Microsurgical Breast Reconstruction in Thin Patients: The Impact of Low Body Mass Indices
Abstract Background The purpose of this investigation was to examine patients with low body mass index (BMI) regarding the feasibility to perform autologous breast reconstruction in such patients, as well as to determine optimal donor sites and evaluate outcomes accordingly. Patients and Methods A...
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| Veröffentlicht in: | Journal of reconstructive microsurgery 2015-01, Vol.31 (1), p.020-025 |
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| container_title | Journal of reconstructive microsurgery |
| container_volume | 31 |
| creator | Weichman, Katie E. Tanna, Neil Broer, P. Niclas Wilson, Stelios Azhar, Hamdan Karp, Nolan S. Choi, Mihye Ahn, Christina Y. Levine, Jamie P. Allen, Robert J. |
| description | Abstract
Background
The purpose of this investigation was to examine patients with low body mass index (BMI) regarding the feasibility to perform autologous breast reconstruction in such patients, as well as to determine optimal donor sites and evaluate outcomes accordingly.
Patients and Methods
All patients undergoing microsurgical breast reconstruction were divided into three cohorts based on BMI. Group 1 included patients with BMI greater than or equal to 22 kg/m
2
and was defined “low-normal BMI.” Patients with BMI 22 to 25 kg/m
2
were placed in Group 2, labeled as “high-normal BMI.” Group 3, defined as “overweight,” included patients with BMI greater than 25 kg/m
2
, but less than 30 kg/m
2
. Patients were then analyzed based on demographics, breast cancer history, intraoperative details, complications, and revisionary surgeries. F-tests, chi-square goodness-of-fit tests, and Freeman–Halton extension of the Fisher exact tests were used for statistical analysis.
Results
During the study period, a total of 259 reconstructions were performed. Group 1 included 30 patients (
n
= 49 flaps), Group 2 included 58 patients (
n
= 98 flaps), and Group 3 included 69 patients (
n
= 112 flaps). Patients undergoing nipple–areolar sparing mastectomy were more likely to be in Groups 1 (39% [
n
= 19]) and 2 (37% [
n
= 37]) as compared with Group 3 (14.2% [
n
= 16]) (
p
|
| doi_str_mv | 10.1055/s-0034-1376398 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1643144550</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1643144550</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-daf0882b2b36d47ecd6d2cd5e9a776183245ba5a9329b6def216a86f144e81823</originalsourceid><addsrcrecordid>eNp1kEtLxDAURoMoOj62LiVLN9W8mqbuVHwMjCiioKuQJrcamTZjkiL-ezvM6M7N_bhw7gf3IHRIyQklZXmaCkK4KCivJK_VBppQUqtC1aLaRBNSCV5IJV520G5KH4RQUVO2jXbYmFRQOkGvd97GkIb45q2Z44sIJmX8CDb0KcfBZh967Hv89D6OB5M99DmdjSvgabcwNuPQ4ln4whfBfeM7kxKe9s5bSPtoqzXzBAfr3EPP11dPl7fF7P5menk-K6wQPBfOtEQp1rCGSycqsE46Zl0JtakqSRVnomxMaWrO6kY6aBmVRsmWCgGKKsb30PGqdxHD5wAp684nC_O56SEMSVMp-AiXJRnRkxW6fDlFaPUi-s7Eb02JXurUSS916rXO8eBo3T00Hbg__NffCBQrIL976EB_hCH247f_Ff4AfxZ9fw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1643144550</pqid></control><display><type>article</type><title>Microsurgical Breast Reconstruction in Thin Patients: The Impact of Low Body Mass Indices</title><source>MEDLINE</source><source>Thieme Connect Journals</source><creator>Weichman, Katie E. ; Tanna, Neil ; Broer, P. Niclas ; Wilson, Stelios ; Azhar, Hamdan ; Karp, Nolan S. ; Choi, Mihye ; Ahn, Christina Y. ; Levine, Jamie P. ; Allen, Robert J.</creator><creatorcontrib>Weichman, Katie E. ; Tanna, Neil ; Broer, P. Niclas ; Wilson, Stelios ; Azhar, Hamdan ; Karp, Nolan S. ; Choi, Mihye ; Ahn, Christina Y. ; Levine, Jamie P. ; Allen, Robert J.</creatorcontrib><description>Abstract
Background
The purpose of this investigation was to examine patients with low body mass index (BMI) regarding the feasibility to perform autologous breast reconstruction in such patients, as well as to determine optimal donor sites and evaluate outcomes accordingly.
