J Reconstr Microsurg 2009; 25(4): 237-241
DOI: 10.1055/s-0028-1104553
© Thieme Medical Publishers

Patient Body Mass Index and Perforator Quality in Abdomen-Based Free-Tissue Transfer for Breast Reconstruction

Jeffrey R. Scott1 , Stephen R. Sullivan1 , Daniel Liu1 , Kari Keys1 , F. Frank Isik2 , Hakim Said1 , David W. Mathes1
  • 1Division of Plastic Surgery, University of Washington Medical Center, Seattle, Washington
  • 2The Polyclinic, Seattle, Washington
Further Information

Publication History

Publication Date:
15 December 2008 (online)


Body mass index (BMI) must be considered when selecting patients suitable for abdomen-based microsurgical breast reconstruction. It is unknown whether BMI or age affects quality or quantity of abdominal wall perforating blood vessels. The purpose of this study was to identify differences in abdominal wall perforating blood vessels among patients with different BMI and age. A retrospective review was conducted of 66 patients undergoing abdomen-based microsurgical breast reconstruction tissue transfer from 2000 to 2006. Median age was 48.6 years (± 8.2). Patients were divided into BMI < 25 (28 patients), BMI 25 to 30 (26 patients), or BMI > 30 (12 patients). Perforator size and location was determined by ultrasound data. There was a greater number of perforators in horizontal zone II compared with the remaining zones (p < 0.05, Bonferroni corrected). There were no differences between age or BMI and the number of perforators or average perforator size per patient. A significant positive linear association was found between the average perforator diameter and total number of abdominal wall perforators. We concluded there is no anatomical difference in perforator quality among patients with varying BMIs ≤ 35. Zone II remains the most likely region for quality perforators. Abdomen-based microsurgical breast reconstruction is reasonable and safe for women with a BMI < 35.


David W Mathes, M.D. 

Chief, Seattle Veterans Affairs Hospital, Assistant Professor, Division of Plastic Surgery

University of Washington Medical Center, 1959 NE Pacific Street, Box 356410, Seattle, WA 98115

Email: dwmathes@u.washington.edu