Characterizing differential risk effects of body mass index for Asian patients in the United States undergoing breast reconstruction

Asian patient populations continue to be underrepresented in both plastic surgery research and rates of breast reconstruction. Better elucidation of reconstruction in Asian women may help guide patient-directed counseling. This study investigates the differential effect of body mass index (BMI), a well-known risk factor, for Asian patients in outcomes after breast reconstruction. Asian and White breast reconstruction patients were identified by CPT code in the National Surgical Quality Improvement Program. Within each cohort, BMI was converted into percentile ranks for standardized comparisons between cohorts. The effects of BMI on occurrence of complications for Asian and White patients were then quantified with multivariate logistic regression models. The final cohort included 86,514 White patients and 4813 Asian patients, of which 9876 (11%) and 424 (8.8%) experienced at least one postoperative complication. The average BMI of White patients who experienced complications was 29.2 ± 6.3 kg/m2, a higher average than that of Asian patients, 25.6 ± 4.8 kg/m2. Higher BMI percentile was a significant predictor of increased risk of complications in White patients (OR: 1.005, 95% CI: 1.004–1.006, p