Gender-affirming Mastectomy: Comparison of Periareolar and Double Incision Patterns

Area of Science:

• Plastic Surgery
• Gender-Affirming Care
• Surgical Outcomes

Background:

• Gender-affirming mastectomy is a common procedure for transgender and nonbinary individuals.
• Surgical technique variations exist, but their impact on outcomes is not well-established.
• This study compares periareolar and double incision mastectomy techniques.

Purpose of the Study:

• To compare patient demographics, risk factors, and surgical outcomes between periareolar and double incision mastectomy.
• To evaluate complication rates associated with different gender-affirming mastectomy techniques.

Main Methods:

• Retrospective review of 490 patients undergoing gender-affirming mastectomy between 2017 and 2020.
• Stratification of patients based on surgical technique: periareolar versus double incision.
• Comparison of demographic data and postoperative outcomes between the two groups.

Main Results:

• No significant differences in complication rates (hematoma, seroma) or need for revision procedures were observed between periareolar and double incision mastectomy.
• Demographics between the groups were similar.
• 490 patients included: 96 periareolar and 390 double incision mastectomies.

Conclusions:

• Surgical technique does not appear to impact postoperative complication or revision rates in gender-affirming mastectomy.
• Both periareolar and double incision techniques are safe and yield comparable outcomes when performed by an experienced surgeon with appropriate patient selection.