Obesity and Complications in Mammoplasty: A Retrospective Review in an Obese Patient Population

With trends of obesity increasing, plastic surgeons are resecting larger weights from larger patients. Published literature has demonstrated the association between body mass index (BMI) and resection weight to postsurgical complications; however, these relationships are unclear in a population that is primarily overweight or obese. Our study examines these relationships to assist plastic surgeons in identifying high-risk patients and discussing preoperative measures to decrease the likelihood of surgical complications.

We performed a retrospective electronic medical record review of a cohort of 182 bilateral reduction mammoplasty procedures performed at a single institution over a four-year period. Patient data were obtained and correlated with postoperative complications.

Within our identified patient cohort, 95% were classified as either overweight or obese. Incidence of complications was 51%, with wound dehiscence having the highest incidence of 36.26%. Using a multivariate regression, our analysis found statistical significance between surgical complications and both smoking status and BMI (P = 0.042 and P = 0.025, respectively). Smokers had an increased risk of complications with an odds ratio of 5.165. For every additional 1 kg/m2 increase in BMI, the odds for surgical complication increased by 1.079. In a subanalysis focusing on wound dehiscence, the use of postoperative drains was a protective factor (P = 0.0065).

Our study population, with a high average BMI and smoking status, demonstrated a statistically significant increase in postsurgical complications. These findings will help counsel obese patients preoperatively on their increased risk of complications.