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Breast Reconstruction Completion in the Obese: Does Reconstruction Technique Make a Difference in Its Achievement?
Christine Velazquez1, Robert C Siska2, Ivo A Pestana2
1Department of General Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina.
Journal of Reconstructive Microsurgery
|April 1, 2021
Summary
Obese women undergoing breast reconstruction have better outcomes with autologous tissue procedures compared to implants. Major complications in implant reconstruction significantly reduced completion rates, highlighting autologous reconstruction
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Breast reconstruction aims to create breast mounds and nipple-areolar complexes.
- Obesity (BMI ≥30) increases perioperative risks in breast reconstruction compared to normal BMI.
- Reconstruction technique and complications may impact completion rates in obese women.
Purpose of the Study:
- To evaluate if reconstruction technique and perioperative complications influence breast reconstruction completion in obese women.
- To compare outcomes between autologous and implant-based breast reconstruction in obese patients.
Main Methods:
- A consecutive series of obese women (BMI ≥30) undergoing mastectomy with either implant or autologous reconstruction were analyzed.
- Data collected included reconstruction completion rates for breast mounds and nipple-areolar complexes (NAC).
- Perioperative complications requiring hospital readmission or unplanned surgery were assessed.
Main Results:
- Autologous reconstruction showed higher completion rates for both breast mounds (>98%) and NAC (57%) compared to implant reconstruction (76% and 33%, respectively).
- Major perioperative complications were significantly more frequent in the implant group (p ≤ 0.0001).
- Autologous reconstruction was associated with significantly higher odds of completing both the breast mound (OR 3.32) and NAC (OR 2.7).
Conclusions:
- Major complications in implant-based breast reconstruction negatively impact overall completion rates.
- Obese women undergoing autologous breast reconstruction demonstrate a higher likelihood of successful reconstruction compared to those receiving implants.
