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Impact of Obesity on Quality of Life After Breast Reconstruction

Koh, Eugene MBBS, MSSc*†; Watson, David I. MD, PhD*; Dean, Nicola R. PhD, MBChB*†

doi: 10.1097/SAP.0000000000002122
Breast Surgery

Background There is an increasing prevalence of obesity in society, often associated with increased medical comorbidities and surgical complications. Some health providers are now placing a body mass index (BMI) limit on whom can be offered breast reconstruction. The objective of this study was to determine the impact of obesity on quality of life as measured by the BREAST-Q, in women undergoing breast reconstruction.

Methods A review of the breast reconstruction database (n = 336) at the Flinders Breast Reconstruction Service was performed, with demographic data, complication rates, and BREAST-Q data being extracted and analyzed. Participants were divided into 2 groups: nonobese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2) for comparison.

Results Preoperatively, obese women scored lower than nonobese women in terms of BREAST-Q scores. Mean prereconstruction scores were 51.62 versus 57.10 (psychosocial), 40.18 versus 48.14 (satisfaction with breasts), and 34.30 versus 40.72 (sexual well-being) (all P < 0.05), and 68.48 versus 72.15 (physical well-being) (P = 0.08). At 12 months post–mound reconstruction, there was a significant improvement in scores in both groups. Additionally, there were no significant differences for BREAST-Q scores between the 2 groups 12 months after surgery. While there was a significantly higher minor complication rate in the obese group compared with the nonobese group, there was no significant difference in the rate of major complications (eg, requiring revision surgery) between the 2 groups.

Conclusions Obese participants gain a similar, if not better, improvement in quality of life after breast reconstruction, despite a higher rate of minor complications. This study did not support withholding breast reconstruction from obese women.

From the *Department of Surgery, Flinders University

Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Adelaide, Australia.

Received December 15, 2018, and accepted for publication, after revision August 7, 2019.

Conflicts of interest and sources of funding: none declared.

This work was presented at the Plastic Surgery Congress of the Australian Society of Plastic Surgeons in June 2017 in the Gold Coast, Australia.

Reprints: Eugene Koh, MBBS, MSSc, Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Level 5, Bedford Park, Adelaide, South Australia 5042, Australia. E-mail:

Online date: November 4, 2019

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