Breast reduction: safe in the morbidly obese?

Background: With an increasing obese population, plastic surgeons are consulted by women requesting larger breast reductions, with body mass indices in the obese to morbidly obese range (30 to >or=40 kg/m) and breasts considered gigantomastic (>2000 g resected from each breast). There have been few descriptions of outcomes in the morbidly obese population. Previous literature reports high complication rates in obese women and large-volume breast reductions.

Methods: Retrospective investigation of 179 reduction mammaplasty patients was performed out to determine whether reduction mass, age, body mass index, smoking, method used (i.e., vertical pedicle, inferior pedicle/central mound, or free nipple graft), and comorbidities influenced complication rates. The patients were categorized by size of reduction, age, and body mass index.

Results: The overall complication rate was 50 percent. There was no statistical difference in the incidence of complications attributable to size of reduction, age, or body mass index (p = 0.37, p = 0.13, and p = 0.38, respectively). Also, smoking status, method used (p = 0.65 and p = 0.17, and p = 0.48 and p = 0.1, respectively) and comorbidities had no effect on complication rates (reduction size, p = 0.054; age, p = 0.12; and body mass index, p = 0.072). There was no significant increase in the rate of complications for each body mass index group based on the reduction mass (p = 0.75, p = 0.89, p = 0.23, and p = 0.07).

Conclusion: It is as safe to perform large-volume breast reductions in the morbidly obese patient with comorbidities as in anyone else.