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Breast reconstruction not as safe for obese patients

ARLINGTON HEIGHTS, Ill. -- Significantly obese women may wish to consider delaying breast reconstruction following mastectomy until they achieve a healthier body weight. According to findings presented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2006 conference in San Francisco, women who are significantly obese are at higher risk for complications and have a lower satisfaction rate than do normal and overweight patients.

"Just because someone is overweight doesn't mean they should not be entitled to undergo breast reconstruction after mastectomy," said Elisabeth Beahm, MD, ASPS Member Surgeon, author of the study, and associate professor at M. D. Anderson Cancer Center. "Feeling 'whole' can be an integral part of recovery from cancer, yet significant concerns have been raised about the wisdom of doing breast reconstruction in very obese patients due to a high complication rate.

The current retrospective study found that patients with a BMI greater than 35 demonstrated significantly increased complication rates for all types of breast reconstruction, from implants to flaps. The complication rate approached 100 percent for morbidly obese patients with a BMI over 40.

"We investigated whether plastic surgeons can safely perform breast reconstruction for these patients or if we would be depriving them reconstruction simply because of empiric concerns for their weight," said Dr. Beahm. "We found that significantly obese patients, those having a BMI of 35 or higher, had a higher risk for complications. Our experience suggests that in many cases it may be more prudent to delay breast reconstruction until the patient has lost weight."

The most frequent complications for obese patients were fluid collections and infection at both the reconstructive site and the flap donor site. When the flap was harvested from the abdominal area, weakness and deformity of the abdominal wall such as hernia and bu
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Contact: LaSandra Cooper
media@plasticsurgery.org
847-228-9900
American Society of Plastic Surgeons
8-Oct-2006


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