Dual-Plane versus Prepectoral Breast Reconstruction in High-Body Mass Index Patients

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Breast reconstruction in high body mass index (BMI) patients (≥30 kg/m) presents unique challenges.
• Increased postoperative complications are a concern in this demographic.
• Optimal surgical techniques for high-BMI patients remain under investigation.

Purpose of the Study:

• To compare complication rates between prepectoral and dual-plane breast reconstruction techniques.
• To determine if the plane of reconstruction influences postoperative outcomes in high-BMI patients.
• To identify independent predictors of complications in this population.

Main Methods:

• Retrospective analysis of high-BMI patients undergoing immediate expander/implant breast reconstruction.
• Stratification of patients based on reconstructive approach: dual-plane versus prepectoral.
• Multivariate logistic regression to assess the independent impact of reconstruction plane on complication rates.

Main Results:

• The prepectoral group (n=68) had significantly lower rates of seroma, surgical-site infection, capsular contracture, and overall complications compared to the dual-plane group (n=65).
• Multivariate analysis identified dual-plane reconstruction as an independent predictor of increased complications.
• Dual-plane reconstruction was associated with a 3-fold increased odds of any complication versus the prepectoral approach.

Conclusions:

• The prepectoral approach demonstrates a lower risk of postoperative complications in high-BMI patients undergoing immediate expander/implant breast reconstruction.
• Prepectoral reconstruction may represent a superior option for managing breast reconstruction in patients with high BMI.
• Further research can validate these findings and refine surgical strategies.