Don’t glaze your eyes over when you read the title. Yes, we know higher BMI affects healing from all surgeries and has higher complication rates. And this article in the Aesthetic Surgery Journal December 2023, “Implant Based Breast Reconstruction: Impact of BMI or Postoperative Complications and Aesthetic Results: A 5 Year Single Center Study” confirms that.
But what I thought was really interesting is that this study looked at high BMI, normal BMI, and low BMI. They qualified low BMI as anyone with a BMI lower than 18.5. And they found that low BMI increased issues too. So to all my super skinny athletic Bay Area women, take note. They conclude, “This study confirmed BMI to be a strong predictor of postoperative complications and aesthetic outcomes and demonstrates that low BMI has a significant impact on the incidence of capsular contracture and aesthetic complications.”
Study:
- Retrospective analysis of patients with mastectomy and immediate breast reconstruction with implant
- 1046 breasts (921 patients) were analyzed. 572 were normal weight, 63 underweight, 215 overweight, and 71 obese.
- Significantly higher rates of complications were seen in obese and overweight patients compared to normal weight. Each unit of increase in BMI correlated to 7% increased odds of overall complications and 13% increased odds of reconstructive failure.
- Underweight individuals had higher rates of capsular contracture relative to normal weight 14.3% vs. 3.65%
- Underweight individuals had higher aesthetic complications 36.4% vs. 25.7%
My thoughts?
Super interesting. I like numbers. It was interesting to see how for each increase of one point in BMI in the overweight and obese, there was a 7-13% increase in issues.
As for the “underweight” women (those with BMI less than 18.5), the increase in capsular contracture rate for underweight individuals was 11 % more than for normal weight women. That is significant. I wonder why? Is it that the mastectomy flaps are thinner, so there is less protection of for the implant? I’d be curious to hear their hypothesis.
The fact that underweight individuals don’t like the aesthetics of their reconstruction didn’t surprise me- they have so little body fat you will see every wrinkle and edge of the implant.