{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:17:31Z","timestamp":1789694251507,"version":"4.0.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Transgender Health"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Often, body mass index (BMI) thresholds may be used to determine surgical candidacy in gender-affirming chest masculinization, but evidence for using these as surgical criteria has not been established. We sought to analyze a national cohort of patients undergoing mastectomy for gender affirmation to assess the risk of postoperative complications among different BMI categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The National Surgical Quality Improvement Program database (from 2010 to 2020) was queried to identify all encounters of mastectomy for gender affirmation. Cases were stratified by BMI categories and 30-day postoperative medical and surgical complications were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 10,775 patients were queried. The overall proportions of medical complications remained low for all groups. Incremental increases in the proportions of readmission, return to the operating room, wound infection, and wound dehiscence were observed with each increase in BMI category (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.001). A multivariate regression model controlling for age, diabetes, American Society of Anesthesiologists (ASA) class, and operative time demonstrated a statistically significant increase in odds ratio (OR) for complications in the obesity II (OR 1.59,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001) and obesity III (OR 1.85,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001) cohorts. Age (OR 1.08,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001), diabetes (OR 1.4,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.016), and increased operative time (OR 1.22,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001) were independently associated with an increase in odds of surgical complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>While the obesity II and III cohorts experienced increased odds of complications, the authors suggest that these complications are not prohibitive. In the setting of comprehensive informed consent, obesity alone should not act as a contraindication to surgery in suitable candidates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/trgh.2023.0112","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T14:25:14Z","timestamp":1698330314000},"page":"178-184","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Association of Body Mass Index Category and Postoperative Complications in Gender Affirming Mastectomy for Chest Reconstruction"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3428-1579","authenticated-orcid":false,"given":"Jessica L.","family":"Marquez","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Utah Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack D.","family":"Sudduth","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Utah Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Utah Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin","family":"Eddington","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Utah Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cori","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Utah Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001738"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2022.2100644"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004827"},{"issue":"1","key":"e_1_3_5_5_2","first-page":"49","article-title":"Female-to-Male gender affirming top surgery: A single surgeon's 15-Year retrospective review and treatment algorithm","volume":"38","author":"McEvenue G","year":"2017","unstructured":"McEvenue G, , Xu FZ, , Cai R, et al. Female-to-Male gender affirming top surgery: A single surgeon's 15-Year retrospective review and treatment algorithm. Aesthetic Plast Surg, 2017; 38(1):49\u201357; doi:10.1093\/asj\/sjx116","journal-title":"Aesthetic Plast Surg"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-005-0201-2"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.5440"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-020-01883-z"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13178-017-0295-8"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.6231"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000005367"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.20517\/2347-9264.2021.130"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2020.0068"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000882"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1457496916645964"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2011.11.053"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003388"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjz335"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002712"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2015.0076"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.14485\/HBPR.1.2.8"},{"key":"e_1_3_5_22_2","unstructured":"American College of Surgeons. American College of Surgeons national surgical quality improvement program. Chicago IL; 2023. Available from: https:\/\/www.facs.org\/quality-programs\/acs-nsqip\/about [Last accessed: Februrary 3 2023]."},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002316"},{"issue":"3","key":"e_1_3_5_24_2","first-page":"299","article-title":"Downsizing obesity: On Ancel Keys, the origins of BMI, and the neglect of excess weight as a health hazard in the United States from the 1950s to 1970s","volume":"74","author":"Rasmussen N","year":"2019","unstructured":"Rasmussen N. Downsizing obesity: On Ancel Keys, the origins of BMI, and the neglect of excess weight as a health hazard in the United States from the 1950s to 1970s. 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