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Effect of Preoperative Testosterone on Gender-Affirming Mastectomy Outcomes
Alissa Haas MPH, Katelyn Stevens, Margaret Bello, Mary Holohan MEd, Mira Prabhakar, Ivan Hadad MD
Indiana University School of Medicine
2023-02-10
Presenter: Alissa Haas
Affidavit:
William Wooden
Director Name: William Wooden
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: Gender-affirming mastectomies have increased in accessibility over the past decade, with upwards of a 13-fold increase in procedures performed. Further assessment of risk factors, including exogenous testosterone use, would improve patient outcomes. Despite numerous investigations over the past decade, there has not been consensus regarding a relationship between testosterone use and post-op complications. We aim to further elucidate any association that may exist.
Methods: A retrospective review of patients undergoing gender-affirming mastectomy was conducted over 32 months. The relationship between preoperative testosterone use and post-operative complications and revisions were evaluated.
Results: 228 patients who underwent gender-affirming mastectomy were identified. 210 patients took testosterone preoperatively (92.1%). Mean time on testosterone was 2.49 years (SD 2.16). There was no difference between patients who were on testosterone and those who were not in rates of revisions (p = 0.424) or complications (p = 0.615). There was no difference in time on testosterone for revision or no revision groups (p = 0.189). Time on testosterone was longer for those who had complications (4.34 vs 2.31 years), though not significant (p= 0.08).
Conclusion: Our results show that testosterone use had no significant effects on rates of revisions or complications in gender affirming mastectomy patients. Additionally, time on testosterone did not have an effect. We suggest that use of gender-affirming hormones preoperatively is not a contraindication in these procedures. Further research is necessary to assess other risk factors for complications and revisions and to compare results across a range of patients, surgeons, and hospitals.
