SO20. Complications Following Gender-affirming Mastectomy: An Administrative Claims Analysis of Over 5800 Patients

PURPOSE: Gender-affirming mastectomy (GAM) is the most requested gender-affirming procedure. Previous studies examining complications following GAM have been limited by small sample sizes or single-institution data. We aimed to evaluate the frequency of complications and revisions following GAM in a national administrative claims dataset. METHODS: We utilized the PearlDiver database, containing administrative claims records from over 165 million patients insured by multiple payors from 2010-2022. Using CPT codes, we identified a subset of patients who underwent GAM from a sample of gender-diverse individuals. Basic demographic information in addition to complication rates and revision procedure rates were collected for patients who underwent GAM. RESULTS: Of the 5808 patients who underwent GAM, 789 (13.6%) experienced at least one postoperative complication. The most common complications included postoperative scarring (6.5%), postoperative pain (3.3%), and sensory disturbances (2.4%). Scar revision was the most common revision procedure (3.1%), followed by nipple-areolar reconstruction (0.7%), and chest contouring (0.3%). There were no recorded instances of VTE. CONCLUSION: In this study, GAM is found to have low rates of complications and revisions. Supported by recent studies demonstrating low regret and high satisfaction following GAM, we believe this study provides further evidence for the safety of this procedure in one of the largest cohorts of GAM patients to date. Future work should explore predictors of complications for patients undergoing GAM.