Super obesity is not necessarily a contraindication to deep inferior epigastric perforator flap breast reconstruction

Abstract

The deep inferior epigastric perforator (DIEP) flap is widely recognised as a safe and reliable flap for use as a first-choice option in autologous tissue breast reconstruction. Patients with obesity represent a challenging group for autologous breast reconstruction, as they are at increased risk of developing major and minor complications in comparison with patients with normal weight. We report a 59-year-old woman with super obesity, who presented to our department with right breast skin necrosis after implant reconstruction following mastectomy for right breast cancer. After implant removal and local treatment with both surgical debridement and negative pressure wound therapy, the patient successfully underwent a DIEP flap breast reconstruction. We conclude that super obesity should not be a contraindication to DIEP flap breast reconstruction.

The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction

“…Some years ago, Ochoa et al were able to prove a positive association between high BMI and wound healing disorder, though not between BMI and abdominal wall morbidity [ 55 ]. Recent studies have reassessed this view, concluding that the BMI ought not be a contraindication to abdominally-based breast reconstruction [ 53 , 56 , 57 ]. Levi et al inferred that the area of visceral fat is a predictor of postoperative donor-site complications on par with the BMI, even surpassing it in the level of accuracy in patients with a BMI above 30 kg/m 2 [ 13 ].…”

Abdominally based free flap breast reconstruction in the severely obese population: Is it safe?

“…As a result, many surgeons will not perform autologous free flap reconstruction on patients with a BMI over arbitrary cutoffs. Despite the increased rate of complications in obese patients, flap survival and reconstructive success have been well documented in this group (Garvey et al, 2012; Klement et al, 2019; Papadakis et al, 2018; Sacher et al, 2020).…”