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Gender confirming mastectomy is safe in obese transgender males.

Al-Rahmani, Duquette, Sood, Gallagher
Indiana University School of Medicine
2017-02-15

Presenter: Farah Al-Rahmani

Affidavit:
Dr. Sood

Director Name: Dr. Rajiv Sood

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Purpose:
Transgender men who have undergone mastectomy report higher quality of life and reduced gender dysphoria. Transgender men are at increased risk of obesity. Many surgeons are reluctant to offer mastectomies in obese transgender men. The purpose of this study was to examine the relationship of BMI and morbidity in transgender patients undergoing mastectomy.

Methods:
A retrospective review of 27 consecutive patients undergoing mastectomy with free nipple graft was conducted. Demographics of enrolled patients were measured including age, BMI, and co-morbidities. Intra-op data measured included operative times, EBL, and weights resected. Outcomes included Hospital stay (LOS), as well as incidence of infection, seroma, and other complications. Patients were compared based on BMI.

Results:
Fifteen of the 27 patients had a BMI greater than 30. ASA, operative time and estimated blood loss (EBL) were higher in the obese group. The average ASA in the obese group was 2, vs 1 in the non-obese group. Average operative time was 195min for the obese group, vs. 163min (p=.02). Average EBL in the obese group was 123.3mL, vs. 43.9mL (p=.007) when BMI<30. Despite these differences BMI was not associated a statistically significant increase in the rate of infection (p=.34). There were no seromas and difference in LOS was not significant.

Conclusion:
Although obesity correlated with increased operative times and EBL, it did not correlate with increased morbidity. Mastectomy for transgender males with higher BMIs may not require deferral for weight loss.

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