Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

Sutinen, Maiju; Eskelinen, E; Kääriäinen, Minna

doi:10.1177/1457496917748225

Cited by 10 publications

(25 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, increased body mass index also increased dehiscence risk at the T junction. Studies examining the effects of obesity on complications in breast reduction operations presented different results [20]. A study of 3558 cases by Fishcer et al [6] found that obesity increases wound healing complications, because of the adverse effects of obesity on myofibroblast activity and collagen maturation.…”

Section: Discussionmentioning

confidence: 99%

“…However, the applicability of these recommendations is controversial. Studies on obese patients showed that the quality of life increased after the operation despite minor complications, and breast reduction operations were cost-effective in the obese patient group as well [20]. The use of incisional vacuum therapy reduced delayed wound healing complications that may occur after breast reduction operations [12,14].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors related to necrosis at the T junction in reduction mammoplasty

Can¹

2022

Journal of Surgery and Medicine

View full text Add to dashboard Cite

Background/Aim: Reduction mammoplasty is an effective and patient-satisfying operation in terms of relieving physical complaints such as back pain, shoulder collapse, and intertrigo due to macromastia. The most used incision is the wise pattern, which allows for easy intervention to the excess vertical and horizontal skin. However, long incisions may cause wound healing problems. The necessity of wide dissection may cause perfusion problems in the lateral and medial flaps at the T junction, where the tips of the flaps meet with the inframamarial sulcus. In the literature, T junction dehiscence is discussed under delayed healing complications. This study aimed to reveal the specific effects of the factors that were shown to cause delayed healing in general on the T junction area. Methods: In this retrospective cohort study, the effects of age, smoking habits, comorbidities, resection volume, and body mass index on T junction dehiscence were investigated among 56 patients who underwent reduction mammoplasty with wise pattern technique. The combined effects of all possible factors effective on dehiscence were investigated by multivariate logistic regression analysis. Results:The median age of the patients was 44.3 (12.5) years. Their mean body mass index was 26.0 (24.0-27.0) kg/m 2 , and 13% of the patients had comorbidities. The rate of dehiscence at the T junction was 28.6%. The most effective factors on the development of dehiscence were smoking and increased body mass index. Logistic regression analysis revealed that smoking increased the risk of T junction dehiscence by 8.543 times (95% Confidence Interval: 1.454-50.213) (P=0.018). No relationship was found between age, resection volume, comorbidities, and T junction dehiscence. Conclusion:The risk of dehiscence in the T junction increased in the patients who smoked and who had a high body mass index. The effect of smoking was much greater on T junction healing than its effect on general wound healing complications. T junction dehiscence should not be considered a delayed wound healing complication solely, but as a flap perfusion problem and preoperative measures should be taken accordingly.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors related to necrosis at the T junction in reduction mammoplasty

Can¹

2022

Journal of Surgery and Medicine

View full text Add to dashboard Cite

show abstract

“…For example, in a nationwide registry of 5371 women who underwent a reduction mammaplasty, as age increased there was a significant increase in postoperative thromboembolic events (deep venous thrombosis, pulmonary embolism). 36 Conversely, Sutinen et al 43 found no association of age with complications in a Finnish cohort of 483 patients. The National Surgical Quality Improvement Program database with 13,503 breast reduction patients was analyzed by Hillam et al, 40 who found no association between patient age and complications.…”

Section: Patient Agementioning

confidence: 94%

“…[33][34][35][36][37][38] Five studies failed to demonstrate age as a significant risk factor for any complication. [39][40][41][42][43] One study showed an association between older age and a reduced risk of delayed wound healing. 39 In a study of 124 women, Ogunleye et al 35 demonstrated that the risk of all complications increased 3 percent per year of age (OR, 1.03; 95 percent CI, 1.00 to 1.08).…”

Section: Patient Agementioning

confidence: 99%

American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty

Perdikis

Dillingham

Boukovalas

et al. 2022

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Summary: A multidisciplinary work group involving stakeholders from various backgrounds and societies convened to revise the guideline for reduction mammaplasty. The goal was to develop evidence-based patient care recommendations using the new American Society of Plastic Surgeons guideline methodology. The work group prioritized reviewing the evidence around the need for surgery as first-line treatment, regardless of resection weight or volume. Other factors evaluated included the need for drains, the need for postoperative oral antibiotics, risk factors that increase complications, a comparison in outcomes between the two most popular techniques (inferior and superomedial), the impact of local anesthetic on narcotic use and other nonnarcotic pain management strategies, the use of epinephrine, and the need for specimen pathology. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development and Evaluation methodology). Evidence-based recommendations were made and strength was determined based on the level of evidence and the assessment of benefits and harms.

show abstract

“…However, reports often describe the complications after reduction mammoplasty as minor with little effect on aesthetic outcomes. [9,10,16] Indeed, increased preoperative BMI has been correlated with high satisfaction following reduction mammoplasty, however, this did not include the morbidly obese (BMI >40). [17] Given these findings, it can be argued that potential complication rate or dissatisfaction should not prevent those with high BMIs from undergoing breast reduction surgery.…”

Section: Introductionmentioning

confidence: 99%

A 12-year review of patient-reported outcomes after reduction mammoplasty in patients with high body mass index

Ngaage

Bai

Gebran³

et al. 2019

Medicine

View full text Add to dashboard Cite

Patients with increased body mass index (BMI) are often denied reduction mammoplasty due to concern for high morbidity. There is a paucity of evidence identifying high BMI as a predictor of poor long-term outcomes in reduction mammoplasty. In this study, we investigated the influence of BMI on long-term patient satisfaction following reduction mammoplasty. All patients undergoing reduction mammoplasty over a 12-year period at a single institution were included in the study. A retrospective chart review was conducted to extract demographics, operative data, and postoperative course including complications. Patients were classified into 4 categories based on BMI (normal (<25), overweight (25–29.9), obese (30–39.9), and morbidly obese (≥40)). Patient satisfaction was assessed using a customized survey which was administered over the phone. Only patients with complete medical records who participated in the survey were included. The 70 patients met the inclusion criteria for the study. Median time from surgery to survey was 6 years. Overall satisfaction after reduction mammoplasty was high, 5 on a 5-point Likert scale. The amount of breast tissue resected correlated with patient BMI ( P <.01). There was no statistical difference in satisfaction across BMI classes. Furthermore, high BMI (obese, and morbidly obese) was not associated with higher postoperative complications ( P = .70). Those with a high overall satisfaction score had a significantly greater self-reported aesthetic score compared to those with low and mid satisfied scores ( P <.01). Following reduction mammoplasty, patients report high satisfaction which is sustained over several years. Obesity is not associated with a higher incidence of complications or lower satisfaction. Our data suggest that patients with a high BMI should not be denied reduction mammoplasty out of concern for higher complication rate or reduced patient satisfaction due to BMI alone, but reduction mammoplasty should be considered in the setting of overall health counseling.

show abstract

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

Abstract: A higher body mass index was strongly associated with an increased risk of minor complications after reduction mammoplasty. It is important to inform obese patients about the increased risk of complications and to encourage them to lose weight before surgery.

Cited by 10 publications

References 26 publications

Factors related to necrosis at the T junction in reduction mammoplasty

Factors related to necrosis at the T junction in reduction mammoplasty

American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty

A 12-year review of patient-reported outcomes after reduction mammoplasty in patients with high body mass index

Contact Info

Product

Resources

About