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J Reconstr Microsurg 2024; 40(09): 730-742
DOI: 10.1055/s-0044-1787266
Original Article

Microsurgical Breast Reconstruction can be Performed Safely in Patients with Obesity

Max L. Silverstein
1   Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
,
Sarah Sorice-Virk
1   Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
,
Derrick C. Wan
1   Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
,
Arash Momeni
1   Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
› Author Affiliations Funding None.
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Abstract

Background Numerous studies have shown that obesity is a risk factor for postoperative complications following breast reconstruction. Hence, obesity has traditionally been considered a relative contraindication to microsurgical breast reconstruction. In this study, we investigated the impact of obesity on outcomes following microsurgical breast reconstruction.

Methods A retrospective analysis of 200 consecutive patients who underwent microsurgical breast reconstruction with free abdominal flaps was performed. Subjects were divided into Nonobese (body mass index [BMI] < 30 kg/m2) and Obese (BMI ≥ 30 kg/m2) cohorts. Univariate and multivariate analyses were performed to evaluate differences in patient characteristics, complication rates, and efficiency metrics between the two groups.

Results Of the 200 subjects included in the study, 128 were Nonobese, 72 were Obese. The prevalence of diabetes (3.9 vs. 16.9%, p = 0.002) and hypertension (14.7 vs. 39.4%, p < 0.001) were significantly greater in the Obese cohort. Among unilateral reconstructions, postoperative length of stay (LOS) was longer among Obese patients (3.1 vs. 3.6 days, p = 0.016). Seroma occurred more frequently in Obese patients following bilateral reconstruction (5.7 vs. 0.0%, p = 0.047). Otherwise, there were no significant differences in complication rates between the groups. On multivariate analysis, BMI was not independently associated with complications, LOS, or operative time.

Conclusion The improvements in clinical and patient-reported outcomes that have been associated with postmastectomy breast reconstruction do not exclude obese women. This study indicates that microsurgical breast reconstruction can be performed safely and efficiently in patients with obesity.

Keywords

breast reconstruction - microsurgery - obesity


Publication History

Received: 02 February 2024

Accepted: 15 April 2024

Article published online:
30 May 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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