Complications and satisfaction in transwomen receiving breast augmentation: short- and long-term outcomes

Abstract

Background To achieve long-term improvement in health care of transgender women, it is necessary to analyze all aspects of gender-confirming surgery, especially the relation of risks and benefits occurring in these procedures. While there are many studies presenting data on the urologic part of the surgery, there are just few data about complications and satisfaction with breast augmentation. Methods This is a retrospective study using parts of the BREAST-Q Augmentation Questionnaire and additional questions for symptoms of capsular contracture and re-operations and analyzing archived patient records of all transwomen which were operated at University Hospital Essen from 2007 to 2020. Results 99 of these 159 patients (62%) completed the questionnaire after a median time of 4 years after surgery. Breast augmentation led to re-operations due to complications in 5%. The rate of capsular contracture (Baker Grad III–IV) in this population was 3%. Most patients (75%) rated high scores of satisfaction with outcome (more than 70 points) and denied to have restrictions due to their implants in their everyday life. All patients reported an improvement in their quality of life owing to breast augmentation. Conclusion Breast augmentation by inserting silicon implants is a safe surgical procedure which takes an important part in reducing gender dysphoria.

Patient Satisfaction Using BREAST-Q and Breast Implant Illness after Breast Reconstruction in Transwomen

“… 5 Considering that all surgery is associated with risk and potential complications, it is essential to understand patient satisfaction outcomes postoperatively. 6 This study demonstrates improved satisfaction in transwomen at 6 months and 12 months postoperative in measures of psychosocial, sexual well-being, and overall satisfaction with breasts. Although the physical well-being of the chest worsened at 6 months postoperatively, it improved between the 6-month and 12-month time point.…”

“…Prior literature on textured implants showed either no change in physical well-being or no restriction in daily activities. 5 , 6 Worsening of physical well-being in the first 6 months is likely multifactorial. Symptoms may be associated with postoperative pain, tightness of the implant, breast pain with heavy lifting, and difficulty sleeping on the chest.…”

Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

“…A total of 17 380 records were identified from the search, with 286 studies 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 ...…”

Feminizing Gender Affirming Breast Surgery: Procedural Outcomes at a Single Academic Institution

“…Despite the transgender cohort being older, having more comorbidities, and a higher average BMI, there was no noteworthy difference in 30-day complication rates between transgender and cisgender patients. 34 Other studies report a minor complication rate of 17.6%, 24 a major complication rate from 5% 35 to 42.8%. 26 One of the most frequently reported complications is capsular contracture.…”

“… 27 , 37 Despite these being the characteristics of most of our patients, except for the radiation (0%), we report a very low incidence of 2.17% similar to a study with a cohort of 159 patients with a 3% incidence. 35 A systematic review evidenced a 2.8% vs 8.6% rate of capsular contracture in submuscular vs subglandular planes. 30 Another study with a long follow-up of 15 years found no difference regarding pocket location and capsular contracture.…”