Breast Augmentation in Transgender Women: A Prospective Comparative Study

Area of Science:

• Plastic Surgery
• Gender Affirming Care
• Surgical Outcomes Research

Background:

• Breast augmentation is integral to chest feminization for assigned male at birth patients (AMABp).
• Both inframammary and periareolar approaches are utilized, but comparative outcome data are limited.
• This study compares surgical outcomes, complications, and patient satisfaction between these two techniques.

Purpose of the Study:

• To evaluate and compare the inframammary and periareolar approaches for breast augmentation in transgender women.
• To assess surgical outcomes, complication rates, and patient-reported satisfaction using the BREAST-Q questionnaire.
• To provide evidence-based insights for surgical decision-making in chest feminization.

Main Methods:

• Prospective study of 95 assigned male at birth patients undergoing primary breast augmentation.
• Patients chose between periareolar or inframammary incision after counseling.
• Outcomes and BREAST-Q satisfaction scores were assessed at least 12 months postoperatively.

Main Results:

• No significant differences in overall complication rates (3.7%) between the two groups.
• Inframammary approach showed a higher rate of secondary aesthetic revisions (28.6% vs. 7.5%).
• High patient-reported satisfaction (BREAST-Q scores) was observed in both groups.

Conclusions:

• Both periareolar and inframammary breast augmentation offer comparable complication rates and patient satisfaction.
• Patient choice in incision type, combined with either approach, leads to high satisfaction in chest feminization.
• The inframammary approach may require more aesthetic revisions compared to the periareolar approach.