Abstract
Background
Obesity is a risk factor for breast cancer and may affect the incidence, and outcomes
of surgical treatment for breast cancer, including breast reconstruction.
Objective
This study aimed to evaluate outcomes of breast reconstruction in patients with obesity.
Methods
In a retrospective review of the NSQIP 2013-2018, adult patients who underwent breast
reconstruction were included. Procedures were categorized to with or without an implant.
Obesity was considered as body mass index(BMI)≥30 kg/m2. We made composite variables for 30-day any complication, wound complications, and
major complications. Regression analysis was used to identify the independent effect
of obesity on outcomes.
Results
A total of 46,042 patients were included(mean age 51.4 ± 11.1 years, 99.8% female).
There were 3134(6.8%) patients with any complication, 2429(5.3%) with major, and 2772(6%)
with wound complications, 2795 patients(6.1%) with unplanned re-operation, and 3 deaths.
Obesity was an independent predictor of any complication, major complications, and
wound complications(OR:1.83-1.87), and unplanned re-operation(OR:1.52). Wound complication
was lower in the implant group(3.7% vs 10.9%) but obesity had a higher odds of wound
complications in the implant group(2 vs 1.4). There was an increase in the odds of
complications as BMI rises.
Conclusion
Patients with a BMI>30 kg/m2 have a significantly higher risk of developing surgical
complications following breast reconstruction with both implant and tissue reconstruction.
Weight loss strategies should be considered in patients who need breast reconstruction
surgeries and this may decrease the risk of postoperative wound complication and the
need for reoperation.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Current trends in postmastectomy breast reconstruction.Plast Reconstr Surg. 2017; 140: 7s-13s
- Identification of complications in mastectomy with immediate reconstruction using tissue expanders and permanent implants for breast cancer patients.Breast Cancer. 2016; 23: 400-406
- A retrospective investigation of abdominal visceral fat, body mass index (BMI), and active smoking as risk factors for donor site wound healing complications after free DIEP flap breast reconstructions.J Plast Reconstr Aesthet Surg. 2018; 71: 827-832
- Effect of bariatric surgery on risk of complications after total knee arthroplasty: a randomized clinical trial.JAMA Netw Open. 2022; 5e226722
- Bariatric surgery to achieve transplant in end-stage organ disease patients: a systematic review and meta-analysis.Am J Surg. 2020; 220: 566-579
Article Info
Publication History
Published online: October 10, 2022
Accepted:
October 4,
2022
Received:
January 21,
2022
Footnotes
Financial Disclosures: None.
Presented at: The American College of Surgeons (ACS) Clinical Congress 2021.
Competing Interest: None.
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
