Obesity and breast reconstruction: Complications and patient-reported outcomes in a multicenter, prospective study Journal Article


Authors: Srinivasa, D. R.; Clemens, M. W.; Qi, J.; Hamill, J. B.; Kim, H. M.; Pusic, A. L.; Wilkins, E. G.; Butler, C. E.; Garvey, P. B.
Article Title: Obesity and breast reconstruction: Complications and patient-reported outcomes in a multicenter, prospective study
Abstract: BACKGROUND: The authors' purpose was to evaluate the effects of body mass index, as defined by World Health Organization criteria, on complications and patient-reported outcomes in implant-based and autologous breast reconstruction. METHODS: Complications and BREAST-Q patient-reported outcomes were analyzed 2 years after breast reconstruction for women from 11 participating sites. Separate mixed-effects regressions were performed to assess body mass index effects on outcomes. RESULTS: A total of 2259 patients (1625 implant-based and 634 autologous) were included. Women with class II/III obesity had higher risks of any complication in both the implant (OR, 1.66; p = 0.03) and autologous (OR, 3.35; p < 0.001) groups, and higher risks of major complications in both the implant (OR, 1.71, p = 0.04) and autologous (OR, 2.72; p = 0.001) groups, compared with underweight/normal weight patients. Both class I (OR, 1.97; p = 0.03) and class II/III (OR, 3.30; p = 0.001) obesity patients experienced higher reconstructive failures in the implant cohort. Class I obesity implant patients reported significantly lower Satisfaction with Breasts scores (mean difference, -5.37; p = 0.007). Body mass index did not significantly affect patient-reported outcomes for autologous reconstruction patients. CONCLUSIONS: Obesity was associated with higher risks for complications in both implant-based and autologous breast reconstruction; however, it only significantly affected reconstruction failure and patient-reported outcomes in the implant reconstruction patients. Quality-of-life benefits and surgical risk should be presented to each patient as they relate to her body mass index, to optimize shared decision-making for breast reconstruction.Risk, I.
Journal Title: Plastic and Reconstructive Surgery
Volume: 145
Issue: 3
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2020-03-01
Start Page: 481e
End Page: 490e
Language: English
DOI: 10.1097/prs.0000000000006543
PUBMED: 32097295
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 April 2020 -- Source: Scopus
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  1. Andrea Pusic
    299 Pusic