The Impact of Body Mass Index on Reduction Mammaplasty

Gust, Madeleine J.; Smetona, John; Persing, John; Hanwright, Philip J.; Fine, Neil A.; Kim, John Yah Sung

doi:10.1177/1090820x13508131

Cited by 35 publications

(25 citation statements)

References 30 publications

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“…Stevens et al (14) associated a BMI > 27 with poor wound healing. Two large studies by nelson et al (12) and Gust et al (13) using the national Surgical Quality Improvement database found a significant increase in the complication rates with increasing obesity classes. In our study, a correlation between BMI and complications was detected regarding minor, but not major, complications.…”

Section: Discussionmentioning

confidence: 98%

“…Complications of RM vary from minor wound complications to more severe complications, such as systemic infections, hematomas, and other wound complications that require reoperation. Potential factors exposing patients to these complications have been studied, but the results are still somewhat incoherent (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). In particular, the association between increased BMI and postoperative complications is unclear.…”

Section: Introductionmentioning

confidence: 99%

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

2018

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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

2018

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“…The scientific evidence for the threshold being at BMI >25 kg m −2 is debatable. Although there is increase in all surgical complications with increasing BMI several studies have found the threshold at BMI 35 kg m −2 at which risk of complications increases while others have found no association between BMI and risk of complications . Either way, a threshold at BMI > 25 kg m −2 seems to have no scientific justification and an increase of the threshold to BMI 30 or even 35 kg m −2 , given the above evidence, should not pose an increased risk for complications.…”

Section: Discussionmentioning

confidence: 96%

“…Women with overweight or obesity constitute a significant fraction of those suffering from hypertrophy of the breast and the prevalence of overweight and obese undergoing reduction mammaplasty has been reported between 67 and 86% .…”

Section: Introductionmentioning

confidence: 99%

Preoperative weight loss program targeting women with overweight and hypertrophy of the breast – a pilot study

2017

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Among women with hypertrophic breasts, the clear majority are overweight or obese. Owing to increased risk of complications, women with a body mass index (BMI) above 25 kg m are precluded from reduction mammaplasty. The primary aim was to investigate if intensive weight loss could ready women with overweight for breast reduction surgery. Six women, all overweight [BMI 30.9 {28.5; 35.8} kg m ] with symptomatic hypertrophy of the breast, were included a 12-week weight loss program. All women desired reduction mammaplasty and were motivated for preoperational weight loss. The first 8 weeks consisted of a formula-based diet supplying 800 kcal daily, in the subsequent 4 weeks regular foods were reintroduced increasing the intake to 1200 kcal daily. Five women completed the trial, and achieved a median (range) weight loss of 10.2 (6.5; 19) kg. Initial breast volume was 1100-2500 mL per breast, this was reduced by 300 (200; 500) mL after the intervention; equivalent to approximately 19%. Waist, hip, upper arm and thorax circumference were significantly reduced following weight loss. At end of study, all the women still suffered from symptomatic breast hypertrophy to substantiate reduction mammaplasty. Surgeries were performed 2 months thereafter. A 12-week intensive preoperative weight loss program enabled women with obesity for breast reduction surgery. Breast size was reduced proportionally more than total weight loss among women with hypertrophy.

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“…Postoperative complication rates after reduction mammaplasty vary between 4% and 63%; and common complications include wound healing problems, wound infections, fat tissue necrosis or foreign body reactions 3,7–13 . Beside this high complication rates and the fact that some complications are more likely to develop 13 , patients can only be informed based on the operation and associated complications of published percentages, but not on their individual risk profile.…”

Section: Introductionmentioning

confidence: 99%

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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The Impact of Body Mass Index on Reduction Mammaplasty

Abstract: Reduction mammaplasty is a safe surgical procedure, even when performed on obese patients. However, patients with higher BMI have a greater risk of surgical site complications. This risk should be discussed preoperatively with obese patients.

Cited by 35 publications

References 30 publications

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

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

Preoperative weight loss program targeting women with overweight and hypertrophy of the breast – a pilot study

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

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