Patients and Methods
All patients undergoing microsurgical breast reconstruction were divided into three cohorts based on BMI. Group 1 included patients with BMI greater than or equal to 22 kg/m
2
and was defined “low-normal BMI.” Patients with BMI 22 to 25 kg/m
2
were placed in Group 2, labeled as “high-normal BMI.” Group 3, defined as “overweight,” included patients with BMI greater than 25 kg/m
2
, but less than 30 kg/m
2
. Patients were then analyzed based on demographics, breast cancer history, intraoperative details, complications, and revisionary surgeries. F-tests, chi-square goodness-of-fit tests, and Freeman–Halton extension of the Fisher exact tests were used for statistical analysis.
Results
During the study period, a total of 259 reconstructions were performed. Group 1 included 30 patients (
n
= 49 flaps), Group 2 included 58 patients (
n
= 98 flaps), and Group 3 included 69 patients (
n
= 112 flaps). Patients undergoing nipple–areolar sparing mastectomy were more likely to be in Groups 1 (39% [
n
= 19]) and 2 (37% [
n
= 37]) as compared with Group 3 (14.2% [
n
= 16]) (
p
< 0.001) as compared with the overweight cohort. Patients with increasing BMI were more likely to undergo abdominally based free flaps as compared with alternative donor sites (Group 1 = 2.26, Group 2 = 7.9, Group 3 = 27 [
p
< 0.001]).
Conclusions
Abdominally based free flaps are possible in the majority of patients, however alternative harvest sites have to be used more frequently in low BMI patients.</description><identifier>ISSN: 0743-684X</identifier><identifier>EISSN: 1098-8947</identifier><identifier>DOI: 10.1055/s-0034-1376398</identifier><identifier>PMID: 24911411</identifier><language>eng</language><publisher>333 Seventh Avenue, New York, NY 10001, USA: Thieme Medical Publishers</publisher><subject>Adipose Tissue - transplantation ; Adult ; Breast Neoplasms - surgery ; Epigastric Arteries - pathology ; Female ; Free Tissue Flaps ; Humans ; Mammaplasty - methods ; Mastectomy ; Microsurgery ; Original Article ; Perforator Flap - blood supply ; Postoperative Complications ; Practice Guidelines as Topic ; Rectus Abdominis - transplantation ; Retrospective Studies ; Risk Factors ; Thinness ; Treatment Outcome</subject><ispartof>Journal of reconstructive microsurgery, 2015-01, Vol.31 (1), p.020-025</ispartof><rights>Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-daf0882b2b36d47ecd6d2cd5e9a776183245ba5a9329b6def216a86f144e81823</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0034-1376398.pdf$$EPDF$$P50$$Gthieme$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1055/s-0034-1376398$$EHTML$$P50$$Gthieme$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3016,3017,27923,27924,54558,54559</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24911411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weichman, Katie E.</creatorcontrib><creatorcontrib>Tanna, Neil</creatorcontrib><creatorcontrib>Broer, P. Niclas</creatorcontrib><creatorcontrib>Wilson, Stelios</creatorcontrib><creatorcontrib>Azhar, Hamdan</creatorcontrib><creatorcontrib>Karp, Nolan S.</creatorcontrib><creatorcontrib>Choi, Mihye</creatorcontrib><creatorcontrib>Ahn, Christina Y.</creatorcontrib><creatorcontrib>Levine, Jamie P.</creatorcontrib><creatorcontrib>Allen, Robert J.</creatorcontrib><title>Microsurgical Breast Reconstruction in Thin Patients: The Impact of Low Body Mass Indices</title><title>Journal of reconstructive microsurgery</title><addtitle>J reconstr Microsurg</addtitle><description>Abstract
Background
The purpose of this investigation was to examine patients with low body mass index (BMI) regarding the feasibility to perform autologous breast reconstruction in such patients, as well as to determine optimal donor sites and evaluate outcomes accordingly.
