Perioperative Blood Pressure and Hematoma Risk After Gender-Affirming Mastectomy

Hematoma is one of the most common complications following gender-affirming mastectomy, with reported rates varying widely across published series1. Prior studies in breast and aesthetic surgery have demonstrated an association between perioperative blood pressure fluctuations, particularly intraoperative hypotension, and postoperative hematoma formation2-4. However, the role of perioperative hemodynamics has not been specifically evaluated in gender-affirming top surgery. We hypothesized that lower intraoperative mean arterial pressure (MAP), as well as large increases in MAP from the intraoperative to immediate postoperative period, would be associated with increased hematoma risk following gender-affirming mastectomy.