It is no secret that we are in the midst of an obesity epidemic and it has been this way for a long time now. In fact, more than 40% of the population of the United States is considered to be obese – an astounding number.
Clinically, obesity is defined as having a BMI (body mass index) of 30 or more and is based on your height and weight. You can find a BMI chart by doing an online search and determine what yours number is.
The consequences on the health of individuals are enormous for those who are obese. Just a few of the many risk factors it is associated with include diabetes, hypertension, heart disease, osteoarthritis and a multitude of cancers.
Obesity is also a major risk factor for surgery, anesthesia, postoperative complications and surgical outcomes. It also has been identified, both by studies and anecdotally, to impact the results and increase the incidence of complications associated with breast reconstruction.
The results of a large and diverse multicenter study was just published in the Plastic and Reconstructive Surgery Journal assessing and quantifying this relationship in more detail. It involved a total of 2259 patients that were stratified with regard to weight and whether their reconstruction was implant based or autologous. The follow up was 2 years.
The control group comprised those that were underweight/normal weight (BMI <25) and overweight (BMI of 25 to 29.9). The obese patients were divided into class I (BMI of 30 – 34.9) and class II/III (BMI of 35 or greater) and their outcomes were then compared to the control group.
There were many useful findings from this comprehensive study. Those women with a BMI of greater than 40 (which is considered to be morbidly obese) who had either the implant based or autologous reconstruction had the highest risk for any complication and major complications. Even more specifically, the autologous reconstructions who had a BMI of 35 or greater had a 3.35 times greater complication rate as compared to those who were normal weight/underweight. Meanwhile, the implant based reconstructions with this same BMI range had a 3.3 times great risk for reconstructive failure.
In the class I obesity group, both the autologous and implant based reconstructions had around a 1.55 times greater risk for any type of complication as compared to the control group and around a 1.6 times greater risk for major complications. The failure rate for implant reconstruction in this group was two times greater.
Even with the overweight group (BMI between 25 and 29.9), the slightly greater weight did have an impact, though relatively small, with regards to any complication and major complications but it was associated with a 1.6 times greater risk for implant reconstructive failure.
In summary, even being just overweight increased breast reconstruction risks and complications. For those women who were obese, the risks for complications, major complications and failures increased dramatically with increasing weight.
This weight factor must be kept in mind when one is considering breast reconstruction. It is beyond the control and totally independent of the plastic surgeon and technique.
If you would like information regarding breast reconstruction or to schedule a consultation, you can contact our office by telephone at (480) 451-3000 or by email.