American Association of Plastic Surgeons

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Obesity And Patient-Reported Outcomes Following Autologous Breast Reconstruction With Abdominal Free Flaps: A 10-Year Experience
Nikhil Sobti, BA, Aadit R. Patel, MD, Robert J. Allen, Jr., MD, Evan Matros, MD, MMSc, MPH, Colleen M. McCarthy, MD, MS, Joseph H. Dayan, MD, Joseph J. Disa, MD, Peter J. Cordeiro, MD, Babak J. Mehrara, MD, Andrea L. Pusic, MD, MHS, Jonas A. Nelson, MD.
Memorial Sloan Kettering Cancer Center, New York, NY, USA.

PURPOSE: Despite the availability of studies evaluating obesity as an independent risk factor for post-operative complication, few have assessed satisfaction from the patient perspective within an obese population. The purpose of our study was to investigate the impact of obesity on postoperative satisfaction. We hypothesize that patient satisfaction will not differ significantly between obese and non-obese groups following autologous breast reconstruction with abdominal free flaps.
METHODS: An IRB approved prospective investigation was conducted to evaluate patient reported outcomes of patients undergoing breast reconstruction between 2007 and 2017 at a tertiary academic medical center. The BREAST-Q reconstruction module was used to assess patient satisfaction between obesity cohorts at the following time intervals: 6 months, 1-year, 2-years, and 3-years.
RESULTS: Overall, 404 patients underwent autologous breast reconstruction with abdominal free-tissue transfer (244 non-obese, 160 obese) and completed the BREAST-Q. Although obese patients demonstrated lower satisfaction with breast in the pre-operative period, no significant differences were noted between cohorts in the post-operative interval. However, obese patients reported significantly lower physical well-being of the abdomen at 3 year follow-up than their non-obese counterparts (p = 0.04).
CONCLUSION: These results suggest that, although obese patients are more likely to present with dissatisfaction with breast in the pre-operative period, they exhibit comparable outcomes, post-operatively. Obese patients may have lower abdominal satisfaction at 3 years as well, though how this is related to the surgery or the disease process overall is not clear and warrants further study.


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