Impact of Body Mass Index, Age and Tobacco Use on the Outcomes of Immediate Breast Reconstruction with Implants and Acellular Dermal Matrix

L Mata Ribeiro; Rita P Meireles; Irís M Brito; Patrícia M Costa; Marco A Rebelo; Rui F Barbosa; Miguel P Choupina; Carlos J Pinho; Matilde P Ribeiro

doi:10.1055/s-0041-1735422

Impact of Body Mass Index, Age and Tobacco Use on the Outcomes of Immediate Breast Reconstruction with Implants and Acellular Dermal Matrix

Indian J Plast Surg. 2021 Sep 27;54(3):350-357. doi: 10.1055/s-0041-1735422. eCollection 2021 Sep.

Authors

L Mata Ribeiro¹, Rita P Meireles², Irís M Brito², Patrícia M Costa¹, Marco A Rebelo³, Rui F Barbosa³, Miguel P Choupina³, Carlos J Pinho³, Matilde P Ribeiro³

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Centro Hospitalar Universitário Lisboa Central, Hospital São José Lisbon, Portugal.
² Department of Plastic and Reconstructive Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
³ Department of Plastic and Reconstructive Surgery, Instituto Português de Oncologia do Porto, Porto, Portugal.

Abstract

Background This study aimed to analyze the effect of body mass index (BMI), age, and tobacco use on alloplastic breast reconstruction. Methods We conducted a retrospective study of patients who submitted to immediate breast reconstructions with an anatomical implant and acellular dermal matrix in a single center between 2016 and 2018. Outcomes evaluated included immediate complications, early complications, reinterventions, readmissions, and reconstruction failure. Patients were divided into two groups concerning each potential risk factor (BMI < or ≥25; age < or ≥ 50 years; and smokers vs nonsmokers). Simple descriptive statistics and univariate analysis were performed. Results A total of 101 breast reconstructions (73 patients) were included in the analysis. The mean BMI was 24, and the mean age was 44.5 years old. Smokers accounted for 14 breast reconstructions (13.9%). The rate of early infections, mastectomy flap necrosis, and implant removal was significantly higher in overweight patients. The total volume of breast drainage was higher in the age ≥ 50 years group. Smoking did not alter the outcomes. Conclusions A BMI ≥ 25 is a risk factor for early infections and reconstructive failure. Age ≥ 50 years is associated with a higher volume of breast drainage but does not seem to impact the success of the reconstruction. Smoking does not appear to affect the outcomes significantly in this type of reconstruction. Surgeons should consider delaying the reconstruction or using autologous tissue when patients are overweight.

Keywords: ADM; BMI; age; alloplastic; immediate breast reconstruction; implant; smoking.

Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).