Are Prophylactic Postoperative Antibiotics Necessary after Masculinizing Mastectomy with Free Nipple Graft? A Single-institution Retrospective Review

Antibiotic overuse, particularly in the postoperative period, has contributed substantially to increased rates of antibiotic resistance. Despite insufficient evidence to support prolonged prophylactic antibiotics following the majority of plastic surgery operations, and societal recommendations against the practice, many surgeons continue to perpetuate this cycle. Regarding “newer” operations, wherein minimal data pertaining to antibiotic use have been published, decision-making is often based on historical tradition. As such, continued communication of relevant data is essential to inform best practice guidelines. The aim of this case series was to report postoperative outcomes following chest masculinization with free nipple grafts performed according to a strict antibiotic protocol, which restricted prophylaxis to a single preoperative dose, in the absence of specific risk factors indicating a need for postoperative antibiotics. In this case series featuring 62 consecutive patients undergoing chest reconstruction with 124 free nipple grafts, there were no nipple losses or nipple graft infection events.