Patients and Methods
All patients undergoing microsurgical breast reconstruction were divided into three cohorts based on BMI. Group 1 included patients with BMI greater than or equal to 22 kg/m
2
and was defined “low-normal BMI.” Patients with BMI 22 to 25 kg/m
2
were placed in Group 2, labeled as “high-normal BMI.” Group 3, defined as “overweight,” included patients with BMI greater than 25 kg/m
2
, but less than 30 kg/m
2
. Patients were then analyzed based on demographics, breast cancer history, intraoperative details, complications, and revisionary surgeries. F-tests, chi-square goodness-of-fit tests, and Freeman–Halton extension of the Fisher exact tests were used for statistical analysis.
Results
During the study period, a total of 259 reconstructions were performed. Group 1 included 30 patients (
n
= 49 flaps), Group 2 included 58 patients (
n
= 98 flaps), and Group 3 included 69 patients (
n
= 112 flaps). Patients undergoing nipple–areolar sparing mastectomy were more likely to be in Groups 1 (39% [
n
= 19]) and 2 (37% [
n
= 37]) as compared with Group 3 (14.2% [
n
= 16]) (
p
< 0.001) as compared with the overweight cohort. Patients with increasing BMI were more likely to undergo abdominally based free flaps as compared with alternative donor sites (Group 1 = 2.26, Group 2 = 7.9, Group 3 = 27 [
p
< 0.001]).
Conclusions
Abdominally based free flaps are possible in the majority of patients, however alternative harvest sites have to be used more frequently in low BMI patients.</description><subject>Adipose Tissue - transplantation</subject><subject>Adult</subject><subject>Breast Neoplasms - surgery</subject><subject>Epigastric Arteries - pathology</subject><subject>Female</subject><subject>Free Tissue Flaps</subject><subject>Humans</subject><subject>Mammaplasty - methods</subject><subject>Mastectomy</subject><subject>Microsurgery</subject><subject>Original Article</subject><subject>Perforator Flap - blood supply</subject><subject>Postoperative Complications</subject><subject>Practice Guidelines as Topic</subject><subject>Rectus Abdominis - transplantation</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Thinness</subject><subject>Treatment Outcome</subject><issn>0743-684X</issn><issn>1098-8947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>EIF</sourceid><recordid>eNp1kEtLxDAURoMoOj62LiVLN9W8mqbuVHwMjCiioKuQJrcamTZjkiL-ezvM6M7N_bhw7gf3IHRIyQklZXmaCkK4KCivJK_VBppQUqtC1aLaRBNSCV5IJV520G5KH4RQUVO2jXbYmFRQOkGvd97GkIb45q2Z44sIJmX8CDb0KcfBZh967Hv89D6OB5M99DmdjSvgabcwNuPQ4ln4whfBfeM7kxKe9s5bSPtoqzXzBAfr3EPP11dPl7fF7P5menk-K6wQPBfOtEQp1rCGSycqsE46Zl0JtakqSRVnomxMaWrO6kY6aBmVRsmWCgGKKsb30PGqdxHD5wAp684nC_O56SEMSVMp-AiXJRnRkxW6fDlFaPUi-s7Eb02JXurUSS916rXO8eBo3T00Hbg__NffCBQrIL976EB_hCH247f_Ff4AfxZ9fw</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Weichman, Katie E.</creator><creator>Tanna, Neil</creator><creator>Broer, P. Niclas</creator><creator>Wilson, Stelios</creator><creator>Azhar, Hamdan</creator><creator>Karp, Nolan S.</creator><creator>Choi, Mihye</creator><creator>Ahn, Christina Y.</creator><creator>Levine, Jamie P.</creator><creator>Allen, Robert J.</creator><general>Thieme Medical Publishers</general><scope>0U6</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150101</creationdate><title>Microsurgical Breast Reconstruction in Thin Patients: The Impact of Low Body Mass Indices</title><author>Weichman, Katie E. ; Tanna, Neil ; Broer, P. Niclas ; Wilson, Stelios ; Azhar, Hamdan ; Karp, Nolan S. ; Choi, Mihye ; Ahn, Christina Y. ; Levine, Jamie P. ; Allen, Robert J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-daf0882b2b36d47ecd6d2cd5e9a776183245ba5a9329b6def216a86f144e81823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adipose Tissue - transplantation</topic><topic>Adult</topic><topic>Breast Neoplasms - surgery</topic><topic>Epigastric Arteries - pathology</topic><topic>Female</topic><topic>Free Tissue Flaps</topic><topic>Humans</topic><topic>Mammaplasty - methods</topic><topic>Mastectomy</topic><topic>Microsurgery</topic><topic>Original Article</topic><topic>Perforator Flap - blood supply</topic><topic>Postoperative Complications</topic><topic>Practice Guidelines as Topic</topic><topic>Rectus Abdominis - transplantation</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Thinness</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weichman, Katie E.