Summary
Background
Obesity is not only a causative factor for premature mortality, it has also been demonstrated
to be associated with an increased postoperative complication rate. As such, it has
traditionally been considered a relative contraindication to autologous breast reconstruction.
The purpose of this study was to assess whether this recommendation is justified.
Methods
A retrospective study was conducted analyzing the effect of obesity on complication
rate after microsurgical autologous breast reconstruction using abdominal tissue.
Patients undergoing breast reconstruction between November 2006 and February 2011
were included. In contrast to prior studies, only patients meeting criteria to undergo
bariatric surgery were included in the study, thus, representing a particularly high-risk
subset of patients (Group 1: BMI greater 40 kg/m2; Group 2: BMI greater 35 kg/m2 with co-morbidities).
Results
A total of 42 breast reconstructions were performed in 28 patients who met inclusion
criteria. Surgical complications were seen in a total of 9 patients (p = 1.00). All complications were successfully managed conservatively and did not prolong
hospitalization. No differences were seen among study groups with respect to donor-site
(p = 0.57) and recipient-site complications (p = 1.00). Of note, no partial or total flap loss was seen in this study.
Conclusions
Obesity is associated with a relatively high risk of minor complications postoperatively.
However, complications can typically be managed non-operatively and on an outpatient
basis with fairly minimal patient morbidity. We believe that obesity should not be
considered a relative contraindication to autologous microsurgical breast reconstruction.
Patients should, however, be informed preoperatively about their higher risk of postoperative
complications.
Keywords
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Article info
Publication history
Published online: October 24, 2011
Accepted:
October 3,
2011
Received:
August 24,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
