The Plastic Surgery Foundation
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Grants We Funded

Grant applicants for the 2023 cycle requested a total of nearly $4 million dollars. The PSF Study Section Subcommittees of Basic & Translational Research and Clinical Research evaluated nearly 140 grant applications on the following topics:

The PSF awarded research grants totaling over $1 million dollars to support nearly 30 plastic surgery research proposals.

ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.

Long-Term Patient-Reported Outcomes Following Gender-Affirming Mastectomy

Principal Investigator
Alexander Khouri MD


The Regents of the University of Michigan

Funding Mechanism
Pilot Research Grant

Focus Area
Other, Breast (Cosmetic / Reconstructive)


Impact Statement: Gender-affirming mastectomy is the most commonly performed gender affirming surgery. No recent high-quality studies have evaluated patient satisfaction and decisional regret in transgender and gender diverse patients many years after the operation. These results would assist patients, physicians, payers, and policymakers in making evidence-based decisions regarding transgender care. A low amount of regret and high patient satisfaction may influence more support for these procedures, including improved insurance coverage and national policies that would increase access to health care for transgender and gender diverse individuals. Results from this study will also generate pilot data for a larger, multicenter study.

Project Summary: Recent estimates suggest that ~2% of the US population identifies as transgender and gender diverse (TGD). Gender-affirming mastectomy (GM) is the most commonly performed gender-affirming surgery for TGD individuals, specifically transmen (i.e., people who are assigned female at birth but identify as male). This procedure is cost-effective and associated with high rates of patient satisfaction and improved quality of life. Opponents of gender affirmation surgery highlight the irreversibility of the procedure and the potential for long-term patient regret. While patient reports and anecdotal evidence from gender surgeons advocate that the rate of regret is low, no recent high-quality studies have evaluated decisional regret and long-term patient-reported outcome measures (PROMs) in this population. We will design and conduct a retrospective cross-sectional cohort pilot study examining long-term PROMs following GM in patients who underwent surgery at the University of Michigan between 1990 and 2019, specifically analyzing the prevalence of decisional regret and long-term patient satisfaction. Results from this study will assist patients, physicians, insurance payers, and national policymakers in making evidence-based decisions regarding transgender care. Further, these findings will lay foundation for a longitudinal, multicenter study evaluating PROMs after GM which may have broader impact on TGD patient's access to health care. The specific aims for the pilot study are as follows: Aim 1: Using validated PROMs, evaluate long-term patient satisfaction and decisional regret among TGD patients undergoing gender-affirming mastectomy. Secondary outcomes assessed will include long term gender-identity congruence, body image, and psychosocial well-being. We hypothesize that patients will report high levels of satisfaction and low decisional regret in the years following GM. Aim 2. Establish and refine a 1) patient contact protocol; 2) data collection process for survey results and medical records; and 3) scalable electronic database for a longitudinal, cross-sectional, multicenter study. We hypothesize that these milestones will be feasible given the experience of our team.

Dr. Alexander Khouri is a third year Plastic Surgery resident at the University of Michigan. He completed his undergraduate studies from Washington University in St. Louis and medical school at the University of Michigan. He has accrued a broad academic skillset with research ranging from award-funded translational benchwork to outcomes-based clinical studies. Over the course of residency, he has developed a passion for hand surgery and is now committed to pursuing a career in the field under the academic and clinical mentorship of Dr. Kevin Chung. His research interests have transitioned to healthcare policy research related to hand surgery and he is now actively publishing in the field.