Complications Following Breast Augmentation In Transfeminine Individuals: A Systemic Review And Meta-Analysis

Document Type

Journal Article

Publication Date



Plastic and reconstructive surgery




BACKGROUND: Breast augmentation is the most commonly performed procedure for gender affirmation in transfeminine individuals. While adverse events among breast augmentation in cis-gender females were well-described, their relative incidence in transfeminine individuals patients is less elucidated. AIM: This study aims to compare complication rates after breast augmentation between cisgender females and transfeminine patients and to evaluate the safety and efficacy of breast augmentation in transfeminine individuals. METHODS: PubMed, the Cochrane Library, and other resources were queried for studies published up to Jan 2022. A total of 1864 transfeminine patients from 14 studies were included in this project. Primary outcomes including complications (capsular contracture, hematoma or seroma, infection, implant asymmetry/malposition, hemorrhage, skin or systemic complications), patient satisfaction, and reoperation rates were pooled. A direct comparison of these rates was performed against historical rates in cisgender females. RESULTS: Within the transfeminine group, pooled rate of capsular contracture was 3.62% ((95% CI, 0.0038-0.0908); hematoma/seroma was 0.63% ((95% CI: 0.0014-0.0134); infection incidence was 0.08% (95% CI, 0.0000-0.0054); implant asymmetry was 3.89% (95% CI, 0.0149-0.0714). There was no statistical difference between rates of capsular contracture (p=0.41) and infection (p=0.71) between the transfeminine vs cis-gender groups, while there were higher rates of hematoma/seroma (p=0.0095) and implant asymmetry/malposition (p<0.00001) in the transfeminine group. CONCLUSION: Breast augmentation is an important procedure for gender affirmation, and in transfeminine individuals carries relatively higher rates of post-operative hematoma and implant malposition relative to cisgender females.