# Impact of Obesity on Outcomes of Gender-Affirming Mastectomies: A Single-Surgeon Experience

## TL;DR

This study finds that obesity does not increase complications in gender-affirming mastectomies, emphasizing the need for patient-centered care.

## Contribution

The study provides new evidence that obesity is not a significant risk factor for complications in this specific surgical context.

## Key findings

- Obese patients had higher resection weights and liposuction volumes compared to non-obese patients.
- No significant differences in complication rates were found between obese and non-obese patients.
- Obesity was not associated with increased postoperative complications in multivariate analyses.

## Abstract

Background: Gender dysphoria refers to the psychological distress arising from a mismatch between an individual’s physical embodiment and their internal sense of gender. Gender-affirming mastectomies can be a pivotal component of gender affirmation for transgender, non-binary, and gender expansive individuals assigned female at birth. The impact of obesity on the outcomes of gender-affirming mastectomies has yet to be fully defined. Methods: A retrospective review of 205 gender-affirming mastectomies performed by the senior author was conducted. Patients were categorized into obese (BMI ≥ 30) and non-obese groups. Baseline characteristics, intraoperative variables, and complication rates were compared. Univariate and multivariate models were performed to evaluate the association between obesity and postoperative complications. Results: Obese patients had higher mean resection weights and liposuction volumes (p < 0.001). Significant differences were observed in the prevalence of fibromyalgia, prior chest surgeries, and hormone therapy usage (p = 0.002, 0.002, and 0.03, respectively). However, no statistically significant differences were found in overall complication rates between obese and non-obese groups in the univariate or multivariate analyses. Conclusions: Our study suggests that obesity is not a significant risk factor for complications in gender-affirming mastectomies patients. The varying impact of high BMI and obesity on surgical outcomes in different surgical fields highlights the importance of patient-centered care and a holistic and individual approach for each patient.