Breast augmentation is a common gender-affirming surgery sought by transgender women and transfeminine people. Even with feminizing HRT, trans women typically do not experience the same degree of breast growth as cisgender women (Reisman, Goldstein, & Safer, 2019), and studies have indicated that 60% of trans women seek to undergo breast augmentation.
A recent abstract by Xu et al. (2019) examines a metric especially relevant to trans women: complication rates in breast augmentation. The authors note that complication rates for the procedure in cis women have been reported as ranging from 1.4 to 14.5%, before examining the cases of 96 transfeminine patients who underwent breast augmentation from 2017 to 2019. They found that complications of the procedure occurred in 20.5% of patients who were undergoing their first breast augmentation, and in 44.4% of those who were undergoing reoperation after an earlier breast augmentation:
Mean age was 37.9 years (range, 21 to 60 years). Primary augmentation was performed in 81% of patients, and 19% presented for secondary augmentation. Ninety-two patients returned for follow-up, with a mean follow-up time of 5.5 months (range, 4 days to 27.4 months). The overall complication rate was 20.5% in primary augmentation patients and 44.4% in secondary.
19 of the 24 patients with complications needed a revision procedure, and the complications experienced were reported as follows:
Complications included 17 cases of capsular contracture, 4 wound dehiscence, 2 seromas, 2 synmastias, 2 implant migrations, 1 hematoma, 1 SSI, 1 implant infection, and 1 implant extrusion. Baker grade III/IV capsular contracture was noted in 7.7% of primary augmentation patients and 33% of secondary augmentation patients.
Even in cisgender women, breast augmentation has been noted to be “one of the most regularly performed interventions requiring reoperation in aesthetic surgery”, with the contracture of the tissue surrounding the implant being “one of the most frequent complications of breast augmentation” (de Benito & Sanchez, 2010). The current study helps to inform trans women seeking breast augmentation of how likely they are to face complications, what those complications can be, and whether these complications will require additional procedures to resolve. ■
