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
