Deep Inferior Epigastric Perforator Flap Reconstruction Outcomes Across Body Mass Index Categories: A Retrospective...

Area of Science:

• Plastic Surgery
• Breast Reconstruction
• Body Mass Index

Background:

• The safety of deep inferior epigastric perforator (DIEP) flap breast reconstruction in patients with varying body mass index (BMI) is debated.
• Obesity is a known risk factor for surgical complications, but specific evidence regarding DIEP flap safety across different BMI categories is limited.

Purpose of the Study:

• To evaluate the impact of body mass index (BMI) on outcomes and complications in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction.
• To determine if BMI should be a contraindication for autologous breast reconstruction using DIEP flaps.

Main Methods:

• A retrospective study analyzed 117 patients (144 flaps) who underwent DIEP flap breast reconstruction from January 2018 to August 2024.
• Patients were categorized into normal weight (18.5-25 kg/m²), overweight (25-29.9 kg/m²), and obese (≥30 kg/m²) BMI groups.
• Preoperative, intraoperative, and postoperative data were collected and analyzed.

Main Results:

• Abdominal seroma rates were significantly higher in the obese group (BMI ≥30 kg/m²).
• Fat necrosis and total flap loss occurred exclusively in the obese group (7.1% each), approaching statistical significance.
• Hospital stays increased with BMI (0.20 days per unit increase), but BMI was not an independent predictor of overall flap complications.

Conclusions:

• Deep inferior epigastric perforator (DIEP) flap breast reconstruction is a safe procedure for patients with class I and II obesity.
• While higher BMI is linked to increased abdominal seroma and longer hospital stays, complication rates are generally acceptable.
• Body mass index alone should not preclude patients from undergoing autologous breast reconstruction if they are not morbidly obese.