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

Abstract

Background Implant-based breast augmentation is a gold standard procedure for transfeminine patients to create a more feminine-appearing chest. In many cases, ancillary procedures are performed simultaneously to achieve an optimal aesthetic result. Objectives To determine the clinical outcomes of patients undergoing feminizing gender-affirming breast surgery in a single academic institution. Methods A retrospective electronic chart review of feminizing gender-affirming breast surgery patients at Mayo Clinic, Rochester from 2017 to 2022 was conducted. Patients demographics and surgical outcomes were gathered. A survival analysis was performed to obtain the time-to-event complication rate. Results Over 5 years, 46 patients (92 breasts) were included. The mean age was 39 years (SD ±15), and most had an above-normal Body Mass Index (58.7%). Thirty (65%) had previous gender-affirming surgeries. The mean implant volume was 289 ml (SD ±95; 140 - 520). Most implants were placed in a subglandular plane (81%) with an inframammary fold incision (91.3%). All implants used were smooth round cohesive silicone gel implants. Ancillary procedures were performed in thirty-two patients (69.57%). Eight patients presented complications (4 major vs 4 minor) in a median postoperative follow-up of 372 vs 392 days; at 1-month follow-up, the probability of a complication to have occurred is 2.17% (95% CI: 0–6.3%) vs 5% (95% CI: 0–11.5%) and at 1 year is 10.21% (95% CI: 0–20.9%) vs 12.5% (95% CI: 0–23.4%) ​which remain the same up to 4 years. Conclusions Breast augmentation with implants is a safe procedure to achieve feminization of the breast with a low rate of complications.