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Evaluation of Obesity as a Risk Factor for Complications and Revisions in Gender Affirming Mastectomy
Alissa Haas MPH, Margaret Bello, Mary Holohan MEd, Steven Liu, Keeley Newsom, Ivan Hadad MD
Indiana University School of Medicine
2023-01-31
Presenter: Alissa Haas
Affidavit:
Alissa Haas
Director Name: William Wooden
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose/Background: A dramatic increase in gender-affirming mastectomies (GAS) over the past decade requires a better understanding of post-operative complications and risk factors. Previous studies have indicated a need for further assessment for patients with a BMI >40 kg/m2. Additionally, there is no literature assessing the association between body surface area (BSA) and postoperative complications and revisions. Our study aims to further understand the role that BMI and BSA play in outcomes of gender-affirming mastectomy.
Methods: A retrospective review of patients undergoing GAS was conducted over 32 months. Surgical and demographic information were collected by manual chart review. The primary outcomes of interest were postoperative complications and revisions.
Results: 227 patients who underwent gender-affirming mastectomy were identified. Average BMI was 31.1 (SD, 8.6), and average BSA was 1.91 (SD, 0.3). 8.8% of patients had postoperative complications and 8.1% had revisions. There was no difference in occurrence of complications (p= 0.63) or revisions (p= 0.317) between BMI categories alone or when controlling for testosterone use, smoking, past medical history, and psychological diagnosis. There was no difference in mean BSA between patients who had complications (p=0.59) or revisions (p=0.95) compared to those who did not.
Conclusions: Our investigation suggests GAS do not result in increased postoperative complication or revision rate on patients classified as overweight or obese. Therefore, obesity should not be used as a standalone contraindication to these life-improving procedures. Continued evidence is needed, including further research into other risk factors for postoperative complications and revisions.