</creatorcontrib><creatorcontrib>Tanna, Neil</creatorcontrib><creatorcontrib>Broer, P. Niclas</creatorcontrib><creatorcontrib>Wilson, Stelios</creatorcontrib><creatorcontrib>Azhar, Hamdan</creatorcontrib><creatorcontrib>Karp, Nolan S.</creatorcontrib><creatorcontrib>Choi, Mihye</creatorcontrib><creatorcontrib>Ahn, Christina Y.</creatorcontrib><creatorcontrib>Levine, Jamie P.</creatorcontrib><creatorcontrib>Allen, Robert J.</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of reconstructive microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weichman, Katie E.</au><au>Tanna, Neil</au><au>Broer, P. Niclas</au><au>Wilson, Stelios</au><au>Azhar, Hamdan</au><au>Karp, Nolan S.</au><au>Choi, Mihye</au><au>Ahn, Christina Y.</au><au>Levine, Jamie P.</au><au>Allen, Robert J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Microsurgical Breast Reconstruction in Thin Patients: The Impact of Low Body Mass Indices</atitle><jtitle>Journal of reconstructive microsurgery</jtitle><addtitle>J reconstr Microsurg</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>31</volume><issue>1</issue><spage>020</spage><epage>025</epage><pages>020-025</pages><issn>0743-684X</issn><eissn>1098-8947</eissn><abstract>Abstract
Background
The purpose of this investigation was to examine patients with low body mass index (BMI) regarding the feasibility to perform autologous breast reconstruction in such patients, as well as to determine optimal donor sites and evaluate outcomes accordingly.
Patients and Methods
All patients undergoing microsurgical breast reconstruction were divided into three cohorts based on BMI. Group 1 included patients with BMI greater than or equal to 22 kg/m
2
and was defined “low-normal BMI.” Patients with BMI 22 to 25 kg/m
2
were placed in Group 2, labeled as “high-normal BMI.” Group 3, defined as “overweight,” included patients with BMI greater than 25 kg/m
2
, but less than 30 kg/m
2
. Patients were then analyzed based on demographics, breast cancer history, intraoperative details, complications, and revisionary surgeries. F-tests, chi-square goodness-of-fit tests, and Freeman–Halton extension of the Fisher exact tests were used for statistical analysis.
Results
During the study period, a total of 259 reconstructions were performed. Group 1 included 30 patients (
n
= 49 flaps), Group 2 included 58 patients (
n
= 98 flaps), and Group 3 included 69 patients (
n
= 112 flaps). Patients undergoing nipple–areolar sparing mastectomy were more likely to be in Groups 1 (39% [
n
= 19]) and 2 (37% [
n
= 37]) as compared with Group 3 (14.2% [
n
= 16]) (
p
< 0.001) as compared with the overweight cohort. Patients with increasing BMI were more likely to undergo abdominally based free flaps as compared with alternative donor sites (Group 1 = 2.26, Group 2 = 7.9, Group 3 = 27 [
p
< 0.001]).
Conclusions
Abdominally based free flaps are possible in the majority of patients, however alternative harvest sites have to be used more frequently in low BMI patients.</abstract><cop>333 Seventh Avenue, New York, NY 10001, USA</cop><pub>Thieme Medical Publishers</pub><pmid>24911411</pmid><doi>10.1055/s-0034-1376398</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0743-684X |
| ispartof | Journal of reconstructive microsurgery, 2015-01, Vol.31 (1), p.020-025 |
| issn | 0743-684X 1098-8947 |
| language | eng |
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| source | MEDLINE; Thieme Connect Journals |
| subjects | Adipose Tissue - transplantation Adult Breast Neoplasms - surgery Epigastric Arteries - pathology Female Free Tissue Flaps Humans Mammaplasty - methods Mastectomy Microsurgery Original Article Perforator Flap - blood supply Postoperative Complications Practice Guidelines as Topic Rectus Abdominis - transplantation Retrospective Studies Risk Factors Thinness Treatment Outcome |
| title | Microsurgical Breast Reconstruction in Thin Patients: The Impact of Low Body Mass Indices |
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