Study Finds Breast Reconstruction For Obese Patients Not As Safe

October 16, 2006 -

Significantly obese women may face an increased risk of complications during breast reconstruction after a mastectomy, according to the results of a new retrospective study, indicating that patients should consider delaying surgery until they achieve a lower body weight through diet and exercise.

The study findings, presented at a conference held by the American Society of Plastic Surgeons, also suggested that obese patients may experience a lower rate of satisfaction after their breast reconstruction surgery than those at a healthy weight.

“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 ASPS member surgeon and study author Dr. Elisabeth Beahm, MD.

Researchers found that women with a mass body index (BMI) over 35 experienced a heightened risk of complications and side effects for all types of breast reconstruction procedures—from flaps to implants. The rate of complication was near 100 percent for morbidly obese patients who had a BMI greater than 40.

The most commonly observed complications for significantly overweight patients involved infection and fluid collections at the flap donor site and reconstructive site. Furthermore, if the flap was taken from the abdomen, obese patients experienced weakness and/or deformity in the area more frequently than normal weight patients.

“Just because someone is overweight doesn't mean they should not be entitled to undergo breast reconstruction after mastectomy,” said Dr. Beahm. “Feeling ‘whole' can be an integral part of recovery from cancer.”

Dr. Beahm adds that while it's hard to tell patients they need to delay breast reconstruction after a mastectomy, safety is the primary concern. “Each case must be individualized. Morbidly obese patients need to work with their plastic surgeons and carefully assess risk factors,” she adds.

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