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Are Drains Necessary in Gender Affirming Mastectomy? Outcomes from 20 Patients
Sabrina Almashni BS, Taborah Z. Zaramo BS, Renee Barry MD, Kerry-Ann S. Mitchell MD PhD
The Ohio State University Department of Plastic and Reconstructive Surgery
2023-02-10
Presenter: Sabrina Almashni
Affidavit:
This is orginal work
Director Name: Gregory D. Pearson, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
INTRODUCTION:
Gender-affirming mastectomy (top surgery) is performed to achieve a gender congruent and aesthetically pleasing chest. Closed-suction drains are commonly utilized to mitigate seromas. However, drains may increase scarring, pain, and number of clinic visits. The aim of this study was to evaluate clinical outcomes and adverse events in patients undergoing drainless top surgery.
METHODS:
An IRB approved retrospective chart review was performed on a series of 20 patients who underwent drainless top surgery between 2020- 2022 by a single surgeon. In the surgical approach, progressive tension sutures were used to anchor the mastectomy flaps and eliminate the dead space. Age, BMI, smoking status, diabetes, mastectomy specimen weights and post operative pain measurement were curated. Two sample t-test and Fishers exact test were used to assess significance in risk factors and postoperative complications.
RESULTS:
Of the 20 patients, one had a major complication, which was a pulmonary embolus (PE) requiring readmission and anticoagulation. There was also a small hematoma that resolved with conservative management and one superficial surgical site infection treated with antibiotics. No patient had a seroma or required reoperation. Anecdotally, patients reported improvement in their overall quality of life after surgery. There was no significant difference in demographic data, medical comorbidities, or mastectomy specimen weight in patients with complications versus those without (p>0.05).
CONCLUSION:
These results showed no increased risks of complications in a drainless approach compared to published studies utilizing drains for gender-affirming mastectomy. Further, a drainless approach may decrease postoperative pain and increase patient satisfaction.
