Patient Preferences for Postoperative Drains Following Gender Affirming Mastectomy: A Modified Standard Gamble...

Area of Science:

• Plastic Surgery
• Adolescent Medicine
• Gender-Affirming Care

Background:

• The necessity of postoperative drains in gender-affirming mastectomy is not well-established.
• Surgeons often decide drain use based on personal judgment due to a lack of consensus.
• Seroma formation is a potential complication of drainless procedures.

Purpose of the Study:

• To understand patient preferences and quantify risk tolerance for seroma formation and secondary procedures in gender-affirming mastectomy.
• To inform patient-centered discussions and surgical decision-making regarding drain use.

Main Methods:

• Adolescent patients undergoing or considering gender-affirming mastectomy were surveyed.
• A modified standard gamble approach assessed patient risk tolerance.
• Data collected on demographics and prior surgical history.

Main Results:

• Thirty adolescent participants (mean age 17.6 years) were recruited.
• Median risk tolerance for seroma formation was 15%; for secondary procedures, it was 10%.
• Risk tolerance did not significantly differ based on prior surgery or age.

Conclusions:

• Patient risk tolerance for seroma and secondary procedures in gender-affirming mastectomy is variable.
• Shared decision-making is essential for optimizing outcomes.
• Balancing patient preferences with surgical risks is key in surgical planning.