Smoking as a risk factor for breast reduction: An analysis of 13,503 cases

Hillam, Jeffery; Borsting, Emily Ann; Chim, Jimmy H.; Thaller, Seth R.

doi:10.1016/j.bjps.2016.12.012

Cited by 28 publications

(34 citation statements)

References 34 publications

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“…In a meta-analysis of 10,593 patients age, smoking, BMI, radiation therapy and RTW were analyzed and a significant correlation found between smoking and postoperative wound healing disorders, as well as a high BMI and smoking increased the risk for developing postoperative complications in general 21 . This is in agreement with three other analyses, one looking at 13,503 cases from the American College of Surgeons National Surgical Quality Improvement Program 22 and the other two in 71 and 173 cases in single center settings, respectively 19,23 . To critically evaluate data is to attribute this to the surgical technique applied: while one literature source 24 reported no significant differences in complications comparing a vertical to an inferior pedicle technique, our data tends to come to the same conclusion, but just in comparison to a superior (cranial) pedicle technique, which is a result of either institutional or surgeon-based preference in either institutions.…”

Section: Discussionsupporting

confidence: 89%

BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?

Winter

Reischies

Tuca

et al. 2019

Sci Rep

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We aimed to evaluate the interaction between individual risk factors and institutional complication rates after reduction mammaplasties to develop a chart for a personalized written patient informed consent. We retrospectively reviewed charts of 804 patients who underwent bilateral breast reduction between 2005 and 2015. The Clavien-Dindo classification was used to classify postoperative complications. Relevant predictors were found by applying a stepwise variable selection procedure. Multilevel predictors were assessed through chi-square tests on the respective deviance reductions. 486 patients were included. The most common complications were wound healing problems (n = 270/56%), foreign body reactions (n = 58/12%), wound infections (n = 45/9, 3%) and fat tissue necrosis (n = 41/8%). The risk factors for the personalized patient chart for the most common complications influencing the preoperative informed consent were: smoking, operative technique, resection weight for wound healing problems; body mass index and allergies for wound infections; and patients’ age, resection weight for fat tissue necrosis. The resultant chart of institutionally encountered most common complications based on individual risk factors is a graphical template for obtaining patient informed consent in the future. Whether this approach influences patient information retainment, incidence of filed lawsuits or behavioral change needs to be prospectively tested in future studies.

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Section: Discussionsupporting

confidence: 89%

BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?

Winter

Reischies

Tuca

et al. 2019

Sci Rep

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“…Adverse outcomes with regard to smoking have been described, especially for procedures with extensive soft tissue dissection such as face lift 17 and abdominoplasty; 18 in addition to several procedures in breast surgery such as breast reduction, mastopexy, or augmentation-mastopexy. 19,20 Smoke inhalation negatively affects microcirculation 21 and is thus of high significance in microsurgery and free flap transfer. 22 Currently, studies suggest that smoking-related complications can be reduced by preoperative cessation for at least 4 weeks.…”

Section: Discussionmentioning

confidence: 99%

Impact of Smoking Status in Free Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction: A Multicenter Study

Prantl

Moellhoff

Fritschen

et al. 2020

J Reconstr Microsurg

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Background Several patient-related factors have been identified with regard to the safety and efficacy of breast reconstructions. Using the largest database available in Europe, the presented study investigated the impact of cigarette smoking on deep inferior epigastric artery perforator (DIEP) free-flap breast reconstructions. Methods In total, 3,926 female patients underwent 4,577 free DIEP-flap breast reconstructions after malignancies in 22 different German breast cancer centers. The cases were divided into two groups: nonsmokers (NS) and smokers (S). Impact of smoking on surgical complications, controlled for covariates, and cluster effects within the cancer centers were analyzed by using generalized linear mixed models. Results Overall, there was no significant difference between the groups of patients regarding the rate of total flap loss. However, the rate of partial flap loss (0.9 vs. 3.2%, p < 0.001) and wound-healing disturbances requiring revision surgery (donor site: 1.5 vs. 4.0; recipient site: 1.3 vs. 3.6%, both p < 0.001) was significantly higher in smokers. Multivariable analysis identified smoking to be an independent risk factor for revision surgery (p = 0.001) and partial flap loss (p < 0.0001). Conclusion Our findings suggest that successful free tissue transfer can be achieved in smokers despite higher rates of partial flap losses and wound-healing disturbances. However, patients with a history of smoking requiring DIEP flap reconstruction should be critically evaluated preoperatively, informed in detail about the higher risk of complications and encouraged to quit smoking prior to surgery.

