BACKGROUND: Gender-affirming surgery provides a psychosocial benefit to transgender women. However, increased medical complexity within the transgender population has limited access for some transgender women. This study compared patient population comorbidities and 30-day peri-operative safety following primary augmentation mammoplasty between cis- and transgender women. METHODS: Data were extracted from the National Surgical Quality Improvement Program (NSQIP) database between 2007 and 2016. Transgender patients were identified using ICD-9 &10 codes for gender dysphoria. Categorical variables were compared using chi-squared and Fisher's exact tests while independent t-tests were used for continuous variables. Statistical significance was set at P<0.05. RESULTS: There were 4,234 breast augmentations identified in cisgender women and 137 in transgender women. Transgender women had a higher frequency of ASA-II and ASA-III patients (P<0.001), diabetes (P<0.001), hypertension (P=0.006), and active smoking status (P<0.001). Despite the higher comorbidity burden and routine use of hormonal therapy, there were no significant differences between populations in major or minor peri-operative complication rates. CONCLUSIONS: Top surgery improves quality of life in transgender women. Despite the more complex pre-operative risk profile in the transgender population, there is no difference in peri-operative safety profiles. Plastic surgeons treating this patient population should consider more liberal surgical indications for reconstructive top surgery compared with cosmetic breast augmentation. 2021 Annals of Translational Medicine. All rights reserved.
BACKGROUND: Gender-affirming surgery provides a psychosocial benefit to transgender women. However, increased medical complexity within the transgender population has limited access for some transgender women. This study compared patient population comorbidities and 30-day peri-operative safety following primary augmentation mammoplasty between cis- and transgender women. METHODS: Data were extracted from the National Surgical Quality Improvement Program (NSQIP) database between 2007 and 2016. Transgender patients were identified using ICD-9 &10 codes for gender dysphoria. Categorical variables were compared using chi-squared and Fisher's exact tests while independent t-tests were used for continuous variables. Statistical significance was set at P<0.05. RESULTS: There were 4,234 breast augmentations identified in cisgender women and 137 in transgender women. Transgender women had a higher frequency of ASA-II and ASA-III patients (P<0.001), diabetes (P<0.001), hypertension (P=0.006), and active smoking status (P<0.001). Despite the higher comorbidity burden and routine use of hormonal therapy, there were no significant differences between populations in major or minor peri-operative complication rates. CONCLUSIONS: Top surgery improves quality of life in transgender women. Despite the more complex pre-operative risk profile in the transgender population, there is no difference in peri-operative safety profiles. Plastic surgeons treating this patient population should consider more liberal surgical indications for reconstructive top surgery compared with cosmetic breast augmentation. 2021 Annals of Translational Medicine. All rights reserved.
Entities:
Keywords:
Transgender; breast augmentation; gender transition; outcomes; top surgery
Authors: K Wierckx; E Elaut; E Declercq; G Heylens; G De Cuypere; Y Taes; J M Kaufman; G T'Sjoen Journal: Eur J Endocrinol Date: 2013-09-13 Impact factor: 6.664
Authors: Darios Getahun; Rebecca Nash; W Dana Flanders; Tisha C Baird; Tracy A Becerra-Culqui; Lee Cromwell; Enid Hunkeler; Timothy L Lash; Andrea Millman; Virginia P Quinn; Brandi Robinson; Douglas Roblin; Michael J Silverberg; Joshua Safer; Jennifer Slovis; Vin Tangpricha; Michael Goodman Journal: Ann Intern Med Date: 2018-07-10 Impact factor: 25.391
Authors: Cecilia Dhejne; Paul Lichtenstein; Marcus Boman; Anna L V Johansson; Niklas Långström; Mikael Landén Journal: PLoS One Date: 2011-02-22 Impact factor: 3.240