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Study suggests obese patients should lose weight before post-mastectomy reconstructive surgery

Article-Study suggests obese patients should lose weight before post-mastectomy reconstructive surgery

Houston — Extremely obese women who undergo breast-reconstruction surgery following a mastectomy face a high risk of complications, according to a new study.

According to researchers at the University of Texas M.D. Anderson Cancer Center here, about 40 percent of all patients who are extremely obese — defined as a body mass index (BMI) greater than 35 — and who had breast reconstruction over a 15-year period ending in 2004, experienced complications such as fat necrosis, flap loss or delayed wound healing.

This result and others are based on a retrospective review of breast reconstruction outcomes in obese patients from the beginning of 1990 to the end of 2004.

The 40 percent figure compares with about 30 percent of patients with a BMI less than 35 who had similar surgery, the study says.

The research suggests that, in many cases, it may be advisable for extremely obese patients to lose weight before reconstructive surgery is attempted.

According to the study, all patients with a BMI lower than 35 had comparable complication rates, but among patients with a BMI of 35 or greater, the complication rates were significantly higher for each type of surgery. The most frequent complications for obese patients were edema and infection at both the reconstructive site and the flap donor site. In abdominal flap procedure, hernia and bulge were significantly more common among obese than normal-weight patients.
Overall, 39 percent of extremely obese women experienced complications from breast-reconstruction surgery, compared with less than 31 percent of women with a BMI less than 35.

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