their singularities. The field of gender identities is new and the concepts and protocols are still being formed. Free yourself from preconceptions and offer your best in a respectful way. Besides, working with a team equally respectful and dedicated, so you will work in harmony, always following ethical precepts that guide medical life."




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