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Letter: Obesity and complications in breast reduction surgery
Journal of Plastic, Reconstructive & Aesthetic Surgery (2010) 63, e168
CORRESPONDENCE AND COMMUNICATION
Letter: Obesity and complications in breast reduction surgery
of recent publications including that of Setala et al.1e4 In conclusion, there appears to be a growing body of evidence suggesting that the rate of complications is not related to the patient’s BMI.
Dear Sir,
References
The recent paper by Setala et al. reported obesity did not significantly increase the risk of complications following reduction mammaplasty.1 We reviewed 159 patients undergoing bilateral breast reduction during a 5-year period in our unit. The mean age of patients was 37.3 years. The mean body mass index (BMI) was 24.5 (range 19.0e 28.0). Eighty patients (50.3%) had a BMI of 25 or more in our population. Our overall complication rate was 25.8%. The most frequent complications were delayed healing or dehiscence (10.7%), followed by infection (9.4%) and fat necrosis (3.8%). Postoperative haematoma occurred in two patients (1.3%) and areolar necrosis in one patient (0.6%), all these patients had a BMI of 25 or more. Fisher’s exact test did not reveal any statistically significant difference in complication rate between the normal and overweight groups. Independent samples t-tests were performed to compare means with respect to specific complications (see Table 1). Our results showed the mean BMI was higher in patients with delayed healing, fat necrosis, haematomas, and areolar necrosis. Statistically, however, this difference was not significant. This finding is consistent with a number
Table 1
1. Setala L, Papp A, Joukainen S, et al. Obesity and complications in breast reduction surgery: are restrictions justified? J Plast Reconstr Aesthet Surg 2009;62:195e9. 2. Roehl K, Craig ES, Gomez V, et al. Breast reduction: safe in the morbidly obese? Plast Reconstr Surg 2008;122:370e78. 3. Cunningham BL, Gear AJL, Kerrigan CL, et al. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg 2005;115:1597e1604. 4. Gamboa-Bodadilla GM, Killingsworth C. Large-volume reduction mammaplasty: the effect of body mass index on postoperative complications. Ann Plast Surg 2007;58:246e9.
R. Nassab N. Hamnett M. Barrett S. Dhital A. Juma Countess of Chester Hospital, Chester, CH2 1UL, UK E-mail address: [email protected]
Complications according to BMI category and mean BMI, p value results from independent samples t-test
Complication
Any complication Infection Delayed healing Fat necrosis Haematoma Areolar necrosis
BMI Group
Present
Absent
p Value
BMI <25
BMI >25
No. (%)
Mean BMI
No. (%)
Mean BMI
21 9 8 3 0 0
20 6 9 3 2 1
41 15 17 6 2 1
24.70 24.50 24.68 25.17 25.50 27.00
118 144 138 153 157 158
24.48 24.54 24.51 24.51 24.52 24.52
(25.8) (9.4) (10.7) (3.8) (1.3) (0.6)
(74.2) (90.6) (89.3) (96.2) (98.7) (99.4)
0.461 0.932 0.697 0.336 0.403 0.131
1748-6815/$ - see front matter ª 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2009.03.007
CORRESPONDENCE AND COMMUNICATION
Letter: Obesity and complications in breast reduction surgery
of recent publications including that of Setala et al.1e4 In conclusion, there appears to be a growing body of evidence suggesting that the rate of complications is not related to the patient’s BMI.
Dear Sir,
References
The recent paper by Setala et al. reported obesity did not significantly increase the risk of complications following reduction mammaplasty.1 We reviewed 159 patients undergoing bilateral breast reduction during a 5-year period in our unit. The mean age of patients was 37.3 years. The mean body mass index (BMI) was 24.5 (range 19.0e 28.0). Eighty patients (50.3%) had a BMI of 25 or more in our population. Our overall complication rate was 25.8%. The most frequent complications were delayed healing or dehiscence (10.7%), followed by infection (9.4%) and fat necrosis (3.8%). Postoperative haematoma occurred in two patients (1.3%) and areolar necrosis in one patient (0.6%), all these patients had a BMI of 25 or more. Fisher’s exact test did not reveal any statistically significant difference in complication rate between the normal and overweight groups. Independent samples t-tests were performed to compare means with respect to specific complications (see Table 1). Our results showed the mean BMI was higher in patients with delayed healing, fat necrosis, haematomas, and areolar necrosis. Statistically, however, this difference was not significant. This finding is consistent with a number
Table 1
1. Setala L, Papp A, Joukainen S, et al. Obesity and complications in breast reduction surgery: are restrictions justified? J Plast Reconstr Aesthet Surg 2009;62:195e9. 2. Roehl K, Craig ES, Gomez V, et al. Breast reduction: safe in the morbidly obese? Plast Reconstr Surg 2008;122:370e78. 3. Cunningham BL, Gear AJL, Kerrigan CL, et al. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg 2005;115:1597e1604. 4. Gamboa-Bodadilla GM, Killingsworth C. Large-volume reduction mammaplasty: the effect of body mass index on postoperative complications. Ann Plast Surg 2007;58:246e9.
R. Nassab N. Hamnett M. Barrett S. Dhital A. Juma Countess of Chester Hospital, Chester, CH2 1UL, UK E-mail address: [email protected]
Complications according to BMI category and mean BMI, p value results from independent samples t-test
Complication
Any complication Infection Delayed healing Fat necrosis Haematoma Areolar necrosis
BMI Group
Present
Absent
p Value
BMI <25
BMI >25
No. (%)
Mean BMI
No. (%)
Mean BMI
21 9 8 3 0 0
20 6 9 3 2 1
41 15 17 6 2 1
24.70 24.50 24.68 25.17 25.50 27.00
118 144 138 153 157 158
24.48 24.54 24.51 24.51 24.52 24.52
(25.8) (9.4) (10.7) (3.8) (1.3) (0.6)
(74.2) (90.6) (89.3) (96.2) (98.7) (99.4)
0.461 0.932 0.697 0.336 0.403 0.131
1748-6815/$ - see front matter ª 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2009.03.007