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“…These patients may felt themselves uncared than patients with drains. Complications can occur after reduction mammoplasties and these complication can effect patient satisfaction [22][23][24][25] . Having a complication reduces the post-operative satisfaction with breasts and information, sexual and physical wellbeing, surgeon and medical staff scores significantly as expected.…”

Section: Resultsmentioning

confidence: 99%

Meme küçültme ameliyatı olan hastaların memnuniyetinin Breast-Q anketi ile değerlendirilmesi

Akşam

Oral

2020

Cukurova Medical Journal

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Öz Purpose: The aim of this study is to evaluate the influence of patient demographics, operative techniques and postoperative care on patient satisfaction after breast reduction operations were evaluated in this study. Materials and Methods: Patients who undergo breast reduction surgery were offered to fulfil Breast-Q reduction module survey in pre-operative and post-operative sixth month period. Patient data such as age, height, weight, smoking, marital status and parenting have been recorded. Operative variances such as drain use and cutaneous stitches and complications, post-operative discharge days, staying in a private room were recorded with postoperative survey module. Results: Seventy-six patients were included in this study. The average age was 45.8 and mean body mass index (BMI) was 29.2. Post-operative satisfaction with breasts, psychosocial, sexual and physical wellbeing scores were significantly higher than pre-operative scores. Older women had higher pre-operative scores from satisfaction with breasts and psychosocial wellbeing. Younger patients and normal weight patients had higher scores from postoperative physical wellbeing. Satisfaction with breasts, sexual and physical wellbeing, satisfaction with information, surgeon and medical stuff scores were significantly lower in patients who had a post-operative complication. Conclusion: Surgery without complications is the most powerful factor that increases patient satisfaction. Patient demographics such as age and BMI can be used for patient selection for higher patient satisfaction. Amaç: Bu çalışmada meme küçültme amelyiatı sonrası, hasta demografik özellikleri, ameliyat teknikleri ve ameliyat sonrası bakımın hasta memnuniyetine etkisi değerlendirilmiştir. Gereç ve Yöntem: Meme küçültme ameliyatı geçiren hastalar arasından, ameliyat öncesi ve ameliyat sonrası altıncı aylık dönemde Breast-Q meme redüksiyonu modülü anketi doldurmayı kabul eden hastalar çalışmaya dahil edildi. Hastaların evlilik durumları, çocuk sahibi olup olmadıkları, sigara kullanımı, boy ve kiloları, yaşları ameliyat öncesinde sorularak kaydedildi. Ameliyat sonrası dren kullanılıp kullanılmadığı, cilt dikişleri olup olmadığı, herhangi bir komplikasyon gelişip gelişmediği, postoperatif yatış gün sayısı, hastanede kaldığı odada başka hasta bulunup bulunmadığı sorgulanarak kayıt altına alındı. Bulgular: Çalışmaya 76 hasta dahil edildi. Ortalama yaş 45.8 ve ortalama vücut kitle indeksi (VKİ) 29.2 idi. Ameliyat sonrası memelerden tatmin, psikososyal, cinsel ve fiziksel iyilik hali puanları ameliyat öncesi puanlardan anlamlı derecede yüksekti. Yaşlı kadınlarda memelerden memnuniyet ve psikososyal iyilik hali ameliyat öncesi puanlarda daha yüksekti. Genç hastalar ve normal kilolu hastalar ameliyat sonrası fiziksel iyilikten daha yüksek puan aldı. Ameliyat sonrası komplikasyonu olan hastalarda memelerden memnuniyet, cinsel ve fiziksel iyilik hali, bilgi memnuniyeti, cerrah ve tıbbi malzeme puanları anlamlı olarak düşüktü. Sonuç: Komplikasyon olmayan cerrahinin, hasta memnuniyetini artıra...

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Smoking as a risk factor for breast reduction: An analysis of 13,503 cases

Cited by 28 publications

References 34 publications

BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?

BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?

Impact of Smoking Status in Free Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction: A Multicenter Study

Meme küçültme ameliyatı olan hastaların memnuniyetinin Breast-Q anketi ile değerlendirilmesi

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