According to a study published by the American Society of Plastic Surgeons (ASPS), obese women may wish to consider delaying breast reconstruction following mastectomy until they achieve a healthier body weight. They have a higher risk of complications and have a lower satisfaction rate than normal and overweight (but nonobese) patients. 

“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,” says Elisabeth Beahm, MD, ASPS member surgeon and author of the study. “We found that significantly obese patients—those having a BMI [body-mass index] 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 study showed 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% for morbidly obese patients (BMI greater than 40).

The most frequent complications reported for obese patients were fluid collection 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 bulging) was much more common than in normal-weight patients.

[www.plasticsurgery.org, October 4, 2006]