ABSTRACT
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.
KEYWORDS
Perforator - body mass index - abdomen
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David W MathesM.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
