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Updated: Jul 17, 2026

Clinical Anthropometrics and Body Composition from 3-Dimensional Optical Imaging
06:48

Clinical Anthropometrics and Body Composition from 3-Dimensional Optical Imaging

Published on: June 7, 2024

Is Body Mass Index Associated With Fibula Free Flap Skin Paddle Thickness?

Jiaxin Yuan1, Yung-Hsin Cheng2, Jasjit K Dillon3

  • 1Resident, Department of Oral & Maxillofacial Surgery, University of Washington, Seattle, WA.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|July 15, 2026
PubMed
Summary

Body mass index (BMI) does not correlate with fibula skin paddle thickness. Clinical and radiographic assessment are recommended for accurate fibula flap thickness estimation.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Biomedical Engineering

Background:

  • Body mass index (BMI) is a common metric for soft tissue free flap thickness.
  • The fibula free flap (FFF) skin paddle is harvested distally, potentially less impacted by central adiposity.
  • No previous studies have investigated the link between BMI and fibula skin paddle thickness.

Purpose of the Study:

  • To determine the association between body mass index (BMI) and fibula skin paddle thickness.
  • To evaluate the utility of BMI as a predictor of fibula skin paddle thickness in reconstructive surgery.

Main Methods:

  • A cross-sectional study was conducted on patients evaluated for FFF reconstruction.
  • Body mass index (BMI) was the primary predictor variable.
  • Fibula skin paddle thickness (mm) was the primary outcome variable, with covariates including age, sex, diagnosis, and leg measurements.

Main Results:

  • The study included 45 subjects with a mean BMI of 26.7 and mean skin paddle thickness of 6.2 mm.
  • No significant linear correlation was found between skin paddle thickness and BMI (r = 0.12; P = .4).
  • Female sex was significantly associated with greater mean skin paddle thickness (7.5 vs 5.5 mm, P = .04).

Conclusions:

  • There is no statistically significant association between BMI and fibula skin paddle thickness in the studied sample.
  • The fibula skin paddle's thickness can be variable and is not reliably predicted by BMI.
  • Clinical and radiographic assessments are crucial for accurate fibula skin paddle thickness estimation.